NOTICE OF PRIVACY PRACTICES AT
THE WASHINGTON PHYSICIAN SERVICES ORGANIZATION (WPSO)
98 Wilson Avenue, Washington, PA 15301
724-229-2422
Effective Date: April 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
If you have any questions about this notice, please contact the WPSO’s Privacy Officer at 724-229-2422 or write to The WPSO, Attn: Privacy Officer, 98 Wilson Avenue, Washington, PA 15301.
WHO WILL FOLLOW THIS NOTICE
This notice describes Washington Physician Services Organization (the “WPSO”, also referred to as “we”) practices and that of:
► Any health care professional authorized to enter information into your WPSO chart.
► All offices of the WPSO.
► Any member of a volunteer group we allow to help you while you are at the WPSO.
► All employees, staff, students, contracted personnel and other approved WPSO personnel.
► The following entities, sites and locations follow the terms of this notice and may share medical information with each other for treatment, payment or WPSO operations purposes as described in this notice: The WPSO, and its offices.
OUR PLEDGE REGARDING MEDICAL INFORMATION
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. In order to provide you with quality care and to comply with legal requirements, we create a record of the care and services you receive at the WPSO. This notice applies to all of the records of your care generated by the WPSO, whether made by the WPSO personnel or your personal doctor.
This notice provides the ways in which the WPSO may use and disclose your medical information. It also describes your rights and certain WPSO obligations regarding use and disclosure of your private medical information.
The WPSO is required by law to:
► Safeguard your medical information;
► Give you this notice of our legal duties and privacy practices with respect to your medical information;
► Follow the terms of this notice that is currently in effect; and
► Provide an updated notice, upon request, and post the most current notice in admissions/registrations areas.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe different ways which we “use” and “disclose” your medical information. Each category is followed by an explanation and in some instances an example. For purposes of this notice, the term “use” refers to medical information that is used within the WPSO or one of the offices related entities listed above for your treatment, WPSO operations, or the payment of your care. The term “disclose” refers to medical information that is given to outside entities for one of the purposes described in this notice. Whether your medical information is used or disclosed, the use or the disclosure will fall within one of the categories listed below and will only be used in the minimal amount necessary to carry out the stated purpose. The term “may” means that the WPSO is permitted under federal law to use or disclose this information without obtaining an additional or specific authorization from you to do so. Even though the WPSO may be permitted to use or disclose information in a given instance, it does not mean that we will disclose the information. We will still try to assure that any use or disclosure is in your interest or is consistent with practices in the healthy care field.
► For Treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other WPSO-approved personnel who are involved in taking care of you at the WPSO. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. In addition, the doctor may need to tell the dietician if you have diabetes so that we can arrange for appropriate meals. Different departments of the WPSO also may share medical information about you in order to coordinate the different things you need, such as prescriptions, lab work and x-rays. We also may disclose medical information about you to people outside the WPSO who may be involved in your medical care after you leave the WPSO, such as family members, clergy or others we use to provide services that are part of your care.
► For Payment: We may use and disclose medical information about you so that the treatment and services you receive at the WPSO or related services (for example, ambulance and physician services) may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about surgery you received at the WPSO so your health plan will pay us or reimburse you for the surgery. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
► For Health Care Operations: We may use and disclose medical information about you for WPSO operations. These uses and disclosures are necessary to run the WPSO and make sure that all our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you, including disclosures to third parties for patient satisfaction surveys and other quality management measures. We may also combine medical information about many WPSO patients to decide what additional services the WPSO should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students, and other WPSO-approved personnel for review and learning purposes. We may also combine the medical information we have with medical information from other WPSO's to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of medical information so others may use it to study health care and health care delivery without learning who the specific patients are.
► Appointment Reminders: We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at the WPSO.
► Treatment Alternatives: We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
► Health-Related Benefits and Services: We may use and disclose medical information to tell you about health-related benefits or services that may be related to your treatment.
► Fundraising Activities: We will not use protect