At Connected Health, we are committed to protecting the privacy of your medical information, health, treatment, or payment information that identifies you, as federal and state laws require. Below you will find Connected Health’s “Notice of Privacy Practices” which explains our approach to your privacy, your legal rights concerning your privacy, and how all of the people and services employed and offered by Connected Health must follow the notice. Please note that this is not a complete listing of how we use and share your health information. If you have a question about any of the information in this summary, you should review the full notice of privacy practices or ask Connected Health staff members for more information. Connected Health has the right to change this summary and the notice without first notifying you.
Your health care provider must provide you a notice that tells you how they may use and share your health information and how you can exercise your health privacy rights. In most cases, you should get this notice on your first visit to a provider or in the mail, and you can ask for a copy at any time. The provider cannot use or disclose information in a way that is not consistent with their notice.
The law requires your doctor, hospital, or other health care provider you see to ask you to state in writing that you received the notice. Please note, the law does not require you to sign the “acknowledgement of receipt of the notice”. Signing does not mean that you have agreed to any special uses or disclosures of your health record. Refusing to sign the acknowledgement does not prevent the entity from using or disclosing health information as the rule permits it to do – in service of your health. If you refuse to sign the acknowledgement, the provider must keep a record that they failed to obtain your acknowledgement.
Connected Health Medical Services, LLC is required by the HIPAA Privacy Rules to obtain your consent in order to share your medical information for certain reasons. This consent will be in effect for as long as Connected Health Medical Services, LLC provides service to you. We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office and on our website.
Connected Health Medical Services, LLC 12620 Perry Highway
Wexford, PA 15090
Email: hipaa@chforu.com
This section explains your rights and some of our responsibilities to help you:
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of the request. We may charge a reasonable, cost-based fee.
You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
You can ask us to contact you in a specific way (for example, home or cell phone or email) or to send mail to a different address. We will say “yes” to reasonable requests.
You can ask us not to use or share certain health information for treatment, payment or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any that you have asked us to make). We’ll provide one accounting year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
For certain health information, you can tell us your choices about what we share.
If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research.
We have to meet many conditions in the law before we can share your information for these purposes.
You can complain with the US Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington DC 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/(opens in a new tab)
We will not retaliate against you for filing a complaint.
We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this notice and five you a copy of it. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.