Notice Of Privacy Practices

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.

Who will follow this notice

This Notice is being given to you because federal law gives you the right to be told ahead of time about how the Allegheny Health Network Providers (AHNP) handle your protected health information (PHI), our Network’s legal duties related to your protected health information and your rights with regard to your protected health information. This notice applies to the privacy practices of the organizations listed below and any other additional entities or physicians that join Allegheny Health Network from time to time. As participants in an Organized Health Care Arrangement (OHCA) we may share with each other your protected health information, and the medical information of others we service, for the health care operations of our joint activities.

  • Allegheny Clinic
  • Bethel Park Health + Wellness Pavilion
  • Emergency Medicine Physicians
  • Healthcare@Home
  • Jefferson Hospital entities including professional corporations controlled or owned by Jefferson Hospital; Emergency Physicians of Pittsburgh, Ltd.; Mahpareh Mostoufizadeh, M.D.; PC Pathology Group; Pittsburgh Anesthesia Associates, Ltd.; and Jefferson Hospital Medical Staff, Allied Health Professionals, Foundation Radiology Group and all associates, affiliates and doctors who take care of you in the hospitals and in doctors’ offices and other facilities controlled or operated by Jefferson Hospital.
  • Lake Erie Medical Group, PC
  • Monroeville Surgery Center
  • Peters Township Health + Wellness Pavilion
  • Premier Medical Associates, PC
  • Saint Vincent Health Center and Saint Vincent Health System, including Saint Vincent Medical Education and Research Institute; Saint Vincent Rehab Solutions; Regional Home Health and Hospice; Westminster Family Practice; Saint Vincent Consultants in Cardiovascular Disease; Westfield Memorial Hospital and all associates, affiliates and doctors who take care of you in the hospitals and in doctors’ offices and other facilities controlled or operated by Saint Vincent Health System.
  • West Penn Allegheny Health System (WPAHS) entities which include Allegheny General Hospital, Allegheny Medical Practice Network, Allegheny Valley Hospital, Canonsburg Hospital, Canonsburg Ambulance Company, Forbes Hospice, Forbes Hospital, West Penn Hospital, West Penn Allegheny Oncology Network, and all associates, affiliates and doctors who take care of you in the hospitals and in doctors’ offices and other facilities controlled or operated by WPAHS.
  • Wexford Health + Wellness Pavilion
  • Wexford Hospital

What is a notice of privacy practices?

We must give you a notice that tells you how we may use and share your health information and how you can exercise your health privacy rights. We respect your right to privacy and function to ensure your confidentiality by following federal and state laws concerning protected health information. This Notice describes the manner and means by which AHNP demonstrates the appropriate privacy measures.

We understand that medical information about you and your health is important to you. We are committed to protecting the privacy of your protected health information. “Protected Health Information” (PHI) is your individually identifiable health information, including demographic information, collected from you or created or received by a health care provider, a health plan, your employer, or a health care clearinghouse that relates to: (i) info your past, present, or future physical or mental health or condition; (ii) the provision of health care to you; or (iii) the past, present, or future payment for the provision of health care to you.

This Notice describes our privacy practices, which include how we may use, disclose, collect, handle, and protect our patients’ PHI. This Notice applies to all of the records of your care generated by us. It also describes your rights and our obligations regarding use and disclosure of your protected health information. We are required by applicable federal and state laws to maintain the privacy of your PHI. We also are required by the HIPAA Privacy Rule (45 C.F.R. parts 160 and 164, as amended) to give you this Notice about our privacy practices, our legal duties, and your rights concerning your PHI.

Understanding your health record / information

Each time you visit a hospital, physician, or other health care provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, response to treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

  • Basis for planning your care and treatment
  • Means of communication among the many health professionals who contribute to your care
  • Legal document describing the care you received
  • Means by which you or a third-party payer can verify that services billed were actually provided
  • Tool in educating health professionals
  • Potential source of data for medical research
  • Source of information for public health officials charged with improving the health of the nation
  • Source of data for facility planning and marketing
  • Tool with which we can assess and continually work to improve the care we render and the outcomes we achieve

Uses and disclosures of protected health information (PHI)

We use your health information within the AHNP and disclose your health information outside of the AHNP for the reasons described in this Notice. The following categories describe some of the ways that we may use and disclose your health information.

The term “may” means that the AHNP 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 we may be permitted to use or disclose information in a given instance, it does not mean that we will disclose the information.

We will restrict use and disclosure concerning AIDS / HIV, mental health, behavioral health and alcohol and drug treatment or other particular categories of health information based upon state law if state law is more stringent or provides additional patient privacy safeguards not included in federal regulations.

1. Treatment

We use your PHI to enable delivery of health care services and for other activities that are included within the definition of “treatment” as set out in 45 C.F.R. § 164.501. Information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. We may disclose your PHI to other doctors, medical students, hospitals, pharmacies or other persons who are integral to providing you care. 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.

We also may disclose your PHI to others who may help in your care, such as your spouse, children or parents.

2. Payment

We may use and disclose your PHI for all activities that are included within the definition of “payment” as set out in 45 C.F.R. § 164.501. For example, we may use and disclose your PHI to coordinate with you, your insurance company, or another third party to ensure that the health care you receive is billed and paid for appropriately. This PHI may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

Additionally, we may also seek prior payment approval from your health plan concerning treatments you are scheduled to receive or determine if your health plan will pay for the treatment. For example, obtaining approval for a hospital stay may require that your relevant PHI be disclosed to your health plan to obtain approval for hospital admission.

3. Health care operations

We may use and disclose your PHI for all activities included within the definition of “health care operations” as set out in 45 C.F.R § 164.501. These uses and disclosures help us maintain and improve patient care and may be used for our health care operations or the operations of another entity that has a direct treating relationship with you.

We may use PHI about many patients to ascertain what new services to offer, what practices are not needed, and whether certain methods of treatment are effective. We may also disclose PHI to doctors, nurses, technicians and other persons to improve the quality of treatment and service.

  • Appointment reminders. We may use and disclose your PHI to contact you and remind you of an appointment.
  • Health-related benefits and services. We may use and disclose your PHI to tell you of health-related benefits or services that may be of interest to you.
  • Release of information to family / friends. We may disclose your PHI to a friend or family member who is helping you pay for your health care, or who assists in taking care of you, unless you tell us not to do so. We may also disclose information to notify, or assist in notifying, a family member, personal representative or another person responsible for your care of your locations. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.
  • Clergy. We may disclose your PHI as permitted by law to ministers, priests or other clergy in order to help them take care of your spiritual needs.

4. Legal obligations and public policy disclosures

We may use and / or disclose your PHI as permitted or required by federal, state or local law, in the following situations:

  • To organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplants.
  • Your PHI may be released if a work force member or business associate believes in good faith that there has been unlawful conduct or violation of professional or clinical standards which are potentially dangerous to one or more patients, workers or the public.
  • To military authorities if you are a member of the armed forces (of either the United States or a foreign government).
  • To workers’ compensation or similar programs to the extent authorized by and necessary to comply with laws relating to workers’ compensation or other similar programs established by law.
  • To public health or legal authorities for public health activities. For example, to report births and deaths, or for the prevention or control of disease, injury, or disability, or, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.
  • In response to a court or administrative order, subpoena, discovery request, or other lawful process, but only if efforts have been made to tell you about the request.
  • To law enforcement if asked to do so (1) to identify or locate a suspect, fugitive, material witness or missing person; (2) regarding the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement; (3) regarding a death we believe may be the result of criminal conduct; (4) regarding criminal conduct at our facilities; or (5) in emergency circumstances to report information regarding a crime.
  • We may disclose PHI to a medical examiner or coroner to identify a dead person or to identify the cause of death. If necessary, we will share PHI with funeral directors.
  • We may use and disclose your PHI when necessary to reduce or prevent a serious threat to your health and safety or another individual or the public. Under these circumstances, we will only disclose your PHI to the person or organization able to help prevent the threat.
  • We may disclose your PHI, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
  • We may disclose to the FDA health information related to known adverse events with respect to food, supplements, pharmaceuticals, product defects or information