Concorde Therapy Group, Inc.

Whenever you visit a hospital, physician, or healthcare provider you are establishing a healthcare record with that provider. Your healthcare record contains such things as your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. Your healthcare or medical record serves many purposes.

It may be used to plan your care and treatment.

It may be used to obtain payment from a third-party, such as an insurance company or Medicare or Medicaid.

It is a means of communication among the health professionals who contribute to your care.

It is a legal document describing the care you received.

It is a means by which you or a third-party payer can verify that services billed were actually provided.

It may be used as a tool in educating health professionals or a source of data for medical research.

It may be a source of information for public health officials.

It may be a source of data for facility planning and marketing.

It may be a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.

Understanding what is in your record and how your health information is used helps you to ensure its accuracy. It also helps you to understand who may access your health information and under what conditions, and it helps you to make more informed decisions when authorizing disclosure to others.

PATIENT RIGHTS

The physical record of your health is the property of the healthcare practitioner or facility that compiled it. However, the underlying information belongs to you. You have the right to:

request restrictions on certain uses and disclosures of your information. We do not have to honor your request for restrictions on activities that are otherwise allowable under law, but if we do, we will abide by our agreement (except in an emergency). If we deny your request, you will receive notification of our denial along with a written basis for our denial. Any request for restrictions on use or disclosure must be made in writing. We will notify you within 30 days of our decision. We may request an additional 30 days to consider your request.

obtain a copy of the notice our Notice of Privacy Practices upon request. You have the right to receive this notice in written form if you received this Notice on our Web site or by electronic mail (e-mail).

 

You have the right to inspect and obtain a copy of your health record, except in certain limited circumstances. Your request must be in writing. We will charge you a reasonable cost-based fee for expenses such as copies and staff time. If you prefer, we will prepare a summary or an explanation of your health information for a fee. Contact us using the information listed at the end of this Notice for a full explanation of our fee structure. You may request that we provide copies in a format other than photocopies. We will use the format you request unless we cannot practicably do so. If you request an alternative format, we will charge a cost-based fee for providing your health information in that format.   You may request an amendment to your healthcare record. Your request must be in writing, and it must explain why the information should be amended. We may deny your request under certain circumstances.

 

You the right to obtain one free annual accounting of disclosures. This accounting is a list of instances in which we or our business associates disclosed your health information for purposes, other than treatment, payment, healthcare operations and certain other activities, for the last 6 years, but not before April 14, 2003. If you request this accounting more than once in a 12-month period, we may charge a reasonable, cost-based fee for responding to these additional requests.

request communications of your health information by alternative means or at alternative locations. You must make your request in writing and specify the alternative means or location, and provide satisfactory explanation how payments will be handled under the alternative means or location you request.

revoke your authorization to use or disclose health information except to the extent that action has already been taken.

We are required to:

maintain the privacy of your health information.

provide you with a Notice of Privacy Practices that describes our legal duties and privacy practices with respect to information we collect and maintain about you.

abide by the terms of our Notice of Privacy Practices.

notify you if we will not agree to a requested restriction.

accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request.

Your Authorization: In addition, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect.

We will not use or disclose your health information without your authorization, except as described in this notice. For example:

TREATMENT - Information obtained by employees of this facility is recorded in your record and is used to determine the course of treatment that should work best for you. Individuals involved in your treatment document the actions they take and their observations. We may provide any subsequent physician or healthcare provider with copies of your healthcare information that should assist him/her in continuing your course of treatment.

PAYMENT - We will bill you or a third-party payor for payment of healthcare services rendered. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

HEALTHCARE OPERATIONS - Members of the clinical staff, the clinical director, or members of our quality assurance committee may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.

We use and disclose health information about your for treatment, payment and healthcare operations. For example:

FAMILY AND FRIENDS - We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition. We may disclose your health information to a family member, friend or other person to the extent necessary to help with your healthcare or with payment for your healthcare, but only if you agree that we may do so.

PERSONS INVOLVED IN CARE - We may use or disclose health information to notify, or assist in the notification of (including identifying or locating) a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination using our professional judgment disclosing only health information that is directly relevant to the person's involvement in your healthcare. We will also use our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up medical supplies or other forms of health information.

MARKETING HEALTH-RELATED SERVICES - We are permitted to make use of your health information in order to notify you of services available through our practice, which may be of benefit to you. We may contact you to provide appointment reminders (such as voice mail messages, postcards, or letters) or information about treatment alternative or other health-related benefits and services that may be of interest to you. We will not release your health information to any outside persons or entities for marketing purposes without your written authorization.

BUSINESS ASSOCIATES - There are some services provided in our organization through contacts with business associates. When services are contracted, we may disclose your health information to our business associates so that they can perform the job we've asked them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information. The Business Associate is obligated to protect your information in the same manner as we do.

RESEARCH - We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and when researchers have established protocols to ensure the privacy of your health information.

REQUIRED BY LAW - We may use or disclose your health information when governmental authorities require us to do so.

Funeral directors - We may disclose health information consistent with applicable laws to carry out their duties.

Organ procurement organizations - Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Fund raising - We may contact you as part of a fund-raising effort.

Food and Drug Administration (FDA) - We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Workers Compensation - We may disclose health information to the extent authorized by and to the degree necessary to comply with laws relating to Workers Compensation or other similar programs established by law.
Public Health - As required by law, me may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Correctional Institution - If you are an inmate of a correctional institution, we may disclose, to the institution or agents thereof, information necessary for your health and the health and safety of other individuals.

Law Enforcement - We may disclose health information for law enforcement purposes as required by law or in response to a valid court order or subpoena. In addition, Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

Abuse or Neglect - We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safely or the health or safety of others.

National Security - We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counter intelligence, and other national security activities.

Through its website, Concorde Therapy Group, Inc., collects anonymous, non-personal, aggregate information, through the use of cookies and IP addresses.

An IP address is a unique number assigned to your computer. This may be automatically identified to the ISP that hosts this website for Concorde Therapy Group, Inc., when you visit this website.

A cookie is a small data file that a website transfers to online users’ hard drives. It enables your computer to more readily access websites that have been previously visited. If you do not wish to have these cookies copied to your system, you may change your browser settings to reject cookies. This will not affect your ability to access this website.

We use this information to measure the number of visitors to our website. This information is limited to the number of visitors within the United States per day, week or month, and the number of visitors from outside the United States.

Some of our web pages ask for personal information. If you choose to provide this information, it is only used to facilitate your request for additional information, or to apply for a job. If your information is sensitive, you may wish to send it to us through the US postal system or other carrier.

Examples of Disclosures for Treatment, Payment and Health Operations

We will use your health information for treatment - For example: Information obtained by your doctor, our nurses, and any other employees of this facility is recorded in your record and is used to determine the course of treatment that should work best for you. Your doctor also documents in your record his/her expectations of recommended treatment. individuals involved in your treatment record the actions they take and their observations. In that way, the physician will have a more complete picture of your health.

We will also provide any subsequent physician or healthcare provider with copies of your healthcare information that should assist him/her in continuing your course of treatment.

We will use your health information for payment - For example: We bill you or a third-party payer for payment of healthcare services rendered. the information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used. This information is necessary in order for us to obtain payment.

We will use your health information for regular health operations - For example: Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.

We are required by law to protect the privacy of your information, provide this notice about our information practices, and follow the information practices that are described in this notice. This notice covers all locations and services of Concorde Therapy Group, Inc. If you have questions and would like additional information, you may contact the Privacy Officer of Concorde Therapy Group, Inc. using the information listed below.

We support your right to the privacy of your health information. If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer of Concorde Therapy Group, Inc. using the information listed below or with the U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with us or with the U.S. Department of Health and Human Services.

Concorde Therapy Group, Inc.

4645 Belpar Street NW

Canton, OH 44718

Telephone: (330) 493-4210

Fax: (330) 493-4744

E-Mail: privacy@concordehealth.com