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.

 

Pulmonary Physicians of Norwich, P.C (PPN) is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices concerning your health information.  If you have questions about any part of this notice or if you want more information about the privacy practices at Pulmonary Physicians of Norwich, P.C. please contact:

 

Pulmonary Physicians of Norwich, P.C., Office Manager, 79 Wawecus Street, Suite 103, Norwich, CT Phone: (860) 886-1862 Fax: (860) 886-2046

Effective Date of This Notice: January 1, 2025

  1. How Pulmonary Physicians of Norwich, P.C. may Use or Disclose Your Health Information

PPN collects health information from you and stores it in a chart and on a computer. This is your medical record. The medical record is the property of Pulmonary Physicians of Norwich, P.C., but the information in the medical record belongs to you. PPN protects the privacy of your health information. The law permits Pulmonary Physicians of Norwich, P.C. to use or disclose your health information for the following purposes:

  1. Treatment. We may use your medical information to provide you medical care. We disclose medical information to our employees, physicians and others who are involved in providing you care. For example, we may share your medical information with other physicians or other health care providers who will provide services, which we may not provide. We may also share this information with a pharmacist who needs to dispense medication or to a laboratory for clinical testing.
  2. Payment. We may use and disclose medical information about you to obtain payment for the services we have rendered. For example, we may give your health insurance the information it requires before it will pay us. We may also disclose information to other health care providers to assist them in obtaining payments such as laboratory or hospital.
  1. Regular Health Care Operations. We may use and disclose medical information about you to operate this medical practice. For example, we may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications or our professional staff. We may also use and disclose this information to request that your health plan authorize services or referrals. We may also use and disclose this information as necessary for medical reviews, legal services and audits, including fraud and abuse detection and compliance programs and business planning and management. We may also share your information with other health care providers, a health care clearinghouse or health plans that have a relationship with you when they request this information, to help them with their quality assessment and improvement activities, their efforts to improve health or reduce health care costs, their review of compliance, qualifications and performance of health care professionals, their training programs, their accreditation, certification or licensing activities, or their health care fraud and abuse detection and compliance efforts.
  2. Appointment Reminders. We may use and disclose medical information to contact and remind you about appointments. If you are not home, we may leave this information on your answering machine or in a message left with the person answering the phone.
  3. Sign-in-sheet. We may use and disclose medical information about you by having you sign in when you arrive at our office. The sign-in-sheet will contain only minimal information. We may also call out your name when we are ready to see you.
  4. Directory. We may list your name, where you are located in our facilities, your general medical condition and your religious affiliation in our directory. This information may be provided to members of the clergy. This information, except your religious affiliation, may be provided to other people who ask for you by name. if you do not want us to list this information in our directory and provide it to clergy and others, you must tell us that you object.
  5. Text Messaging. Pulmonary Physicians of Norwich respects your privacy and is committed to protecting your personal information. When you op in to receive SMS messages, we collect: your phone number and consent to send SMS messages. We use this information in order to send you the SMS messages you’ve opted in to receive, provide you updates, promotions or other relevant content based on your preferences. We do not share you phone or SMS op-in information with third parties for marketing purposes. You can opt out of receiving SMS messages at any time be replying with “STOP” to any message we send you. We implement measures to protect your personal information from unauthorized access or disclosure. Message and data rates may apply based on your mobile carrier’s terms. We are not responsible for any charges, errors, or delays in SMS delivery caused by your carrier or third-party service providers. By opting in, you confirm that you are the owner or authorized user of the phone number provided and that you are at least 18 years old.
  6. Notification and communication with family.             We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others. In the event of a disaster, we may disclose information to a relief organization so that they may coordinate these notification efforts.
  7. Required by law. As required by law, we may disclose your health information, but we will limit our use or disclosure to the relevant requirements of the law. When the law requires us to report abuse, neglect or domestic violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we will further comply with the requirement set forth below concerning those activities.
  8. Public health. As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child, elder or other abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.
  9. Health oversight activities.             We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.
  10. Judicial and administrative proceedings. We may, and are sometimes required by law, to disclose your health information in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order. We may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order.
  11. Law enforcement. We may disclose your health information to a law enforcement official for purposes such as identifying of locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.
  12. Deceased person information. We may disclose your health information to coroners, medical examiners and funeral directors.
  13. Organ donation. We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues.
  14. Research. We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board.
  15. Public safety. We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
  16. Specialized government functions. We may disclose your health information for military, national security, or prisoner [and government benefits <only for health plans>] purposes. <Note that disclosures for government benefits purposes are limited to health plans only.>
  17. Worker’s compensation. We may disclose your health information as necessary to comply with worker’s compensation laws.
  18. Breach Notification. In the case of a breach of unsecured protected health information, we will notify you as required by law. If you have provided us with a current email address, we may use email to communicate information related to the breach. In some circumstances our business associate may provide the notification. We may also provide notification by other methods as appropriate. [Note: Only use email notification if you are certain it will not contain PHI and it will not disclose inappropriate information. For example if your email address is “digestivediseaseassociates.com” an email sent with this could, if intercepted, identify the patient and their condition.]
  19. Marketing. We may contact you to give you information about products or services related to your treatment, case management or care coordination, or to direct or recommend other treatments or health-related benefits and services that may be of interest to you. We may also encourage you to purchase a product or service when we see you.
  20. Change of Ownership. In the event that Pulmonary Physicians of Norwich is sold or merged with another organization, your health information/record will become the property of the new owner.
  21. When Pulmonary Physicians of Norwich May Not Use or Disclose Your Health Information

Except as described in this Notice of Privacy Practices, Pulmonary Physicians of Norwich will not use or disclose your health information without your written authorization. If you do authorize Pulmonary Physicians of Norwich to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.

  • Your Health Information Rights
  1. You have the right to request restrictions on certain uses and disclosures of your health information, by a written request specifying what information you want to limit and what limitations on our use or disclosure of that information you wish to have imposed. If you tell us not to disclose information to your commercial health plan concerning health care items or services for which you paid for in full out-of-pocket, we will abide by your request, and will notify you of our decision.
  2. You have the right to receive your health information through a reasonable alternative means or at an alternative location. You must sign a records release and payment may be required.
  3. You have the right to inspect and copy your health information with limited exceptions. We may charge a reasonable fee [if there is state law restricting or setting fees include that here] for copies. We may require inspection or copy requests to be in writing. We may deny your request under limited circumstances and you may have a right to appeal our decision.
  4. You have the right to request that Pulmonary Physicians of Norwich amend your health information that is incorrect or incomplete. Pulmonary Physicians of Norwich is not required to change your health information and will provide you with information about a denial and how you can disagree with the denial.
  5. You have a right to receive an accounting of disclosures of your health information made by Pulmonary Physicians of Norwich, except that Pulmonary Physicians of Norwich does not have to account for the disclosures described in parts 1 (treatment), 2 (payment), 3 (health care operations), 4 (information provided to you), 6 (directory listings) and 17 (certain government functions) of section I of this Notice of Privacy Practices.
  6. You have a right to a paper copy of this Notice of Privacy Practices.

If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact:

Pulmonary Physicians of Norwich, Office Manager, 79 Wawecus Street, Suite 103, Norwich, CT Phone: (860) 886-1862 Fax: (860) 886-2046

  1. Changes to this Notice of Privacy Practices

Pulmonary Physicians of Norwich reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment. Until such amendment is made, Pulmonary Physicians of Norwich is required by law to comply with this Notice.

  1. Complaints

Complaints about this Notice of Privacy Practices or how Pulmonary Physician of Norwich handles your health information should be directed to:

Pulmonary Physicians of Norwich, Office Manager, 79 Wawecus Street, Suite 103 Norwich, CT Phone: (860) 886-1862 Fax: (860) 886-2046

 

If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to:

Department of Health and Human Services

Office of Civil Rights

Hubert H. Humphrey Bldg.

200 Independence Avenue, S.W.

Room 509F HHH Building

Washington, DC 20201

You may also address your complai8nt to one of the regional Offices for Civil Rights. A list of these offices can be found online at http://www.hhs.gov/ocr/regmail.html, or you may also submit your complaint electronically by visiting http://www/hhs.gov/ocr/privacy/index.html.

You will not be penalized for filing a complaint.