The privacy of your health information is important to us.

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Legal Duty.

We are required by applicable federal and state law to maintain the privacy of your child's health information. We are also required to give you this notice about our privacy practices, our legal duties and your rights concerning your child's health information. We must follow the privacy practices that are described in this Notice while it is in effect. We must notify you if we are unable to agree to a requested restriction or to a request about how health information is used or disclosed. This Notice takes effect November 10, 2003 and will remain in effect until we replace it.

Pediatric Care Group, P.C. creates, retains, uses and discloses health information about your child for treatment, administrative purposes and for various other reasons required and permitted by law. The terms of this Notice apply to information that is created, or received by us that relates to the health, health care, and payment for health care of your child, and where applicable, of other members of your family.

We reserve the right to change our privacy policy at any time, to the extent permitted by law. Any such changes will be reflected in a revised Notice of Privacy Practices. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain, including health information we created or received prior to when we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and post the revised Notice on this website and in our office.

You may obtain a copy of our privacy Notice at any time. For more information about our privacy practices or for additional copies of this Notice, please contact the Privacy Officer named at the end of this Notice.

USES AND DISCLOSURES OF HEALTH INFORMATION
A. TREATMENT, PAYMENT AND HEALTHCARE OPERATIONS

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

Treatment:
We may use or disclose your child's health information to a physician or other healthcare provider providing treatment to the child. We may provide your child's health information to a pharmacy for the purpose of ordering a prescription. We may provide health information to a laboratory or diagnostic facility for the purpose of ordering appropriate diagnostic tests. We may coordinate the management of your child's care with other healthcare providers and/or practitioners, including other physicians with whom we consult.

Payment:
We may use and disclose your child's health information to obtain payment for services we provide your child.

Healthcare Operations:
We may use and disclose your child's health information in connection with our healthcare operations. Healthcare operations include (among other things) quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing and credentialing activities, and various routine business functions.

Family and Friends:
We must convey health information to adults charged with caring for our minor patients. Accordingly, we must disclose your child's health information to the child's parents or guardians, as described in the patient's rights section of this Notice. We may disclose health information to another family member, friend or other person to the extent necessary to help with your child's health care or to obtain payment for your child's health care, but only if you agree that we may do so. If a child is brought to our office by a caregiver who is not the parent or guardian, or we are otherwise contacted by such a person about the child's health care, we will assume that the parent's or guardian's consent to discuss the child's health care has been given. We will obtain a parent's oral or written agreement to such disclosures when possible. Pennsylvania law permits older children to consent on their own to certain types of medical care. In such cases, the child's healthcare information will not be disclosed to the parent or guardian without the child's authorization. When a patient is no longer a minor, we will obtain his or her consent to disclosures to others when required by law to do so. You may want to discuss with us in advance any concerns or preference about disclosures to caregivers who may bring your child in for care.

B. USES AND DISCLOSURES THAT YOU SPECIFICALLY AUTHORIZE
You may give us written authorization to use your child's health information or to disclose it to any specified person or group of people for any specified purpose. If you give us 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. Unless you give us written authorization, we cannot use or disclose your child's health information for any reason except those described in Parts A or C of this Notice.

C. OTHER USES AND DISCLOSURES
Appointment Reminders/Treatment Options:
We may use or disclose your child's health information to provide you with appointment reminders or information about treatment alternatives or other health related services that may be of interest to you (such as voicemail messages, postcards or letters.)

Marketing Health-Related Services:
We will not use your child's health information for marketing efforts without your written authorization.

Required by Law:
We may use or disclose your child's health information when we are required to do so by law. We may disclose information for judicial and administrative proceedings pursuant to legal authority, to report victims of abuse, neglect, or domestic violence, to report crimes in emergencies and to assist law enforcement authorities in their duties. Health information may be disclosed in order to comply with worker's compensation laws.

Abuse or Neglect/Health and Safety:
We may disclose your child's health information to the appropriate authorities if we reasonably believe that he or she is a possible victim of abuse or neglect. We may disclose health information to the extent required by law and necessary to avert a serious threat to your child's health and safety or the health and 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, counterintelligence, and other national security activities.

For Disaster Relief Purposes:
We may use or disclose our child's health information in disaster relief efforts as deemed necessary by the authorities involved.

Health Oversight Activities:
We may use or disclose your child's health information in activities such as audits, licensure review and health related investigations.

Public Health:
Your child's health information may be used or disclosed for public health activities including disclosing reportable health conditions to the Health Department, communicating with individuals exposed to communicable disease as required by law, and communicating with the FDA as necessary. Health information may be disclosed for cadaveric organ or tissue donation. . Health information may be disclosed to funeral directors or coroners as needed to allow them to carry out their duties.

Research:
Health information may be used, in limited circumstances prescribed by law, for research purposes as reviewed by an institutional review board or privacy board with protocols in place to ensure privacy of the health information.

Incidental Uses and Disclosures:
Incidental disclosures of your child's health information may occur despite the efforts that we make to ensure the privacy of health information. For example, two patients may be receive care in close proximity to one another, and inadvertent disclosure may occur.

Patient Rights
Access:
You have the right to look at or get copies of your child's health records, with limited exceptions. You must make a request in writing in order to obtain access to your child's health records. If you prefer, we will prepare a summary or explanation of your child's health information. We may charge copying and mailing fees and/or a fee for preparing such a summary or explanation.

Accounting of Disclosures:
You have a right to receive an accounting of disclosures made of your child's health information for purposes other than treatment, payment, healthcare operations and certain other activities.

Additional Restrictions:
You have the right to request that we place restrictions on communications with others about your child's health information. Your request should be in writing and we reserve the right to reject these additional restrictions.

Alternative Communication:
You have the right to request that we communicate with you about your child's health information by alternative means or at alternative locations. Requests should be in writing and specify the details of the alternative request. We will accommodate all reasonable requests. Please note, however, that alternative means of communications, such as e-mail, may not provide the level of confidentiality or security that a parent or guardian may desire.

Amendment:
You have the right to request that we amend your child's health information. Your request must be in writing with an explanation of the changes. We may deny your request under certain circumstances.

Notice:
You are entitled to a paper copy of this Notice of Privacy Practices upon request.

Questions and Complaints:
If you want more information about our privacy practices or have questions or concerns, please contact us. If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your child's health information or in response to a request regarding your child's health information, you may complain to us using the contact information listed below. You may also submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file such a complaint upon request. We support your right to privacy of health information and will not retaliate in any way if you choose to file a complaint.

Contact Information:
Marie Carrier Kinsley, MD, Privacy Officer,
Pediatric Care Group, P.C.
261 Old York Road
Suite 620
Jenkintown, PA 19046

Phone: (215) 885-8700
Fax: (215) 885-8795