ON NOTICE OF PRIVACY PRACTICES
acknowledges that we must maintain and provide to patients (or their personal
representative, e.g., their parent or
guardian) a Notice of Privacy Practices (NPP).
The NPP will inform patients about how we may use and disclose the
patient’s protected health information (PHI).
It will also describe the patient’s rights and Patriot Pediatrics’
duties with respect to PHI.
As described in the NPP,
in many cases, the individual reviewing this policy
or the NPP (i.e., “you”) will be the
parent or guardian of one of our patients.
In general, as your child’s personal representative, you have the
ability to act for him/her and exercise his/her rights as described in this
policy and in the NPP. Please note,
however, that all references in this policy and in the NPP to “your
information,” or “your records,” etc., refer to the information and records of
Under the HIPAA Privacy
Rule, you generally have the following rights:
right to receive a copy of Patriot Pediatrics’ NPP
right to request restrictions on certain uses and disclosures of PHI by
right to request restrictions on how we communicate PHI to you
right to inspect and copy PHI, with certain exceptions (e.g., psychotherapy notes)
right to request an amendment of PHI, with certain exceptions (e.g., in cases when the PHI is
already accurate and complete)
right to request an accounting of the disclosures of PHI made by us,
except for disclosures made for treatment, payment, or health care
operations (“TPO”), and except for certain other disclosures including
those made pursuant to a valid authorization
will distribute a Notice of Privacy Practices to you on the day we first
render services to the patient.
NPP will contain a statement that we are required by law to maintain the
privacy of PHI, to provide you with notice of our legal duties and privacy
practices, and to notify affected individuals following a breach of
NPP will contain a statement that we are required to abide by the terms of
the NPP currently in effect.
NPP will contain: (a) a statement that you may complain to Patriot
Pediatrics or to the Secretary of the Department of Health and Human
Services if you believe your privacy rights have been violated, (b) a
brief description of how you may file a complaint, and (c) a statement
that you will not be retaliated against for filing a complaint.
NPP will contain the name or title, and the telephone number, of a person
to contact for further information.
NPP will contain the date on which the NPP is first in effect.
we offer you the opportunity to receive a copy of the NPP via e-mail, we
may do so only if you accept our offer and you have not withdrawn your
must use our best efforts to obtain a written acknowledgement from you
that you have received a copy of the NPP. If we are unable to
obtain such an acknowledgement, we must document our efforts to obtain the
acknowledgement and the reason why we did not obtain the
acknowledgment. We will place and retrain each acknowledgement
or best efforts statement in the patient’s medical record.
will post the NPP in a clear and prominent area of the office. If
we revise the NPP, we will post the revised version in a clear and
prominent area, and we will distribute the revised version to you upon your
request. We are not required to mail or send the revised notice
will post our NPP on our website.
will document our compliance with the HIPAA Privacy Rule’s NPP
requirements by retaining copies of every version of NPPs for at least six
years, and, as described above, by retaining copies of written acknowledgements.