WHITE ROSE SURGICAL ASSOCIATES LTD.
PRIVACY NOTICE

 

White Rose Surgical Associates Ltd. is committed to protecting medical information about you. This notice describes how medical information about you may be used a/Id disclosed and how you can get access to this information. Please review it carefully.

 

White Rose Surgical Associates Ltd. physicians and staff are committed to keeping your medical record information confidential but will use it for treatment, payment and health care operations. We also may use medical information to contact you as a reminder that you have an appointment for medical care.

 

FOR TREATMENT: Our physicians and staff may use your medical information about you to provide medical treatment or services. We may disclose medical information about you to other doctors or healthcare personnel who are involved in your care. We may also disclose medical information about you to other people involved in your medical care such as family members, clergy, etc.

 

FOR PAYMENT: Our billing office will use your medical information to bill you and your insurance company or third party payer for services that we provide to you. We may also give your health plan medical information about a treatment you are going to receive in order to obtain prior approval or to determine whether your plan will cover treatment.

 

FOR HEALTH CARE OPERATIONS: We may use and disclose medical information about you for operational reasons. Business associates who provide contracted services such as claims processing, legal representation, accounting etc. may be disclosed medical info1mation about you. A business associate agreement will provide that the information will be kept confidential.

 

YOUR HEALTH INFORMATION RIGHTS:

  • You have the right to inspect and obtain a paper copy of your medical record. (fees may apply)
  • You have the right to request restrictions on certain uses and disclosures of your medical record.
  • You have the right 10 receive communication about your medical record in a confidential manner.
  • You have the right to request an amendment to your medical record.
  • You have the right to obtain an accounting disclosure of your medical record.

 

The release of information for uses and disclosures that are not described in the Notice will only occur with the patient's written authorization and that such authorization may be revoked in writing. If you have any questions, or would like additional information, please contact the Privacy Officer at (717) 848-2067.

 

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