Christina Curtin, Privacy Officer- Stony Brook Pediatrics, P.C.
Mail: P.O. Box 499, Dansville, NY 14437
Phone: (585) 335-5200
The privacy of your medical information is important to us. This page describes how medical information about you (as a patient of this practice) may be used and disclosed and how you can obtain access to this protected information. Please review this information carefully.
Federal law provides that we may use your medical information (protected health information) for treatment of you, without further specific notice to you, or written authorization by you. For example, if we refer you to a specialist, we may provide laboratory or test data to that specialist (subject to more stringent New York laws, such as restrictions on disclosure of information concerning HIV/AIDS).
Federal law provides that we may use your medical information to obtain payment for our service without further specific notice to you, or written authorization by you. For example, we may contact your health insurer to certify that you are eligible for benefits and we may provide your insurer with details regarding the treatment received that they may be covering.
Federal law provides that we may use and disclose your medical information for our health care operations without further specific notice to you, or written authorization by you. Our office, for example, may use your protected health information to evaluate the care you received from us or to conduct internal cost management and business activities for our practice.
We may use or disclose your medical information, without further notice to you, or specific authorization by you, where:
1. required by law;
2. required for public purposes;
3. required by law to report child abuse;
4. where required by a health oversight agency for oversight activities authorized by law, such as the Department of Health;
5. required by law in judicial or administrative proceedings;
6. required for law enforcement purposes by a law enforcement official;
7. required by law to the coroner, medical examiner, or funeral director;
8. permitted by law for organ donation purposes;
9. permitted by law to avert a serious threat to health or safety;
10. permitted by law and required by military authorities if you are a member of the USA Armed Forces;
New York law provides additional protection for information regarding HIV/AIDS. We will continue to follow New York State law with respect to such information.
We may contact you by mail or phone, at your residence, to remind you of appointments or to provide information about treatment alternatives and health related benefits or services that may be of interest to you.
You can make reasonable request, in writing, for us to use alternative methods of communicating with you in a confidential manner. A form for requesting limitations and restrictions of protected health information may be obtained from our Privacy Officer.
You have the right to request restrictions on certain of the uses or disclosures described above. Except as stated below, we are not required to agree to such restrictions. You have the right to inspect and obtain copies of your medical information. A reasonable fee will be charged.
You have the right to request amendments to your medical information. Such request must be in writing, and must state the reason for the requested amendment. If we disagree with any requested amendment, we will further notify you of your rights.
You have the right to request an accounting of any disclosures we make of your medical information, except for: disclosures we make to you, or to carry out treatment, payment or health care operations, or as required by law. A written request is required to obtain an “accounting of disclosures” which must contain a specific time period, not to exceed six (6) years from the date of the request and may not include dates prior to April 14, 2003.
You are entitled to receive a paper copy of this “Notice of Privacy: at any time.
We are required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices.
We are required to abide by the terms of this notice as long as it is currently in effect. We reserve the right to revise this notice, and to make a new notice effective for all protected health information we maintain. Any revised notice will be posted in our office, and copies will be available there.
If you want to complain about violations of your privacy rights, you have a right to file a complaint with the Secretary of the Department of Health and Human Services of the United States. You may also file a complaint with us. Complaints should be direct to our Privacy Officer. No retaliatory action will be taken against you for any complaint you may make.