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Notice of Privacy Practices

 

This notice describes how your medical information may be used and disclosed and how you can gain access to this information. Please review it carefully.

The Importance of Privacy at Northside Christian Health Center
At Northside Christian Health Center, we strive to be the most trusted provider of health care in the area. That means we are committed to protecting the privacy of your medical information. We believe that you are entitled to understand how your medical information is used at Northside Christian Health Center and how it is shared with our partners in your care. Please read this Notice of Privacy Practices (the
"Notice") thoroughly. If you have any questions or need additional information about issues covered in this Notice, please contact the Northside Christian Health Center Privacy Official at 816 Middle Street, Pittsburgh, PA 15212 or at 412-321-4001.

I. Permitted Uses or Disclosures of Your Medical Information
A. Treatment, Payment, and Healthcare Operations:
To function as a hospital, we will need to use and disclose your medical information for treatment, payment, and healthcare operations. Examples of each are listed below:

Treatment:

  • Disclose that you have diabetes to a physician treating you for a joint replacement because diabetes may slow the healing process. In addition, the physician may need to tell the dietitian if you have diabetes so that we can arrange for appropriate meals. It is important to note that physicians providing care at our hospital are required to abide by the terms of this Notice.
  • Disclose your medical information to people or entities outside Northside Christian Health Center who are involved in your treatment while at the Hospital or will be caring for you after you are discharged.
  • Use and disclose your name, address, employment, insurance carrier, emergency contact information, and appointment scheduling information in an effort to coordinate your treatment with us and with other healthcare providers.

Payment:

  • Share copies or excerpts of your medical records which are necessary for payment of your account with an insurance company, third party administrator, health plan, another healthcare provider, or collection agency.
  • Disclose information to obtain pre-approval for payment of treatment from your insurance company.
  • In order for us to operate our business in an efficient, safe and legal manner, we may need to use or disclose your medical information for activities including monitoring the effectiveness of our services, managing costs, obtaining accreditation, and training personnel. In cases where medical information is shared with Trinity Health, our corporate parent, they will abide by the terms of this Notice.

Healthcare Operations:

  • In order for us to operate our business in an efficient, safe and legal manner, we may need to use or disclose your medical information for activities including monitoring the effectiveness of our services, managing costs, obtaining accreditation, and training personnel. In cases where medical information is shared with Trinity Health, our corporate parent, they will abide by the terms of this Notice.

B. Fundraising Activities:
We may contact you in an effort to raise money to benefit Northside Christian Health Center. We will seek your permission if we want to use medical information related to your specific treatment. If we use a related foundation or company to assist us with our fundraising efforts, that foundation or company may only use your information for the purposes of fundraising for Northside Christian Health Center and must keep your information private. Any fundraising materials we send you will let you know how to opt out of receiving similar communications in the future or you may do so by contacting the Privacy Official at 412-321-4001.

C. Educational and Health Promotional Activities:
We may contact you to provide information about our services and health improvement education. We may send you newsletters or contact you by other means regarding treatment options, health-related information, disease-management programs, wellness programs, or other community based initiatives or activities.

D. Family/Friends:
We may disclose medical information about you to a family member or a close personal friend who you have designated to be involved in your medical care or who helps you pay for your health care. You have a right to request that your medical information not be shared with some or all of your family members or friends. In addition, we may disclose medical information about you to an agency assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.

E. Media:
We may update the media by releasing medical information about you only if the request identifies you by your name. Prior to disclosing medical information to the media, we will give you an opportunity to agree or object to the disclosure. If you agree to the disclosure to the media, the Hospital will disclose only your condition described in general terms that do not communicate specific medical information, such as "good,, "fair," "serious," or "critical." If you would like for us to disclose more information to the media, you will need to sign an authorization.

F. Research:
During your stay with us, you may be asked to participate in a research study. Your involvement in the study is completely voluntary. Before you are part of a research study, we will inform you about the study and seek your consent to participate in the study. If the research study involves your treatment, we will ask for your written permission to allow us and the researchers to use and disclose your medical information for the research study. In rare cases, we are allowed by law to use your medical information without your consent as long as a special review board authorizes the research study and ensures your privacy will be protected.

G. Required by Law:
We may disclose medical information about you when required by federal or state law.

H. Public Health Activities:
We may use or disclose your medical information for public health activities, including:

  • Preventing or controlling injury or disease.
  • Reporting child abuse, neglect, or domestic violence.
  • Reporting quality, safety, or effectiveness issues of FDA-regulated products and activities.
  • Reporting to employers about work related illness or injury.

I. Health Oversight:
We may disclose your medical information to government agencies as authorized or required by law.

J. Judicial and Administrative Proceedings:
We are required to disclose your medical information in response to a court order, subpoena, discovery request, or other lawful process.

K. Law Enforcement Purposes:
We may disclose your medical information for law enforcement purposes. For example, we may provide information to law enforcement officials relating to a criminal investigation.

L. Coroners, Medical Examiners, and Funeral Directors:
We may share your medical information with a coroner or medical examiner. For example, this disclosure will be necessary to identify a deceased person or to determine a cause of death. We may also disclose your medical information to funeral directors as necessary to carry out their duties.

M. Organ Donation:
We may disclose medical information to an organ procurement organization or entity for organ, eye, or tissue donation purposes.

N. Military:
If you are a member of the Armed Forces or a Veteran, we may release medical information about you to military authorities.

O. National Security and Intelligence Activities:
We may disclose your medical information to authorized federal officials for lawful intelligence and other national security activities.

P. Protective Service for the President and Others:
We may disclose your medical information to authorized federal officials for the purpose of providing protective services to the U.S. President, heads of state or others, or to conduct special investigations.

Q. Workers' Compensation:
We will make certain disclosures that are required in order to comply with workers' compensation or similar programs.

R. Other Uses of Medical Information:
Any uses or disclosures that are not for treatment, payment, health care operations or permitted by law will be made only after obtaining your signed authorization. A written authorization will let you know why we are using or disclosing your medical information. You have the right to revoke an authorization at any time, except to the extent that we have relied on an authorization.

II. Your Rights Regarding Your Medical Information
You have the following rights concerning your medical information. To exercise any of these rights, please make a written request to the Northside Christian Health Center Medical Records Department, 816 Middle Street, Pittsburgh, PA 15212.

A. Right of Access:
You have the right to inspect and receive a copy of your medical information as long as we maintain it. You do not have a right to inspect or copy:

  • Psychotherapy notes.
  • Information that will be used in a civil, criminal, or administrative action or proceeding.
  • Information prohibited or protected by law.

You will be charged a reasonable copying fee.

B. Right to Amend:
You have the right to request that we amend your medical information for as long as we maintain it. Your request must include justification for the amendment. We may deny your request for an amendment, if:

  • We did not create the information.
  • The information is not part of your medical record.
  • The information would not be available for your inspection (due to its condition or nature).
  • The information is accurate and complete.

If we deny your amendment request, we will notify you in writing with the reason for the denial. We will also inform you of your right to submit a written statement disagreeing with the denial. We may prepare a rebuttal to your statement of disagreement and will provide you with a copy of that rebuttal. You may ask that Northside Christian Health Center include your request for amendment and the denial any time that we disclose the information that you wanted changed.

C. Right to an Accounting of Disclosure:
You have the right to receive an accounting of disclosures we made of your medical information for six years from the date you make the request. This list will not include disclosures:

  • To carry out treatment, payment, or healthcare operations.
  • To you or your personal representative.
  • To family and friends you authorized to receive the information.
  • For national security or intelligence purposes.
  • To correctional institutions or law enforcement officials.
  • If you signed an authorization to release the information.
  • Any disclosures that occurred prior to April 14, 2003.
  • From the hospital's directory.
  • Permitted by law.

In any given 12-month period, Northside Christian Health Center will provide you with an accounting of the disclosures of your medical information at no charge. Any additional requests for an accounting within that time period will be subject to a reasonable fee for preparing the accounting.

D. Right to Request Restrictions:
You have the right to request restrictions of certain uses and disclosures of your medical information. For example, you may restrict to only certain family members, relatives, close personal friends, or other individuals involved in your care. We will consider all reasonable requests.

E. Right to Confidential Communications:
You have the right to receive confidential communications of your medical information by alternative means or at an alternative location. For example, you may request that we only contact you by mail or at work. We will consider all reasonable requests.

F. Right to Receive a Copy of this Notice:
You have the right to receive a paper copy of this Notice of Privacy Practices, upon request. In addition, you may also visit our website at www.holycrosshealth.org.

III. How to File a Privacy Complaint and Contact Information
If you believe your privacy rights have been violated, you may file a complaint with Northside Christian Health Center or with the Secretary of the Department of Health and Human Services. For information about filing a complaint, please contact the Northside Christian Health Center Privacy Official at 412-321-4001. All complaints filed with us must be submitted in writing directly to the Northside Christian Health Center Privacy Official at 816 Middle Street, Pittsburgh, PA 15212. We will not retaliate against you for filing a complaint.

IV. Changes to this Notice
We will abide by the terms of the Notice currently in effect. We reserve the right to change the terms of this Notice. We will provide you with the revised Notice at your first visit following the revision of the Notice. The effective date of this Notice is September 30, 2010.

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816 Middle Street, Pittsburgh, PA 15212
P: 412-321-4001 | F: 412-321-4063

 

After-Hours Statement

Call 412-321-4001 and the answering service will page the physician on call if you have a medical emergency when the Center is closed.

About Us

The North Side Christian Health Center provides comprehensive whole-person primary and preventative health care to the underserved in accordance with our Christian principles and values. We see caring for the health and well-being of people and communities as not only our work but our mission.