Privacy Notice

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

Brookside Clinical Laboratory, Inc. (called Brookside in this Notice) is committed to protecting the privacy of your personal and health information. At Brookside, we are committed to protecting the confidentiality of individuals’ laboratory test results and other patient protected health information (PHI) that we collect or create as part of our diagnostic testing.

We urge you to read this Notice of Privacy Practices carefully so that you will understand both our commitment to the privacy of your PHI, and how you can participate in that commitment. Should you have any questions about this Notice or our privacy practices, please write to us at the following address:

Brookside Clinical Laboratory, Inc.
4000 Edgmont Avenue
Brookhaven, PA 19015
Attention: Privacy Officer

This Notice if Effective as of April 14, 2003.

Brookside’s Privacy Policy

Brookside and its employees are committed to obtaining, maintaining, using and disclosing patient protected health information (PHI) in a manner that protects patient privacy. We will only use or disclose the minimum amount of your PHI we consider necessary to perform a job or complete an activity. This Notice applies to all PHI we maintain. Your doctor may have different notices regarding his/her use and disclosure of your PHI created in his/her/office.

Brookside is required by law to provide you, upon request, with this Notice of Privacy Practices with respect to PHI, to maintain the privacy of PHI, to make, and to list the rights of individuals and our legal duties with respect to their PHI. Your PHI at Brookside includes personal and medical information, (such as your name, address, date of birth, test ordered, etc.) that we obtain from you physician, health plan, or other sources. Your PHI also includes the laboratory testing results that we create. An example of PHI is as follows, John Doe, Date of Birth: 7/1/42, resides at 456 Main St, Anywhere, USA, blood sugar result of 150.

Brookside is requite4d to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of this Notice of Privacy Practices and to make the provisions of the new Notice of Privacy Practices effective for all PHI that we maintain.

How we may use and disclose your Protected Health Information

Your PHI will be used or disclosed for treatment, payment or healthcare operations purposes and for other purposes permitted or requited by law. Not every use or disclosure is listed, however all of the ways we use or disclose your PHI will fall into one of the categories listed below.

If we wanted to use or disclose your PHI for other purposes, we would have to obtain your written authorization.

For Treatment: As a health care provider that provides laboratory testing for ordering physicians, Brookside uses your PHI as part of our testing process and discloses your PHI to physicians and other authorized health care professionals who need access to your laboratory results to treat you. In addition to your treating, we may provide a specialist consulting physician with information about your results to further validate the results before release to your physician. Occasionally, we may contact you to arrange for a redraw of your specimens.

For Payment: We will use your PHI in our billing departments and disclose your PHI to insurance companies, hospitals, physicians, and health plans for payment purposes, or to third parties to assist us in creating bills, claim forms, or getting paid for your services. In some cases we may have to contact you to obtain billing information or for other billing purposes. When required, we may use an outside collection agency to obtain payment.

For Healthcare Operations: We may use or disclose you PHI in the course of activities necessary to support our health care operations, such as performing quality checks on our testing, for teaching purposes, or for developing normal reference ranges for tests that we perform.

Disclosures to Business Associates: Brookside may disclose your PHI to other companies or individuals who need your PHI in order to provide specific services to us. These other entities, know as “business associates”, must comply with the terms of a contract designed to ensure that they will maintain the privacy and security of the PHI we provide to them or which they create on our behalf. Our business associates must only use your PHI for designated treatment, payment, or health care operations purposes that they perform on our behalf.

As Permitted or Required by Law: We may use or disclose your PHI for various public policy purposes that are authorized or required by federal or state law.

Public Health: We may disclose your PHI when reporting communicable disease results to public health department as requited by law.

Public Safety: When the appropriate conditions apply, we may use or disclose PHI to prevent or lessen a serious imminent threat to the health or safety of a person or the public.

To Avert a Serious Threat to Health or Safety: We may use or disclose you PHI when necessary to prevent a serious threat to your health and safety or that of another person or the general public. Any use or disclosure for this purpose would only be made to someone able to help prevent the threat.

Health Oversight: We may disclose your PHI in connection with government oversight, licensure, auditing, and other purposes.

Judicial and Administrative Proceedings: We may disclose your PHI as required to comply wit subpoenas, court orders, discovery requests or other legal process in the course of a judicial or administrative proceeding.

Law Enforcement: We may also disclose PHI for law enforcement purposes.

Specialized Government Functions: We may disclose your PHI for military and veterans activities, national security or intelligence purposes, to or to correctional institutions or to law enforcement officials having custody of an inmate.

Workers Compensation: We may disclose your PHI as necessary to comply with requirements of workers’ compensation or similar programs that provide benefits for work-related injuries or illness without regard to fault.

Note Regarding State Law: For the above purposes, in cases where state law is more restrictive state than federal law, we are required to follow the more restrictive state law.

Your rights concerning privacy and confidentiality

Access: You or your authorized or designated personal representative have the right to inspect and copy your PHI. Brookside will deny access to certain information for specific reasons; for example, state law prohibits such patient access.

Accounting: You have the right to receive an accounting of disclosures of your PHI that were made by Brookside for a period of up to six years prior to the date of your written request, but not including any disclosure made prior to April 14, 2003, when the Privacy Rule went into effect. Under the law, this accounting does not include disclosure made for purposes of treatment, payment, health care operations, or certain other excluded purposed, but includes other types of disclosures, including disclosures for public health reporting or in response to a court order.

Restrictions: You have the right to ask us if we will agree to restrictions on certain uses and disclosures of your PHI, but we are not required to agree to your request.

Confidential Communications: You have the right to request that we send your PHI to an alternate address, but we are not required to agree to your request.

Notice of Privacy Practices: You have the right to request a paper copy of this Notice.

Complaints: If you believe your privacy rights have been violated, you have the right to register a complaint with Brookside or the Secretary of the U.S. Department of Health and Human Services. Brookside will not retaliate against any individual for filing a complaint. You may file a complaint by writing to us at the address located at the beginning of this Notice.

How to exercise your rights: Write to use with your specific written request and be sure to include sufficient information for us to identify all of your records.

How to contact us

If you have questions or concerns regarding the privacy or confidentiality of your PHI, or you wish to register a complaint, please write us at the address located at the beginning of this Notice.

Brookside reserves the right to amend this Notice of Privacy Practices, at any time, to reflect changes in our privacy practices, and these changes will apply retroactively. Any such changes will be applicable to and effective for all PHI that we maintain in including PHI we created or received prior to the effective date of the Notice revision.