Patient Information

Transparency for Billing and Insurance at Healthcare South, P.C.

Effective January 1, 2022, the No Surprises Act (which Congress passed as part of the Consolidated Appropriations Act of 2021) is designed to protect patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured patients to receive a good faith estimate of the anticipated cost of their care.

Billing Disclosures – Your Rights and Protections Against Surprise Medical Bills

When you receive emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from “surprise billing” – also known as balance billing.

What is “balance billing?”

When you see a doctor or other healthcare provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other associated costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care — when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

• Emergency Services: If you have an emergency medical condition and receive emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may receive after you are in stable condition unless you provide written consent and waive your protections from being balanced billed for these post-stabilization services.
  
• Certain Services at an In-Network Hospital or Ambulatory Surgical Center: When you receive services from an in-network hospital or ambulatory surgical center, certain providers at the facility may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist or intensivist services. These providers cannot balance bill you and may not ask you to waive your protections from balance billing. If you receive other services at these in-network facilities, out-of-network providers cannot balance bill you, unless you provide written consent and waive your protections.

You are never required to give up your protection from balance billing. You also are not required to receive care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing is not allowed, you also have the following protections:

• You are only responsible for paying your share of the cost (such as copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
• Your health plan generally must:
  • Cover emergency services without requiring you to obtain approval for services in advance (“prior authorization”)
  • Cover emergency services by out-of-network providers
    Base what you owe to the provider or facility (“cost-sharing”) on what your carrier would pay an in-network provider or facility and show that amount in your explanation of benefits
  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

Third-Party Providers

• You may be provided care by third-party healthcare providers. In this event, you have the right to receive a good-faith estimate from all providers that may be involved in your care.

Good Faith Estimate

If you are uninsured or not using insurance for a non-emergency item or service, you have the right to receive a “Good Faith Estimate” explaining how much your medical care might cost before you receive such care. This estimate must include:

• A list of items and services that the scheduling provider or facility reasonably expects to provide you for the scheduled visit/services.
• The Good Faith Estimate list must include expected charges or costs associated with each item or service from each provider and facility along with applicable diagnosis and service codes
• A notification that if the billed charges are higher than the good faith estimate, you can ask your provider or facility to update the bill to match the good faith estimate, ask to negotiate the bill, or ask if there is financial assistance available
• Information on how to dispute your bill if it is at least $400 higher for any provider or facility than the good faith estimate you received from that provider or facility (see below)

Questions?

If you believe you’ve been wrongly billed, or to review more information about your rights (including your right to a Good Faith Estimate), you may contact the U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227) or visit cms.gov/nosurprises for more information about your rights under federal law. You may also contact your health plan to ask them why you got the bill and if it’s correct. If it was an emergency, ask your health plan if they processed your claim as an emergency. Finally, you may contact the Massachusetts Attorney General’s Consumer Hotline at 617-727-8400.

As physicians and other health care providers practicing in Healthcare South, we recognize that we have an obligation to respect the dignity of each patient and to conduct each visit in a manner that strives to provide a comfortable and considerate atmosphere providing appropriate gowns, privacy for undressing, sensitive use of draping, and clear explanations of various components of the physical examination.

Some physical examinations will be highly focused and the patient will be fully clothed; in other cases the patient may be partially or completely unclothed. In every case patients are free to request a chaperone. The chaperone may be a patient advocate or an authorized health care professional. The health care professionals will at all times adhere to the standards of confidentiality consistent within Healthcare South. During the time that a chaperone is present, the health care provider will strive to keep all inquiries of a sensitive nature to a minimum. The intake nurse or the physician should convey the policy of providing a chaperone.

There are a variety of circumstances, including those in which the patient requests confidentiality, which would render the presence of a chaperone problematic. Physician judgment and discretion must be paramount in evaluating the need for a chaperone, but the patient’s request will be given the highest priority. If a chaperone is provided, a separate opportunity for private conversation will be provided.

Although this policy has been drafted using the recommendations of both the American Medical Association and the American Academy of Pediatrics, we recognize that each patient encounter is unique and a variance from this policy should in no way be construed as a deviation from proper or ethical practice.

Policy on Consent for Treatment

The following policy has been adapted from the guidelines of the American Academy of Pediatrics. They can be found in Consent for Medical Services for Children and Adolescents and Informed Consent, Parental Permission, and Assent in Pediatric Practice.

Today less than one third of children live in two-parent families in which only the father works outside the home. Because of foster care placement, or temporary or permanent arrangements with relatives or friends, parents may not be available to give consent for treatment of their children. There are two situations that need to be examined: first where emergency treatment must be given and second where non-emergent treatment might be given.

Most states have provisions in which competent minors may arrange for care involving contraceptives, pregnancy, abortion, sexually transmitted diseases, drug and alcohol abuse, and psychiatric disorders. The provisions are less clear when these situations are not in force.

The dilemma for practicing pediatricians is whether to follow a strict interpretation of the law or to adopt a more practical approach. Clearly, consent is not required in life- or limb-threatening emergencies, although the definition of emergency varies from state to state. In most instances, however, when pediatric patients come to our offices, only routine care, not emergency care, is needed. In support of a common sense approach to treatment, Holder noted that in a review of 30 years of emergency medical care, lack of consent was not the basis for a judgment against the physician. Legal definitions aside, the overwhelming sentiment is that physicians should be guided by an approach that is in the best interest of the patient. This will be the primary criterion we use when the decision to treat or not is made.

To provide expedient care for children in an ethical, legal, and reasonable manner in situations where nonelective medical treatment is given, the American Academy of Pediatrics (AAP) makes the following recommendations, which we will make every attempt to follow. The first several of these cover an emergent situation. The later guidelines define when a minor could be considered to be giving informed consent, which in many but not all instances is binding. In a non-emergent situation, we will use guidelines #9 and #10 to determine the patient’s decisional capacity or #11 to determine legal empowerment.

1. When another adult is acting in place of a parent for a child (in loco parentis), the physician should document the situation in the medical record, including attempts to obtain verbal or written consent from a parent.
2. Physicians in primary care settings might assist parents by providing them information regarding the need to provide written consent for nonelective medical treatment for their child when unavailability can be anticipated, including times when the child is in child care, left with friends or relatives, at school or camp, or with noncustodial relatives.
3. Parents should provide child care centers, schools, or other caretakers with the following information: how they can be reached if medical care becomes necessary; basic information about the child’s health care record, including immunizations, allergies, medications, and chronic illnesses; and preferences for a physician or facility for treatment. Written consent should be provided.
4. No evaluation of a life-threatening or emergency condition of a child will be delayed because of a perceived problem with consent or payment authorization. Decisions regarding the emergent nature of treatment should be made on the basis of that evaluation.
5. The act of leaving a child with a custodian by the parent or the state represents implied consent in situations where the parent is not immediately available for verbal consent, and nonelective medical care is needed. These situations might include, but are not limited to, the following conditions.
   • Relief of pain or suffering
   • Suspected serious infectious disease
   • Assessment and treatment of serious injury
   • Life, limb, or central nervous system-threatening conditions.
6. Patients should participate in decision-making commensurate with their development; they should provide assent to care whenever reasonable. Parents and physicians should not exclude children and adolescents from decision-making without persuasive reasons. Indeed, some patients have specific legal entitlements to either consent or to refuse medical intervention.
7. Although physicians should seek parental permission in most situations, they must focus on the goal of providing appropriate care and be prepared to seek legal intervention when parental refusal places the patient at clear and substantial risk.
8. Only patients who have appropriate decisional capacity and legal empowerment can give their informed consent to medical care. In all other situations, parents or other surrogates provide informed permission for diagnosis and treatment of children with the assent of the child whenever appropriate.
9. The doctrine of informed consent reminds us to respect persons by fully and accurately providing information relevant to exercising their decision-making rights. Experts on informed consent include at least the following elements in their discussions of the concept:
   a) Provision of information: patients should have explanations, in understandable language, of the nature of the ailment or condition; the nature of proposed diagnostic steps and/or treatment(s) and the probability of their success; the existence and nature of the risks involved; and the existence, potential benefits, and risks of recommended alternative treatments (including the choice of no treatment).
   b) Assessment of the patient’s understanding of the above information.
   c) Assessment, if only tacit, of the capacity of the patient or surrogate to make the necessary decision(s).
   d) Assurance, insofar as is possible, that the patient has the freedom to choose among the medical alternatives without coercion or manipulation.
10. Decision-making involving the health care of older children and adolescents should include, to the greatest extent feasible, the assent of the patient as well as the participation of the parents and the physician. Pediatricians should not necessarily treat children as rational, autonomous decision makers, but they should give serious consideration to each patient’s developing capacities for participating in decision-making, including rationality and autonomy. If physicians recognize the importance of assent, they empower children to the extent of their capacity.[12] Even in situations in which one should not and does not solicit the agreement or opinion of patients, involving them in discussions about their health care may foster trust and a better physician-patient relationship, and perhaps improve long-term health outcomes.Assent should include at least the following elements:
    a) Helping the patient achieve a developmentally appropriate awareness of the nature of his or her condition.
    b ) Telling the patient what he or she can expect with tests and treatment(s).
    c) Making a clinical assessment of the patient’s understanding of the situation and the factors influencing how he or she is responding (including whether there is inappropriate pressure to accept testing or therapy).
    d ) Soliciting an expression of the patient’s willingness to accept the proposed care. Regarding this final point, we note that no one should solicit a patient’s views without intending to weigh them seriously. In situations in which the patient will have to receive medical care despite his or her objection, the patient should be told that fact and should not be deceived.
11. The traditional notion of informed consent clearly applies to patients who have reached the legal age of majority, except when the patient has been determined to be incompetent. In addition, laws designate two settings in which minors have sole authority to make health care decisions. First, certain minors are deemed “emancipated” and treated as adults for all purposes. Definitions of the emancipated minor include those who are: 1) self-supporting and/or not living at home; 2) married; 3) pregnant or a parent; 4) in the military; or 5) declared to be emancipated by a court. Second, many states give decision-making authority (without the need for parental involvement) to some minors who are otherwise unemancipated but who have decision-making capacity (“mature minors”) or who are seeking treatment for certain medical conditions, such as sexually transmitted diseases, pregnancy, and drug or alcohol abuse. The situations in which minors are deemed to be totally or partially emancipated are defined by statute and case law and may vary from state to state. Legal emancipation recognizes a special status (e.g., independent living) or serious public and/or individual health problems that might not otherwise receive appropriate attention (e.g., sexually transmitted disease).

We have over the past several years attempted to modify our referral process to meet the needs of our patients, their insurance carriers, and the various specialty care offices to which we refer. There are over one hundred specialists to whom we routinely refer; each of who has their own office policies. Some of the physicians are particularly respectful of the referral process, judiciously use the referrals we authorize and always reply with their findings in a timely fashion along with their reasons for needing further visits. Others deal exclusively with the patients, reply to the consultation very slowly, do not involve us in any further treatment planning, and make all follow up appointments suggestions exclusively with the patients. This latter policy is unacceptable to us.

A referral to a specialist is a request for their help in determining how to address a specific problem; it is not a transfer of care. We do not expect one referral to an allergist or a dermatologist to translate into our permission to treat the patient for life without every asking again if we the physician still need the specialist’s help. If we are not performing well enough in a specific area that you feel that you need repeated visits to a particular specialist even when we feel we can meet your child’s needs here, then you need to find a new primary care giver. .

For each referral, you must contact our office at least one week before the referral appointment to give us enough time to review the request and contact you beforehand if necessary. No referral will be authorized if it originates with the family without contacting us first to discuss the problem and no referral will be authorized if we are not given the one week lead time.

Each insurance company has a different policy regarding referrals based on the products they sell you or your employers. In general, there are three major types of coverage: HMO coverage, PPO coverage, and general Indemnity coverage. The HMO coverage is the least expensive and has the tightest restrictions. It is marketed to the subscribers as allowing each patient to the network wide group of physicians. Unfortunately for us, your physicians, we cannot be part of their primary care network unless we agree to accept part of the risk involved in care for you. In simple terms, if the cost of your medical care exceeds the budget the insurance company has set, the physician providers must make up the shortfall. We the physicians end up paying for your referrals. Each of us is ethically bound to provide the single best care we can provide for each patient we care for. We recognize this responsibility and take it very seriously; however, if we are responsible for each referral, we need to be part of each referral request. This may seem onerous and impractical to you, and it certainly is cumbersome for us, but it is absolutely necessary. We have contacted each of our specialist colleagues about this situation. They will require that you have a referral in place before they provide specialty care.

For the other options offered by your insurance carrier, the referral restrictions may be less onerous. For a PPO product, you may not need a referral as long as the specialist is with your plan’s network; for an Indemnity product you may not need a referral at all. It is your responsibility ultimately to determine the specific dictates of your plan; as much as we can, we will help you with this responsibility, recognizing that there are a multitude of insurance carriers and products that we have to deal with.

Please see the listing of insurances that Healthcare South accepts, please note that there may be plans within each of these insurance carriers that Healthcare South is not a participating provider of ; it is the patients responsibility to be familiar with their policy. If you have a question about the plans we accept please contact our billing department at 781-803- 6940 and we will be more than happy to assist you.Our medical practices accept the insurance carriers listed below. Some of the carriers have insurance links, where you can change your primary care physician over the internet.

• Aetna
• Blue Cross/BlueShield
• Cigna
• Champus/Champva
• Children’s Medical Security Plan
• Choicecare / Humana
• Fallon
• Harvard Pilgrim Health Care
• MassHealth PCC Plan
• Medicare Part B
• Multiplan
• Allways Health Partners
• Senior Whole Health
• PHCS
• Tricare
• Tufts
• Unicare
• United Healthcare

You should always check with your own health insurance plan or your employer before getting care to make sure you understand your covered benefits and costs as well as whether we are participating providers with your plan.

Healthcare South, P.C.
NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003
Last Modified: May 12, 2013

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

We are required by law to protect the privacy of health information that may reveal your identity, and to provide you with a copy of this notice, which describes the health information privacy practices of our medical group, its medical staff and affiliated health care providers who jointly perform health care services with our medical group, including physicians and physician groups who provide services at our facilities. A copy of our current notice will always be posted at all registration and/or admission points, including in the reception area.  You will also be able to obtain your own copies by accessing our website at www.healthcaresouth.com or calling the Privacy Officer at 781-803-2786.

If you have any questions about this notice or would like further information, please contact the above referenced individual.

WHAT HEALTH INFORMATION IS PROTECTED

We are committed to protecting the privacy of information we gather about you while providing health-related services.  Some examples of protected health information include information indicating that you are a patient of our medical group or receiving health-related services from our facilities, information about your health condition, genetic information, or information about your health care benefits under an insurance plan, each when combined with identifying information, such as your name, address, social security number or phone number.

REQUIREMENT FOR WRITTEN AUTHORIZATION

Generally, we will obtain your written authorization before using your health information or sharing it with others outside of our medical group.  There are certain situations where we must obtain your written authorization before using your health information or sharing it, including:

Most Uses of Psychotherapy Notes, when appropriate.

Marketing. We may not disclose any of your health information for marketing purposes if our medical group will receive direct or indirect financial payment not reasonably related to our medical group’s cost of making the communication.

Sale of Protected Health Information. We will not sell your protected health information to third parties.  The sale of protected health information, however, does not include a disclosure for public health purposes, for research purposes where our medical group will only receive payment for our costs to prepare and transmit the health information, for treatment and payment purposes, for the sale, transfer, merger or consolidation of all or part of our medical group, for a business associate or its subcontractor to perform health care functions on our medical group’s behalf, or for other purposes as required and permitted by law.

WRITTEN AUTHORIZATION

If you provide us with written authorization, you may revoke that written authorization at any time, except to the extent that we have already relied upon it.  To revoke a written authorization, please write to the Privacy Officer at our medical group. You may also initiate the transfer of your records to another person by completing a written authorization form.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION WITHOUT YOUR WRITTEN AUTHORIZATION

There are some situations when we do not need your written authorization before using your health information or sharing it with others, including:

1. Treatment, Payment and Health Care Operations. Treatment.  We may share your health information with providers at the medical group who are involved in taking care of you, and they may in turn use that information to diagnose or treat you.  A provider in our medical group may share your health information with another provider to determine how to diagnose or treat you.  Your provider may also share your health information with another provider to whom you have been referred for further health care. Payment.  We may use your health information or share it with others so that we may obtain payment for your health care services.  For example, we may share information about you with your health insurance company in order to obtain reimbursement after we have treated you.  In some cases, we may share information about you with your health insurance company to determine whether it will cover your treatment. Health Care Operations.  We may use your health information or share it with others in order to conduct our business operations.  For example, we may use your health information to evaluate the performance of our staff in caring for you, or to educate our staff on how to improve the care they provide for you.
2. Appointment Reminders, Treatment Alternatives, Benefits and Services.  In the course of providing treatment to you, we may use your health information to contact you with a reminder that you have an appointment for treatment, services or refills or in order to recommend possible treatment alternatives or health-related benefits and services that may be of interest to you.
3. Business Associates.  We may disclose your health information to contractors, agents and other “business associates” who need the information in order to assist us with obtaining payment or carrying out our business operations.  For example, we may share your health information with a billing company that helps us to obtain payment from your insurance company, or we may share your health information with an accounting firm or law firm that provides professional advice to us. Business associates are required by law to abide by the HIPAA regulations. If we do disclose your health information to a business associate, we will have a written contract to ensure that our business associate also protects the privacy of your health information. If our business associate discloses your health information to a subcontractor or vendor, the business associate will have a written contract to ensure that the subcontractor or vendor also protects the privacy of the information.
4. Friends and Family Designated to be Involved in Your Care.  If you have not voiced an objection, we may share your health information with a family member, relative, or close personal friend who is involved in your care or payment for your care, including following your death.
5. Proof of Immunization. We may disclose proof a child’s immunization to a school, about a child who is a student or prospective student of the school, as required by State or other law, if a parent, guardian, other person acting in loco parentis, or an emancipated minor, authorizes us to do so, but we do not need written authorization. The authorization may be oral.
6. Emergencies or Public Need.Emergencies or as Required by Law.  We may use or disclose your health information if you need emergency treatment or if we are required by law to treat you. We may use or disclose your health information if we are required by law to do so, and we will notify you of these uses and disclosures if notice is required by law. Public Health Activities.  We may disclose your health information to authorized public health officials (or a foreign government agency collaborating with such officials) so they may carry out their public health activities under law, such as controlling disease or public health hazards.  We may also disclose your health information to a person who may have been exposed to a communicable disease or be at risk for contracting or spreading the disease if permitted by law.  We may disclose a child’s proof of immunization to a school, if required by State or other law, if we obtain and document the agreement for disclosure (which may be oral) from the parent, guardian, person acting in loco parentis, an emancipated minor or an adult. And finally, we may release some health information about you to your employer if your employer hires us to provide you with a physical exam and we discover that you have a work related injury or disease that your employer must know about in order to comply with employment laws. Victims of Abuse, Neglect or Domestic Violence.  We may release your health information to a public health authority authorized to receive reports of abuse, neglect or domestic violence.
7. Health Oversight Activities.  We may release your health information to government agencies authorized to conduct audits, investigations, and inspections of our facilities.  These government agencies monitor the operation of the health care system, government benefit programs such as Medicare and Medicaid, and compliance with government regulatory programs and civil rights laws. Lawsuits and Disputes.  We may disclose your health information if we are ordered to do so by a court or administrative tribunal that is handling a lawsuit or other dispute.  We may also disclose your information in response to a subpoena, discovery request, or other lawful request by someone else involved in the dispute, but only if required judicial or other approval or necessary authorization is obtained. Law Enforcement.  We may disclose your health information to law enforcement officials for certain reasons, such as complying with court orders, assisting in the identification of fugitives or the location of missing persons, if we suspect that your death resulted from a crime, or if necessary, to report a crime that occurred on our property or off-site in a medical emergency. To Avert a Serious and Imminent Threat to Health or Safety.  We may use your health information or share it with others when necessary to prevent a serious and imminent threat to your health or safety, or the health or safety of another person or the public.  In such cases, we will only share your information with someone able to help prevent the threat.  We may also disclose your health information to law enforcement officers if you tell us that you participated in a violent crime that may have caused serious physical harm to another person (unless you admitted that fact while in counseling), or if we determine that you escaped from lawful custody (such as a prison or mental health institution). National Security and Intelligence Activities or Protective Services.  We may disclose your health information to authorized federal officials who are conducting national security and intelligence activities or providing protective services to the President or other important officials. Military and Veterans.  If you are in the Armed Forces, we may disclose health information about you to appropriate military command authorities for activities they deem necessary to carry out their military mission.  We may also release health information about foreign military personnel to the appropriate foreign military authority. Inmates and Correctional Institutions.  If you are an inmate or you are detained by a law enforcement officer, we may disclose your health information to the prison officers or law enforcement officers if necessary to provide you with health care, or to maintain safety, security and good order at the place where you are confined.  This includes sharing information that is necessary to protect the health and safety of other inmates or persons involved in supervising or transporting inmates.Workers’ Compensation.  We may disclose your health information for workers’ compensation or similar programs that provide benefits for work-related injuries.Coroners, Medical Examiners and Funeral Directors.  In the event of your death, we may disclose your health information to a coroner or medical examiner.  We may also release this information to funeral directors as necessary to carry out their duties.

   Organ and Tissue Donation.  In the event of your death or impending death, we may disclose your health information to organizations that procure or store organs, eyes or other tissues so that these organizations may investigate whether donation or transplantation is possible under applicable laws.

8. Completely De-identified or Partially De-identified Information.  We may use and disclose your health information if we have removed any information that has the potential to identify you so that the health information is “completely de-identified.”  We may also use and disclose “partially de-identified” health information about you if the person who will receive the information signs an agreement to protect the privacy of the information as required by federal and state law.  Partially de-identified health information will not contain any information that would directly identify you (such as your name, street address, social security number, phone number, fax number, electronic mail address, website address, or license number).
9. Incidental Disclosures.  While we will take reasonable steps to safeguard the privacy of your health information, certain disclosures of your health information may occur during or as an unavoidable result of our otherwise permissible uses or disclosures of your health information.  For example, during the course of a treatment session, other patients in the treatment area may see, or overhear discussion of, your health information.
10. Fundraising. We may use or disclose your demographic information, including, name, address, other contact information, age, gender, and date of birth, dates of health service information, department of service information, treating physician, outcome information, and health insurance status for fundraising purposes. With each fundraising communication made to you, you will have the opportunity to opt-out of receiving any further fundraising communications. We will also provide you with an opportunity to opt back in to receive such communications if you should choose to do so.
11. Changes to This Notice.  We reserve the right to change this notice at any time and to make the revised or changed notice effective in the future.

YOUR RIGHTS TO ACCESS AND CONTROL YOUR HEALTH INFORMATION

You have the following rights to access and control your health information:

1. Right to Inspect and Copy Records.  You have the right to inspect and obtain a copy of any of your health information that may be used to make decisions about you and your treatment for as long as we maintain this information in our records, including medical and billing records.  To inspect or obtain a copy of your health information, please submit your request in writing to the Privacy Officer. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies we use to fulfill your request.  If you would like an electronic copy of your health information, we will provide you a copy in electronic form and format as requested as long as we can readily produce such information in the form requested.  Otherwise, we will cooperate with you to provide a readable electronic form and format as agreed. In some limited circumstances, we may deny the request.
2. Right to Amend Records.  If you believe that the health information we have about you is incorrect or incomplete, you may ask us to amend the information for as long as the information is kept in our records by writing to us. Your request should include the reasons why you think we should make the amendment.  If we deny part or all of your request, we will provide a written notice that explains our reasons for doing so.  You will have the right to have certain information related to your requested amendment included in your records.
3. Right to an Accounting of Disclosures.  You have a right to request an “accounting of disclosures,” which is a list with information about how we have shared your health information with others.  To obtain a request form for an accounting of disclosures, please write to the Privacy Officer.  You have a right to receive one list every 12-month period for free.  However, we may charge you for the cost of providing any additional lists in that same 12-month period.
4. Right to Receive Notification of a Breach.  You have the right to be notified within sixty (60) days of the discovery of a breach of your unsecured protected health information if there is more than a low probability the information has been compromised.  The notice will include a description of what happened, including the date, the type of information involved in the breach, steps you should take to protect yourself from potential harm, a brief description of the investigation into the breach, mitigation of harm to you and protection against further breaches and contact procedures to answer your questions.
5. Right to Request Restrictions.  You have the right to request that we further restrict the way we use and disclose your health information to treat your condition, collect payment for that treatment, run our normal business operations or disclose information about you to family or friends involved in your care.  You also have the right to request that your health information not be disclosed to a health plan if you have paid for the services out of pocket and in full, and the disclosure is not otherwise required by law.  The request for restriction will only be applicable to that particular service.  You will have to request a restriction for each service thereafter.  To request restrictions, please write to the Privacy Officer. We are not required to agree to your request for a restriction, and in some cases the restriction you request may not be permitted under law.However, if we do agree, we will be bound by our agreement unless the information is needed to provide you with emergency treatment or comply with the law.  Once we have agreed to a restriction, you have the right to revoke the restriction at any time.  Under some circumstances, we will also have the right to revoke the restriction as long as we notify you before doing so.
6. Right to Request Confidential Communications. You have the right to request that we contact you about your medical matters in a more confidential way, such as calling you at work instead of at home, by notifying the registration associate who is assisting you.  We will not ask you the reason for your request, and we will try to accommodate all reasonable requests.
7. Right to Have Someone Act on Your Behalf.  You have the right to name a personal representative who may act on your behalf to control the privacy of your health information.  Parents and guardians will generally have the right to control the privacy of health information about minors unless the minors are permitted by law to act on their own behalf.
8. Right to Obtain a Copy of Notices.  If you are receiving this Notice electronically, you have the right to a paper copy of this Notice.  We may change our privacy practices from time to time.  If we do, we will revise this Notice and post any revised Notice in our registration area and on our website.
9. Right to File a Complaint.  If you believe your privacy rights have been violated, you may file a complaint with us by calling the Privacy Officer at 781-803-2786, or with the Secretary of the Department of Health and Human Services. We will not withhold treatment or take action against you for filing a complaint.
10. Use and Disclosures Where Special Protections May Apply.  Some kinds of information, such as HIV-related information, alcohol and substance abuse treatment information, mental health information, psychotherapy information, and genetic information, are considered so sensitive that state or federal laws provide special protections for them.  Therefore, some parts of this general Notice of Privacy Practices may not apply to these types of information.  If you have questions or concerns about the ways these types of information may be used or disclosed, please speak with your health care provider.

Medical Associations and Affilations

• American Academy of Family Physicians (AAFP)
• American Academy of Pediatrics (AAP)
• Centers for Disease Control and Prevention (CDC)
• New England Quality Care Alliance (NEQCA)

Emergent Care

• Poison Prevention

American Academy of Pediatrics Dosing Charts

• Tylenol/Acetaminophen
• Advil/Ibuprofen
• Benadryl/Diphenhydramine

Children Resources

• Cerebral Palsy Treatment
• Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
• Head Smart Concussion Handbook
• Healthy Children
• ImPACT Testing

Local Resources for Children and Families Dealing with Serious Illness or Death

• Children’s Emotional Health Link
  The Children’s Emotional Health Link (CEHL) is dedicated to helping parents, pediatricians and other providers improve the emotional health of children and families.
• Comfort Zone Camp
  Comfort Zone Camp if a nonprofit 501(c)3 bereavement camp that transforms the lives of children who have experienced death of a parent, sibling or primary caregiver. The free camp include confidence building programs and age based support groups that break the emotional isolation grief brings. It takes place in Sandwich, MA.
• The Dougy Center
  Information on grieving and referrals to programs nationally for grieving children, teens and their families.
• Good Grief Program
  For twenty years the Good Grief Program has provided a grief support program in Hingham for children aged 5-13 and their parent/guardian (from October-May). It provides a developmentally informed parent consultation to help adults help children facing life’s speed bumps.
• GriefNet
  online groups for grief support
• Grief and Children
  Online grief education, support group curricula and free downloadable resource sheets including one entitled “Navigating Children’s Grief: How to Help Following a Death” (arranged by child’s age).
• GriefWeavers, LLC
  Weymouth and Kingston
  A practice for individuals, couples and groups designed to facilitate the grief process by providing an environment in which bereaved persons can acknowledge, understand and integrate or “weave” grief and loss into their lives.
• Helping Children Cope With Loss
  **This website has a link to an extensive list of books about illness and grieving for children and adults.**
  Rockland, MA
  Free, community based program. It is a single session arts and imagination based program for children aged 6-10 who have lost a loved one. The mission is to help families learn the skills to converse with their children about feelings, fears and ways to cope.
• Hope Floats Healing and Wellness Center
  Kingston
  An educational center for individuals and families who are grieving or face other life challenges. The center helps people cope with bereavement, improve their wellness and explore mind, body and spirit connections.
• National Alliance for Grieving Children (NAGC)
  Promotes awareness of the needs of children and teens grieving a death and provides education and resources for anyone who wants support.