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Notice of Privacy Practices

This Notice describes how protected health information about you may be used and disclosed and how you may obtain access to this information. Please review it carefully.

I. What is the Notice of Privacy Practices?

This Notice of Privacy Practices (the “Notice”) describes the commitment of PM Pediatric Care, PM Pediatrics, Children’s Health℠ PM Urgent Care, Pediatric Medical Urgent Care, and WakeMed Children’s PM Pediatrics Urgent Care (referred to as “we,” “us” or “our” in this Notice) to protect the privacy and confidentiality of our patients’ information. For purposes of this Notice, when we refer to “you” or “your,” we mean you as a patient or you as the provider of information about a minor patient. This Notice explains our confidentiality practices, the ways we may use and share patients’ information under the law and your right to access and control this information. This Notice also describes the nature of our participation with one or more health information exchanges (“HIEs”), and explains how we may use and disclose your PHI electronically through the HIEs unless you affirmatively opt out.

In this Notice, “protected health information” or “PHI” refers to any individually identifiable information that we obtain from you or another person that relates to your past, present or future physical or mental health conditions, the health care you have received or the payment for your care. Protected health information includes, but is not limited to:

II. Who Must Follow this Notice of Privacy Practices?

The practices described in this Notice will be followed by all of our employees, healthcare professionals, trainees, students, volunteers, independent contractors and business associates (collectively referred to as “Personnel” in this Notice).

III. Overview.

This Overview is a summary of the remainder of the Notice. This Overview summarizes the ways that we may use and share your PHI and your rights to access and control this information. For more details, please read sections IV through VII of this Notice.

We may use and disclose your PHI without your prior authorization for the following purposes:

All of our patients have the following rights regarding their PHI. We may ask you to submit a written request to enforce any of these rights:

IV. Ways We May Use and Share Your Protected Health Information.

We may use and share your PHI for certain purposes allowed by law. This section describes the purposes for which we may use or disclose your PHI without your prior specific authorization. Not every permissible use or disclosure is listed. However, every permitted use or disclosure will fall within at least one of the following categories:

V. Disclosure of Your Protected Health Information in Special Situations.

VI. Uses and Disclosures Requiring Your Written Authorization.

VII. Your Rights with Regard to Your Protected Health Information.

Centralized Case Management Operations
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Room 509F HHH Bldg.
Washington D.C. 20201

VIII. Future Changes to the Notice of Privacy Practices.

We reserve the right to change this Notice and its practices without providing you notice. We reserve the right to make a revised Notice effective for the PHI we already have about you and any PHI we receive in the future. You may request a written copy of the current Notice of Privacy Practices at any time from the Compliance Department. The current Notice will also be posted on our website at www.pmpediatriccare.com.

IX. Contact

If you have questions or requests regarding this Notice of Privacy Practices, you may contact us by calling our corporate office at (516) 869-0650 or sending a letter to One Hollow Lane, Suite 301, Lake Success, NY 11042. This Notice of Privacy Practices may not be used or reproduced without our prior written consent.