490 Boston Post Road, Suite 2002 Sudbury, MA 01776(978) 443-0707
(978) 440-9389

Patient Privacy

This pamphlet describes how medical information about you may be used and disclosed and how you can get access to this information. Please read it carefully.

 

Our Privacy Obligations to You

Protecting your medical information is an important priority for Mill Brook Pediatrics, P.C. This Notice explains what information we collect, with whom we share it, and how you can direct us not to share information with certain parties. We are required by law to:

  • Maintain the privacy of your health and medical information
  • Give you this Notice of our legal duties and privacy practices
  • Follow the terms of this Notice that is currently in effect.

 

What this Privacy Notice Covers

This notice describes the privacy practices of Mill Brook Pediatrics, P.C. and Emerson Office acting as an organized health care arrangement (OHCA)

 

Information Collection and Use

The following categories describe different ways that we use and disclose medical information about you. Please note that not every use or disclosure in a category will be listed. However, all the ways we are permitted to use and disclose information will fall within one of these categories.

 

For Treatment

We may use medical information about you to provide you with treatment and other services. With your consent, we may disclose medical information about you to doctors, nurses, technicians, medical students or other personnel who are involved in taking care of you at the Office or who are involved in taking care of you for follow-up treatment. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. Different departments of the Office also may share information in order to coordinate the different things you need, such as prescriptions, lab work and x-rays.

 

For Payment

We may use and, with your consent, disclose medical information about you so that the treatment and services you receive at the office may be billed to and payment be collected from you, and insurance company, or a third party. For example, we may need to give your health plan information about treatment you received at the Office so your health plan will pay us or reimburse you for the cost of your treatment.

 

For Health Care Operations

We may use and, with your consent, disclose medical information about you for Office operations. These used and disclosures are necessary to run the Office and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you.

 

Appointment Reminders

We may use and disclose your medical information to contact you about appointments for treatment or for medical care at the Office.

 

Individuals Involved in Your Care or Payment for Your Care

Unless you object, we may share your medical information with a friend or family member who is involved in your medical care. If you are incapacitated or in an emergency circumstance, we may use our professional judgment to determine whether a disclosure is in your best interest. We may also give information to someone who helps pay for your care.

 

Public Health Risks

We may disclose your medical information for certain public health activities. These activities generally include the following:

  • To prevent or control disease, injury or disability.
  • To report births and deaths.
  • To report child abuse and neglect, elder abuse and disabled person abuse.
  • To report information about products and services under the jurisdiction of the U.S. Food and Drug Administration.
  • To report abortions to state government agencies as required by law.

 

Health Oversight Activities

Your medical information may be shared with a health oversight agency for activities authorized by law: for example audits, investigations, inspections, and licensing.

 

Law Enforcement

We may disclose your medical information in response to a court order, subpoena, or other lawful process.

 

Coroners, Medical Examiners