Evening and
weekend
Adult and Pediatric
Urgent Care by
appointment.


Addresses

322 E. Center
Street
West Bridgewater, MA
02379

1215 Broadway
Raynham, MA 02767

New England Sinai Hospital
150 York Street
Stoughton, MA 02072

HIPAA

Bridgewater Goddard Park Medical Associates, Inc. NOTICE Of PRIVACY PRACTICES

Download Download the Bridgewater Goddard Park Medical Associates, Inc. HIPAA Document Click Here

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.

BGPMA complies with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regarding the security and confidentiality of confidential patient medical information. The following is a summary of your rights regarding the privacy of your healthcare information.

“Protected Healthcare Information” (PHI)

RE: Patient medical record releases and disclosures

1. Uses and Disclosures of Protected Health Information

- As permitted by HIPAA, your protected health information (PHI) may be used and disclosed without your specific authorization by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing quality health care services to you.
- Your PHI may also be used and disclosed without your specific authorization to support the normal business operations of our medical practice which includes information used to process healthcare claims, participation with government compliance activities to prevent fraud and abuse, physician licensure and accreditation, peer review and other payment and healthcare operations activities, as permitted by HIPAA.
- You may at any time request a listing of our business associates and normal business activities and policies and procedures which may require the disclosure of your PHI.
- We will make reasonable efforts to communicate your rights in a language you understand.
- We will only disclose information to someone other than the patient if the patient has designated that individual as an authorized party to receive PHI.
- In the event of an emergency, we may use and disclose your PHI. We will make all reasonable efforts to secure authorization from you prior to treatment. However, if you are unable to provide authorization, we will only disclose what is minimally necessary to ensure your safety and will notify you of the disclosed PHI when it is more appropriate.

2. Treatment

- We may use and disclose your PHI to third parties, such as physicians, specialists, laboratory and hospital personnel in order to provide, manage and/or coordinate your health care and other related services.

3. Payment

- Your PHI may be used and disclosed to obtain payment for your healthcare services. This may include your insurance company reviewing your medical record for medical necessity and utilization review activities before determining your eligibility for coverage.
- Your PHI may be used or disclosed by us or our business associates to comply with worker’s compensation laws and other similar legally established programs (FMLA, ADA,ERISA, State Law, Disability)

4. Healthcare and Business Operations

- We, or our business associates on our behalf, may use or disclose your PHI in order to support the business activities of our medical practice. These activities include, but are not limited to, quality assessment activities, training of medical students, government compliance activities, internal clinical studies, utilization review, disease management, etc.

- We, or our business associates on our behalf, may use or disclose your PHI, as necessary, to provide you with educational information about treatment alternatives, other health-related information and/or information about our organization that we believe will be beneficial to you.

- You may contact our Privacy Officer if you do not wish to receive these materials.

5. Federal, State and Local Law

- We, or our business associates on our behalf, may use or disclose your PHI to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.

6. Public Health

- We or our business associates on our behalf, may disclose your PHI to a public health authority as required by law for purposes of controlling disease, injury or disability.

7. Communicable Diseases

- We, or our business associates on our behalf, may disclose your PHI, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

8. Government Agencies

- We, or our business associates on our behalf, may disclose PHI to a government health oversight agency which oversees the healthcare system, its government benefit and regulatory programs and/or civil rights laws for activities authorized by law, such as, provider chart audits, investigations, and inspections.

9. Abuse or Neglect

- We, or our business associates on our behalf, may disclose your PHI to a public health authority that is authorized by law to receive reports of child or adult abuse, neglect, or domestic violence.

10. Food and Drug Administration

- We, or our business associates on our behalf, may disclose your PHI to a person or company required by the Food and Drug Administration (FDA) to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacement, or to conduct post marketing surveillance.

11. Law Enforcement

- We, or our business associates on our behalf, may also disclose PHI, so long as applicable legal requirements are met, for law enforcement purposes.

12. Legal Proceedings

- We, or our business associates on our behalf, may disclose PHI in the course of any judicial or administrative proceedings, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized) in certain conditions in response to a subpoena, discovery request or other lawful process.

13. Coroners, Funeral Directors, and Organ Donation

- We, or our business associates on our behalf, may disclose PHI to a coroner, medical examiner, and/or funeral director for identification purposes, determining cause of death, for the coroner or medical examiner to perform other duties authorized by law and/or to disclose such information in reasonable anticipation of death.
- PHI may be used and disclosed for cadaveric organ, eye or tissue donation purposes.

14. Research

- We may disclose your PHI to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your PHI.

15. Criminal

- We may disclose your PHI if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose PHI if it is necessary for law enforcement authorities to identify or apprehend an individual.
- We may use or disclose your PHI if you are an inmate of a correctional facility and your physician created or received your PHI in the course of providing care to you.

16. Military Activity and National Security

- We may disclose your PHI for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits or to a foreign military authority if you are a member of that foreign military service. We may also disclose PHI to authorized federal officials for conducting national security and intelligence activities.

“Your Rights”
1. You have the right to inspect , copy, amend and/or restrict use of your PHI.
2. Your physician is not required to agree to accept a request for an amendment or restriction that you may request, especially if the physician believes disclosure of PHI could put a patient in harm’s way. Reasons for request denial will be provided to you in writing.
3. If your physician agrees to a requested restriction, we may not use or disclose your PHI unless it is an emergency.
4. When requesting records you may be asked to provide “proof of identification” such as a:
- Driver’s License
- Social Security Card
- Passport or
- Birth Certificate
5. There may be a reasonable charge for the copying of records as allowed by state law.
6. You may not copy the following records: psychotherapy notes, information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and PHI that is subject to other laws prohibiting access to PHI.
7. You have the right to request to receive confidential information from us by alternative means or at an alternative location. For example, you may ask to discuss your treatment or condition in a private room.
8. You may receive an accounting of certain disclosures we have made, if any, that occur after April 14, 2003, other than for the purposes of treatment, payment or healthcare operations. We are not obligated to re-disclose any information that we have already made to you, to authorized family members or friends involved in your care, or for notification purposes.
9. We cannot be held responsible for PHI given to you initially that may be accidentally read, mishandled, destroyed and/or divulged by you or family members, friends or other parties once in your possession.
10. You have a right to receive a paper copy of this notice if this was sent to you electronically.
11. Every individual has a right receive a notice of their rights. Parents and legal guardians will be asked to sign a notice of patient rights on behalf of their children.
12. “Hotline”
Complaints may be made to us or to the Secretary of Health and Human Services (HHS) or Office of Civil Rights if you believe your privacy rights have been violated. You may file a complaint with us by notifying the office of our Privacy Officer or Kathy Miller, VP of Human Resources/ Patient and Employee Relations at 508-894-0890.