OUTPATIENT LABORATORY
ULTRASOUND AND PLAIN FILMS
NUCLEAR MEDICINE
NERVE CONDUCTION TESTING
HOLTER MONITOR TESTING
MED HEALTH SERVICES


Pricing transparency gets cloudier as health care costs soar
 

Earlier this fall, Highmark Inc. paid Pittsburgh Cardiovascular Institute $581 for doing a nuclear stress test for a patient. The insurer compensated UPMC Monroeville $1,540 for the same procedure — a common measure of how well the heart is working — in another patient.

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Pittsburgh Cardiovascular Institute
200 James Place, 1st Floor
Monroeville, PA 15146
Phone: 412-372-2035 Fax: 412-229-1432
     
 

Pittsburgh Cardiovascular Institute Privacy Policy


 

Pittsburgh Cardiovascular Institute · 200 James Place, 1st Floor · Monroeville, PA 15146

Pittsburgh Cardiovascular Institute is committed to protecting the privacy of your personal and health information. At Pittsburgh Cardiovascular Institute, we are committed to protecting the confidentiality of individuals' diagnostic test results and other patient protected health information (PHI) that we collect or create as part of our diagnostic testing activities.

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.

Pittsburgh Cardiovascular Institute 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 that we maintain. Your doctor may have different notices regarding his/her use and disclosure of your PHI created in his/her office.

Pittsburgh Cardiovascular Institute is required by law to provide you with this Notice of Privacy Practices with respect to PHI, to maintain the privacy of PHI, to state the uses and disclosures of PHI that Pittsburgh Cardiovascular Institute may make, and to list the rights of individuals and our legal duties with respect to their PHI. Your PHI at Pittsburgh Cardiovascular Institue includes personal and medical information (such as your name, address, date of birth, test ordered, etc.) that we obtain from you, your physician, health plan, or other sources. Your PHI also includes the diagnostic testing results that we create. An example of PHI is as follows: Jane Doe, Date of Birth: 2/15/68, resides at 123 Mosside Street, Monroeville, PA, along with the attached testing results.

Pittsburgh Cardiovascular Institute is required 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. The current Notice will be displayed on our website and a copy is available upon request.

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 required 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 example, patient authorization is often required by state law for each release of HIV test results, except if the results are being released to public health officials as required by law. You have the right to revoke your authorization at any time, except if we have already made a disclosure based on that authorization. We do not need your authorization or permission to use or disclose your PHI for the following purposes:

· For Treatment

As a health care provider that provides diagnostic testing for ordering physicians, Pittsburgh Cardiovascular Institute 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 diagnostic results to treat you. In addition to your treating physician, we may provide a specialist physician with information about your results to further validate the results before release to your physician. Occasionally, we may contact you to arrange for retesting.

· 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 our services. For example, we may send your name, date of service, test performed, diagnosis code, and other information to a health plan so that the plan will pay us for the services we provided. 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 your 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

Pittsburgh Cardiovascular Institute may disclose your PHI to other companies or individuals who need your PHI in order to provide specific services to us. These other entities, known 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. For example, we may disclose your PHI to temporary employees or to accreditation bodies such as the American College of Radiology and/or College of American Pathologists (CAP) or other private accrediting organizations that inspect and certify the quality of our diagnostic testing laboratories.

· 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. For example, we are required to disclose your PHI to the Secretary of the U.S. Department of Health and Human Services ("HHS") upon request. We must provide you with copies of your PHI at your request, except where restricted or prohibited by state law. We will provide the information regarding your specific state to you upon request.

· Public Health

We may disclose your PHI when reporting communicable disease results to public health departments as required by law, for example, gonorrhea. We may disclose your PHI for FDA reporting purposes.

· Public Safety

When the appropriate conditions apply, we may use or disclose PHI to prevent or lessen a serious and 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 your 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. For example, we may disclose your PHI in an investigation regarding a physician's license.

· Health Oversight

We may disclose your PHI in connection with governmental oversight, licensure, auditing, and other purposes. For example, governmental agencies periodically review our records to ensure that Pittsburgh Cardiovascular Institute is complying with the rules of various regulatory and licensing agencies. Other agencies may audit our billing and laboratory records to verify that the health care was provided as claimed or that we were paid correctly.

· Judicial and Administrative Proceedings

We may disclose your PHI as required to comply with 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. For example, we may be required to release PHI as required by law or in compliance with a court order, judicial subpoena, court-ordered warrant, grand jury subpoena, administrative request, investigative demand or similar legal process, but only if efforts have been made to tell you about the request or to obtain an order of protection for the requested information. We may release PHI for other law enforcement purposes, such as to identify or locate a suspect, fugitive, material witness, or missing person.

· Specialized Government Functions

We may disclose your PHI for military and veterans activities, national security or intelligence purposes, 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. For example, workers compensation programs may require that we provide the results of diagnostic testing as part of the case file.

· We may contact you for specific reason

Although we do not do so today, we may want to contact you in the future regarding health-related products or services that may be of interest to you.

Your rights concerning privacy and confidentiality:

· Access

You or your authorized or designated personal representative have the right to inspect and copy your PHI.

· Amendments

You have the right to request amendments to your PHI (but we are not required to make the requested amendments).

· 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 Pittsburgh Cardiovascular Institute or the Secretary of the U.S. Department of Health and Human Services. Pittsburgh Cardiovascular Institute will not retaliate against any individual for filing a complaint. You may also file a complaint by calling us directly.

· How to exercise your rights

Write to us with your specific written request and be sure to include sufficient information for us to identify all of your records. Pittsburgh Cardiovascular Institute will consider your request and provide you a response within a reasonable timeframe.

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 or contact us here.

Pittsburgh Cardiovascular Institute 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 Protected Health Information (PHI) that we maintain including PHI we created or received prior to the effective date of the Notice revision.