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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.

CRISP

We have chosen to participate in the Chesapeake Regional Information System for our patients (CRISP), a regional health information exchange serving Maryland and D.C. As permitted by law, your health information will be shared with this exchange in order to provide faster access, better coordination of care and assist providers and public health officials in making more informed decisions. You may "opt-out" and disable access to your health information available through CRISP by calling 1-877-952-7477 or completing and submitting an Opt-Out form to CRISP by mail, fax or through their website at www.crisphealth.org. Public health reporting and Controlled Dangerous Substances information, as part of the Maryland Prescription Drug Monitoring Program (PDMP), will still be available to providers.

Understanding your health record:

A record is made each time you visit a hospital, physician or other health care provider.   Your symptoms, examination and test results, diagnosis, treatment and a plan for future care are recorded.  This information is most often referred to as your ?health or medical record?, and serves as a basis for planning your care and treatment.  It also serves as a means of communication among any and all other health professionals who may contribute to your care.  Understanding what information is retained in your record and how that information may be used will help you to ensure its accuracy, and enable you to relate to who, what, when, where and why others may be allowed access to your health information.  This effort is being made to assist you in making informed decisions before authorizing the disclosure of your medical information to others.

Understanding your health information rights:

Your health record is the physical property of the health care practitioner or facility that compiled it but the content is about you (or your child), and therefore belongs to you.  You have the right to request restrictions on certain uses and disclosures of your information, and to request amendments be made to your health record.  Your rights include being able to review or obtain a paper copy (at a cost for copying) of your health information, and to be given an account of all disclosures.  You may also request communications of your health information be made by alternative means or to alternative locations.  Other than activity that has already occurred, you may revoke any further authorizations to use or disclose your health information. 

Our responsibilities:

This office is required to maintain the privacy of your health information and to provide you with notice of our legal commitment and privacy practices with respect to the information we collect and maintain about you.  This office is required to abide by the terms of this notice and to notify you if we are unable to grant your requested restrictions or reasonable desires to communicate your health information by alternative means or to alternative locations.

This office reserves the right to change its practices and effect new provisions that enhance the privacy standards of all patient medical information.  In the event that changes are made, this office will post changes either on our web site or in the office.

Other than for reasons described in this notice, this office agrees not to use or disclose your health information without your authorization.

To receive additional information or report a problem

For further explanation of this notice you may contact Stuart B. Taylor, M.D. at Pediatric and Adolescent Care, P.A. 301-869-2292.

 If you believe your privacy rights have been violated, you have the right to file a complaint with our medical office or with the Secretary of Health and Human Services with no fear of retaliation by this office.

Your health information will be used for treatment, payment and health care operations.

Treatment-Information obtained by your health practitioner in this office will be recorded in your medical record and used to determine the course of treatment that should work best for you.  This consists of your physician recording his/her own expectations and those of others involved in providing you care.  The sharing of your health information may progress to others involved in your care, such as specialty physicians or lab technicians.

Payment-Your health care information will be used in order to receive payment for services rendered by this office.  A bill may be sent to either you or a third-party payer with accompanying documentation that identifies you, your diagnosis, procedures performed and supplies used.

Health Care Operations-The medical staff in this office will use your health information to assess the care you received and the outcome of your case compared to others like it.  Your information may be reviewed for risk management of quality improvement purposes in our efforts to continually improve the quality and effectiveness of the care and services we provide.

Contact Us

Pediatric & Adolescent Care, P.A.

(301) 869-2292
903 Russell Avenue, Suite 301 Gaithersburg, MD 20879