Refer a Patient

Privacy Policy

Notice of Privacy Practices

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.

1. We have a legal duty to safeguard your protected health information (phi).

We are legally required to protect the privacy of your health information. We call this information "protected health information," or "PHI" for short, and it includes information that can be used to identify you that we've created or received about your past, present, or future health condition, the provision of health care to you, or the payment for this heath care. We must provide you with this notice about our privacy practices that explains how, when, and why we use and disclose your PHI. With some exceptions, we may not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure. We are legally required to follow the privacy practices that are described in this notice.

However, we reserve the right to change the terms of this notice and our privacy policies at any time. Any changes will apply to the PHI we already have. Before we make an important change to our policies, we will promptly change this notice. You can request a copy of this notice by calling the Privacy Officer at (856) 552-1300 at any time and can view a copy of this notice on our website at

2. How we may use and disclose your protected health information

We use and disclose health information for many different reasons. For some of these uses or disclosures, we need your specific authorization. Below, we describe the different categories of uses and disclosures.

A. Uses and Disclosures For Treatment, Payment, or Healthcare Operations

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

1. For Treatment. We may disclose your PHI to physicians, nurses, and other health care personnel who provide you with health care services or are involved in your care. For example, we meet regularly to coordinate patient care and schedule visits.

2. To obtain payment for treatment. We may use and disclose your PHI in order to bill and collect payment for the treatment and services provided to you. For example, we may provide portions of your PHI to our billing department and your health plan to receive payment for the health care services we provided to you

3. For healthcare operations. We may disclose your PHI in order to operate this agency. We may use your PHI as a part of general agency administrative and business functions, quality assessment/performance improvement activities, medical review, auditing functions, determining the competence of health care professionals; evaluating agency performance; conducting training programs with students or new employees; licensing, survey, certification, accreditation and credentialing activities; and certain fundraising and marketing activities. For example, our agency periodically holds clinical record review meetings where staff of several disciplines audit clinical records for clinical standards and effective outcomes.

B. Other Uses and Disclosures

1. When a disclosure is required by federal, state or local law, judicial or administrative proceedings, or law enforcement. For example, we make disclosures when a law requires that we report information to government agencies and law enforcement personnel about victims of abuse, neglect, or domestic violence; when dealing with gunshot or other wounds; or when ordered in a judicial of administrative proceeding.

2. For public health activities. For example, we report information about births, deaths, and various diseases to government officials in charge of collecting that information, and we provide coroners, medical examiners, and funeral directors necessary information relating to an individual's death.

3. For health oversight activities. For example, we will provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization.

4. For purposes of organ donation. We may notify organ procurement organizations to assist them in organ, eye, or tissue donation and transplants.

5. For research purposes. In certain circumstances, we may provide PHI in order to conduct medical research.

6. To avoid harm. In order to avoid a serious threat to the health or safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.

7. For specific government functions. We may disclose PHI of military personnel and veterans in certain situations. And we may disclose PHI for national security purposes, such as protecting the President of the United States or conducting intelligence operations.

8. For workers' compensation purposes. We may provide PHI in order to comply with workers' compensation laws.

9. Decedents. We may provide PHI to a coroner, medical examiner or funeral director for purposes of their duties.

10. Appointment reminders and health-related benefits or services. We may use PHI to provide appointment reminders or give you information about treatment alternatives, or other health care services or benefits we offer.

C. Uses and Disclosures When You Have the Opportunity to Object:

1. Disclosures to family, friends, or others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part.

D. All Other uses and Disclosures Require Your Prior Written Authorization. In any other situation not described above, we will ask for your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you can later revoke that authorization in writing to stop any future uses and disclosures (to the extent that we haven't taken any action relying on the authorization).

3. Limitations on use and disclosure

If a use or disclosure of PHI identified in this notice is subject to a law more stringent than HIPAA, the more stringent law will apply.

4. What rights you have regarding your PHI.

You have the following rights with respect to your PHI:

A. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask that we limit how we use and disclose your PHI. We will consider your request but are not legally required to accept it. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make.

B. The Right to Choose How We Send PHI to You. You have the right to ask that we send information to you to an alternative address (to your work address) or by alternative means. Your request must be in writing. We will attempt to honor your request.

C. The Right to See and Get Copies of Your PHI. In most cases, you have the right to look at or get copies of your PHI, but you must make the request in writing. If we don't have your PHI but we know who does, we will tell you how to get it. We will respond to you within 30 days after receiving your written request. In certain situations, we may deny your request. If we do, we will tell you, in writing, our reasons for the denial and explain your right to have the denial reviewed.

If you request copies of your PHI, we will charge you a reasonable fee. Instead of providing the PHI you requested, we may provide you with a summary or explanation of the PHI as long as you agree to that and to the cost in advance.

D. The Right to Receive an Accounting of the Disclosures We have Made. You have the right to get a list of instances in which we have disclosed your PHI. The list will not include uses or disclosures made for treatment, payment, or health care operations, directly to you, to your family, or pursuant to a valid uthorization. The list also won't include uses or disclosures made for national security purposes, to corrections or law enforcement personnel, or before 14 April, 2003. We will respond within 60 days of receiving your request. The list we will give you will include disclosures made in the last six years unless you request a shorter time. The list will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. We will provide the first accounting to you at no charge, but if you make more than one request in the same year, we will charge you a reasonable fee for each additional request.

E. The Right to Amend Your PHI. If you believe that there is a mistake in your PHI or that a piece of important information is missing, you have the right to request that we correct the existing information or add the missing information. We will respond within 60 days of receiving your request in writing. You must provide the request and your reason for the request in writing. We may deny your request in writing if the PHI is (i) correct and complete, (ii) not created by us, (iii) not allowed to be disclosed, or (iv) not part of our records. Our written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you don't file one, you have the right to request that your request and our denial be attached to all future disclosures of your PHI. If we approve your request, we will make the change to your PHI, tell you that we have done it, and tell others that need to know about the change to your PHI.

F. The Right to Get this Notice by E-Mail. You have the right to get a copy of this notice by e-mail. You also have the right to receive a paper copy of this notice.

5. How to make a complaint about our privacy practices

If you believe your privacy rights have been violated, you may complain to our agency or to the Office for Civil Rights. There will be no retaliation against you for filing a complaint.

A complaint to the government must be in writing and filed within 180 days of when the act or omission happened and must describe the act or omission that violated your privacy.


Office for Civil Rights
US Department of Health and Human Services
Jacob Javits Federal Building
26 Federal Plaza - Suite 3312 New York, NY 10278
Voice Phone: 212-264-3313
Fax: 212-264-3039
TDD: 212-264-2355

If you have any questions about this notice or any complaint about our privacy practices, please call Moorestown VNA at (856) 552-1300 and ask for the Privacy Officer. You may write the Privacy Officer at:
300 Harper Dr. Moorestown, NJ 08057.

6. Effective date of this notice:

14 April 2003.