38
USES AND DISCLOSURES THAT MAY BE MADE EITHER WITH YOUR AGREEMENT OR THE
OPPORTUNITY TO OBJECT
Unless you object, we may disclose to a member of your family, a relative, a close friend or any other
person you identify, orally or in writing, your health information that directly relates to that person's
involvement in your health care. If you are unable to agree or object to such disclosure, we may disclose
such information as necessary if we determine that it is in your best interest based on our professional
judgment. We may use or disclose your health information to notify or assist in notifying a family
member, personal representative or any other person that is responsible for your care of your location or
general condition.
USES AND DISCLOSURES BASED ON YOUR WRITTEN AUTHORIZATION
Marketing:
We must obtain your written authorization to use and disclose your health information for
most marketing purposes.
Sale of Health Information:
We must obtain your written authorization for any disclosure of your health
information which constitutes a sale of health information.
Other Uses:
Other uses and disclosures of your health information will be made only with your written
authorization, except as described in this notice or as otherwise required or allowed by applicable law.
In the event that we ask for your authorization to use or disclose your health information, we will provide
you with an appropriate authorization form. Once you've given us a written authorization, you can
revoke that authorization at any time, except to the extent that we have taken action in reliance on your
authorization.
INDIVIDUAL RIGHTS
Access:
You have the right to see or get an electronic or paper copy of your health information by
submitting a request to us in writing using the information listed at the end of this notice. There are
certain exceptions to your right to obtain a copy of your health information. For example, we may deny
your request if we believe the disclosure will endanger your life or that of another person. Depending on
the circumstances of the denial, you may have a right to have this decision reviewed. We will charge you
a fee to cover the costs incurred by us in complying with your request.
Disclosure Accounting:
You have the right to an accounting of disclosures of your health information
made by us by submitting a request to us in writing using the information listed at the end of this
notice. This right only applies to instances when we or our business associates disclosed your health
information for purposes other than treatment, payment, health care operations, upon your written
authorization, and certain other activities. The right to receive this information is subject to certain
exceptions, restrictions and limitations. You must specify a time period, which may not be longer than 6
years. You may request a shorter timeframe. You have the right to one free request within any 12-month
period, but we may charge you for any additional requests in the same 12-month period. We will notify
you about any such charges, and you are free to withdraw or modify your request in writing before any
charges are incurred.
Restriction Requests:
You have the right to request restrictions on the use and disclosure of your health
information by submitting a request to us in writing using the information listed at the end of this notice.
Your request must state the specific restriction requested and to whom you want the restriction to apply.
We are not required to agree to these additional restrictions, except we must agree not to disclose your
health information to your health plan if the disclosure (1) is for payment or health care operations and
is not otherwise required by law, and (2) relates to a health care item or service which you paid for in
full out of pocket. If we agree to a restriction, we will abide by our agreement (except in an emergency).
Confidential Communication:
You have the right to receive certain communications confidentially. That
means you can request that we communicate with you by alternative means or to an alternative location
by submitting a request to us in writing using the information listed at the end of this notice. We will
accommodate your request if it is reasonable and specifies the alternative means or location. We may
also condition this accommodation by asking you for information as to how payment will be handled.
Amendment:
You have the right to amend your health information in our records for as long as we
maintain the information. You must make a request in writing, using the information listed at the end
of this notice, to obtain an amendment. Your written request must explain why the information should
be amended. If we agree to amend your health information we will make reasonable efforts to inform
others of the amendment and to include the changes in any future disclosures of that information.
We may deny your request if, for example, we determine that your health information is accurate and
complete. If we deny your request, we will send you a written explanation and allow you to submit a
written statement of disagreement to be appended to the information you want amended.
Paper Notice:
If you receive this notice electronically you are entitled to receive this notice in written
form. Please contact us using the information listed at the end of this notice to obtain this notice in
written form.
Breach:
You have the right to be notified if you are affected by a breach of unsecured health information.
QUESTIONS AND COMPLAINTS
If you want more information about our privacy practices or have questions or concerns, please contact
us using the information listed at the end of this notice. If you are concerned that we may have violated
your privacy rights, or you disagree with a decision we made about your rights to your health information
you may complain to us using the information listed at the end of this notice. You may also complain to
the U.S. Department of Health and Human Services. We support your right to protect the privacy of your
health information. We will not retaliate against you in any way if you choose to file a complaint with us
or with the U.S. Department of Health and Human Services.
CONTACT INFORMATION
BioTelemetry, Inc.
Privacy Officer
1000 Cedar Hollow Road, Suite 102
Malvern, PA 19355
Telephone: 610.729.7000
Email: [email protected]
Update Effective date: August 30, 2017
