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Naugatuck Valley Surgical Center
Privacy Notice

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.

This Privacy Notice concerns the practices of Naugatuck Valley Surgical Center (“NVSC”) and SurgiCenter Anesthesiologists, P.C. (“SCA”). NVSC and SCA strongly believe in protecting the confidentiality and security of information we collect about you. This Notice refers to NVSC and SCA by using the terms “us,” “we,” or “our.” NVSC and SCA have an organized health care arrangement for purposes of sharing protected health information only and are otherwise independent of one another. Nothing in this Notice should be construed to create or imply any agency, partnership or joint venture between the entities.

This Privacy Notice is being provided to you as a requirement of a federal law, the Health Insurance Portability and Accountability Act (“HIPAA”). This Privacy Notice describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required
by law. It also describes your rights to access and control your protected health information in some cases. Your “protected health information” is information, including demographic data, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

  I.   Uses and Disclosures of Protected Health Information

NVSC and SCA may use your protected health information for purposes of providing treatment, obtaining payment for treatment, and conducting health care operations. Your protected health information may be used or disclosed only for these purposes unless we have obtained your authorization or the use or disclosure is otherwise permitted by the HIPAA privacy regulations or state law. Disclosures of your protected health information for the purposes described in this
Privacy Notice may be made in writing, orally, by electronic transmission or by facsimile.

  A. Treatment.   We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party for treatment purposes. For example, we may disclose your protected health information to a pharmacy to fill a prescription or to a laboratory to order a blood test. We may also disclose protected health information to physicians who may be treating you or consulting with the facility with respect to your care. In some cases, we may also disclose your protected health information to an outside treatment provider for purposes of the treatment activities of the other provider.

  B. Payment.   Your protected health information will be used, as needed, to obtain payment for the services that we provide. This may include certain communications to your health insurance company to get approval for the procedure that we have scheduled. For

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