Privacy Notice


Effective Date:  July 1, 2012



We know that information about you and your health is personal.  We will protect your medical information.  We keep a record of the care and services you receive through Lancaster Cleft Palate Clinic. The law requires us to keep this record. We also use it to give you quality care.  This notice applies to all records of your care created by Lancaster Cleft Palate Clinic.  Records include those made by health care staff or your doctor.  State and Federal Law requires us to keep private any identifiable medical information.  We must also give you this explanation of our duties and practices relating to your medical information and we must follow the terms of the current notice.  We reserve the right to change this notice.  Information we already have about you or that we may receive in the future is covered if we decide to change this notice.  We will post a copy of the most recent notice at Lancaster Cleft Palate Clinic.


For Treatment:  We may use and reveal your medical information to give you treatment or services.  All Lancaster Cleft Palate Clinic health care providers may disclose your medical information to manage your care.  This could include prescriptions, lab work and x-rays.  Also, we may disclose your medical information with others who may be involved in your medical care after you leave.  This could include disclosing your medical information to a doctor, nursing home or home health agency that is providing follow-up care.

For PaymentWe may use and disclose your medical information relating to the billing and payment of treatment and services you received through Lancaster Cleft Palate Clinic.  Payment may be collected from you, an insurance company, or another party.  For example, we may need to give your health plan information about treatment you received so they will either pay us or repay you.  We may also tell your health plan about a treatment you are going to receive to get pre-approval or determine if your plan will cover the treatment.

For Health Care Operations:  We may use and disclose medical information about you to manage our organizations and make sure that everyone gets quality care.  For example, we may use this information to evaluate our own treatment and services.  We may also disclose information with doctors, nurses, technicians, medical students, and other Lancaster Cleft Palate Clinic staff for educational purposes, or combine our medical information with that from other health care providers to see how we are doing and where we can improve.  We may remove identifiable information so others may study health care and health care delivery.


Right to Inspect and Copy:  In most cases, you can inspect and/or get a copy of your official medical and billing records.  You may be charged a fee for this service.

Right to AmendIf you feel that your official medical and billing records are wrong or incomplete, you may ask us to make changes.

Right to an Accounting of Disclosures:  You have the right to ask for an “accounting of disclosures.”  This is a list of the releases we made of your official medical and billing records for reasons other than treatment, payment or related healthcare operations purposes.  We may charge a fee for this information.

Right to Request Restrictions:  You have the right to ask us not to use your medical information in certain ways.  Lancaster Cleft Palate Clinic does not have to agree.  If we do agree, we will do what you ask unless the information is needed for your emergency medical treatment.

Right to Request Confidential Communications:  You can ask that we contact you about medical matters in a specific way.  For example, you can ask that we only call you at work or contact you through the mail.

Right to Obtain a Paper Copy of This Notice.  You may ask for a paper copy of this notice even if you have agreed to accept this notice electronically.


Appointment RemindersWe may use and disclose medical information to remind of you an appointment.

Treatment AlternativesWe may use and disclose medical information to tell you about treatment options that might interest you.

Health-Related Benefits and Services:  We may use and disclose medical information to tell you about health-related benefits or services that may interest you.

Fundraising Activities:  We may use certain information (name, address, telephone number, dates of service, age, and gender) to raise money for Lancaster Cleft Palate Clinic.  Lancaster Cleft Palate Clinic and its business units may contact you for its fundraising purposes.

Marketing.  We may contact you to provide information about treatment alternatives or other health-related benefits and services offered by Lancaster Cleft Palate Clinic.  We may contact you if we think these offers might interest you.

Food and Drug Administration (FDA).  We may use or disclose medical information to the FDA regarding negative events involving food, supplements, product and product defects, or post-marketing observation information.  The FDA may use this information to help with product recalls, repairs, or replacements.

Individuals Involved in Your Care or Payment for Your Care.  We may release medical information about you to a friend or family member helping with your care.  We may also give information to someone who helps pay for your care.  We may tell your family or friends your general condition and that you are in the hospital.  We may disclose medical information about you with a disaster relief group.  This would help your family to learn about your condition, how you are doing and where you are.

Research.  We may disclose your health information to researchers when an institutional Review Committee has approved their work.  This Committee must have looked over the proposal and set up standards to make sure your information stays private.

As Required By Law.  We will disclose medical information about you when federal, state or local laws require us.  We may release medical information about you to federal officials for intelligence, counterintelligence, and other national security measures authorized by law.

Public Safety.  We may disclose your medical information to prevent or lessen a threat to the health or safety of one or more persons.

Military and Veterans. If you are a member of the armed forces, we may release your medical information to military command authorities.  We may also release medical information about foreign military personnel to the proper foreign military authority.

Worker’s Compensation.  We may release your Medical Information for workers’ compensation or other programs that provide benefits for work-related injuries or illnesses.

Public Health Risks:    We may disclose your medical information for public health purposes.  These reasons include:  to prevent or control disease, injury or disability; to report births and deaths; to report child abuse or neglect; to report reactions to medications or problems with products; to let people know about recalls of products they may be using; to notify someone who may have been exposed to a disease or who could get or spread a disease or condition; to notify the proper government authority if we believe a patient has been the victim of abuse, neglect or domestic violence.  We will only disclose this information if you agree or when we must or we are authorized by law.

Health Oversight Activities.  We may disclose your medical information to a health oversight agency for approved activities.  Examples include audits; investigations, inspections, and licensure.  These activities help the government oversee the health care system, government programs, and compliance with civil rights laws.

Lawsuits and DisputesIf you are in a lawsuit or a dispute, we may disclose your medical information as asked by a court or administrative order.  We may also disclose medical information about you because of a subpoena, discovery request, or other legal process from someone else involved in the situation.  We will only do this if efforts were made to tell you about the requested information.

Law EnforcementWe may release medical information in reasons to court orders, subpoenas, warrants, and summons or similar process.  We may also release this information to identify or find a suspect; fugitive, material witness, or missing person.  We may release information about the victim of a crime if, under certain limited conditions, we cannot obtain the person’s agreement.  We may also release medical information about criminal conduct at the clinic, in emergencies; we may release medical information to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.

Coroners, Medical Examiners and Funeral DirectorsWe may release medical information to a coroner or medical examiner.  This may be needed to identify the deceased or to determine the cause of death.

Inmates.  If you are an inmate of a correctional institution or in the charge of a law enforcement official, we may release medical information about you to the institution or official.  This release would help the institution to provide you with health care; to protect your health and safety or the health and safety of others; or for the safety and security of the institution.

When using and disclosing your protected health information for any of the above noted purposes Lancaster Cleft palate Clinic shall endeavor to comply with the most stringent of Federal, state or local laws.


If you feel that we have violated your privacy rights, or you disagree with a decision we made about the right to use your records, you may contact the office

listed below.  You also may send a written complaint to the U.S. Department of Health and Human Services.  The office listed below can give you that address.  We will not retaliate against you for filing a complaint.


Lancaster Cleft Palate Clinic, 223 N. Lime Street, Lancaster, PA  17602

Phone:  (717) 394-3793  Fax:       (717) 396-7409