Patient 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.

We at Coordinated Care Network understand that your medical information is private and confidential. Accordingly, we want you to be aware of your rights with respect to your medical information.

" You have the right to request restrictions on certain uses and disclosures of your health information, as provided by federal regulations at 45 C.F.R. § 164.522(a). Coordinated Care Network is not required to agree to such a restriction.
" You have the right to receive health information through confidential communications. For example, you have the right to request that health information is only transmitted to a certain address or through a certain medium (such as over the telephone or through sealed envelope).
" You have the right to inspect and copy your health information, as provided by federal regulations at 45 C.F.R. §164.524.
" You have the right to amend your health information, as provided by federal regulations at 45 C.F.R. § 164.526, if you feel that your information is incorrect.
" You have the right to receive a listing of to whom Coordinated Care Network has disclosed your health information, as provided by federal regulations at 45 C.F.R. § 164.528.
" You have the right to receive a paper copy of this notice.

The remainder of this document sets forth the privacy policy of Coordinated Care Network, including our obligations under federal law and a list of the circumstances in which your health information will be used and disclosed without your written authorization. Other uses or disclosures will only be made if we receive your written authorization. You may revoke such an authorization at any time, as provided by federal regulations at 45 C.F.R. § 164.508(b)(5).

For more information or to report a problem, please contact Mr. Thomas J. Pollack at (412)349-6300.

Duties of Coordinated Care Network
Coordinated Care Network is required by law to maintain the privacy of your health information and to provide you with this notice of our legal duties and privacy practices.

Coordinated Care Network is required to comply with the terms of the privacy notice that is currently in effect.

Coordinated Care Network reserves the right to alter its privacy policy. Changes to the privacy policy will be effective for all health information that we maintain, including health information collected while a prior privacy policy was in effect, in accordance with federal regulations at 45 C.F.R. § 164.530(i)(2)(ii).

Routine Uses and Disclosures
Your health information may be routinely disclosed so that we can provide you with quality medical treatment, so that we can receive payment for our services, and in order to operate our organization. The following provides descriptions and examples of these types of routine uses and disclosures:

Treatment: Treatment means the provision, coordination, and management of your health care. We will use and disclose your health information in order to provide quality medical treatment. For example, we may provide your health information to a pharmacy in order to provide you with your medication.

Payment: Payment means the activities that we undertake in order to receive payment for our services to you. For example, we may send your name and health information to an insurance company or government program in order to receive payment for our services to you.

Health Care Operations: Health Care operations means the activities of our organization aimed at improving the delivery of health care, such as quality assurance programs, staff training, and administrative activities. For example, we may use your health information to evaluate the performance of our staff that provided services to you.

Uses and Disclosure That Require Opportunity to Object
Others Involved in Your Healthcare:
Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person's involvement in your health care. If you are unable to agree or object to such a 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 protected 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, general condition or death. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.

Other Uses and Disclosures
There are a number of other occasions in which we may use or disclose your health information. The following provides descriptions of these types of uses and disclosures:

Required By Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.

Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability. We may also disclose your protected health information, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.

Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.

Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.

Legal Proceedings: We may disclose your protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), in certain conditions in response to a subpoena, discovery request or other lawful process.

Law Enforcement: We may also disclose your protected health information, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information requests for identification and location purposes, (3) pertaining to victims of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises of the practice, and (6) medical emergency (not on the Practice's premises) and it is likely that a crime has occurred.

Coroners, Funeral Directors, and Organ Donation: We may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose protected health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties. We may disclose such information in reasonable anticipation of death. Protected health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes.

Research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.

Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.

Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

Workers' Compensation: Your protected health information may be disclosed by us as authorized to comply with workers' compensation laws and other similar legally-established programs.
Inmates: We may use or disclose your protected health information if you are an inmate of a correctional facility and your physician created or received your protected health information in the course of providing care to you.

Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. seq.

Appointment Reminders
Coordinated Care Network may use your health information to provide you with appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Complaints
If you believe that your privacy rights have been violated, you may file a written complaint at the following address:

Mr. Thomas J. Pollack
Coordinated Care Network
300 Penn Center Blvd. Suite 505
Pittsburgh, PA 15235

You also may file a complaint with the Secretary of the Department of Health and Human Services. No action will be taken against you for filing such a complaint.