Patient Information / Details Regarding Treatment

Confidentiality

Your medical records are entirely confidential. No information is released without your written consent. On your initial visit, we will ask you to sign a form authorizing us to release pertinent information to your insurance company, and others you may specify.

Confidentiality Compliance

With the passage of the Health Insurance Portability and Accountability Act (HIPAA) in 1996, Congress has mandated that all health care providers formalize their confidentiality policies and inform patients of them.

If you are a patient of Lancaster NeuroScience & Spine Associates, we formally document our policies, and require your signed acknowledgement, indicating that you have received our notice of privacy practices. In certain instances, we may also need to obtain your written approval to use or disclose health information when treatment or payment requires such disclosure.

• NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION

• ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION (FORM)

• ASSIGNMENT OF MEDICAL BENEFITS OTHER THAN MEDICARE (FORM)