This Notice describes the privacy practices of the Main
Line Health (MLH) which includes Lankenau Medical
Center, Bryn Mawr, Paoli and Riddle hospitals; Bryn Mawr
Rehabilitation Hospital, Mirmont Treatment Center, Main
Line HealthCare, Main Line/Rehabilitation Affiliates,
and Main Line Health HomeCare & Hospice.
While treating you, our employees, volunteers, students
and health care professionals affiliated with MLH follow
this Notice. In addition, any person involved in your
care, entities, sites and locations may share medical
information about you with each other for treatment,
payment or health care operations as described in this
We are required by law to maintain the privacy of your
health information and to provide you with this Notice.
Our duties to
safeguard your protected health information
Protected health information (PHI) is any information
related to your health care that is shared or maintained
in any manner. It includes your insurance information as
well. This Notice applies to all of your PHI generated
by Main Line Health or any of its entities. Your
personal doctor may have different policies or notices
regarding the doctor’s use and disclosure of your
medical information created in the doctor’s office.
This Notice will tell you about the ways in which we may
use and disclose your PHI. We also describe your rights
and certain obligations we have regarding the use and
disclosure of your PHI.
We are required by law to:
make sure that your PHI is kept private;
give you this Notice of our legal duties and
privacy practices related to your PHI; and,
follow the terms of this Notice that is
currently in effect.
How Main Line
Health may use and disclose medical information about
you—treatment, payment and health care operations
Except in an emergency or other special situation, we
will ask you to sign a general consent, as required by
Pennsylvania law, so that we may use and disclose your
PHI for the following purposes:
Treatment. We may use and disclose PHI
about you in connection with your treatment, for example
to diagnose you. In addition, we may contact you to
remind you about appointments, give you instructions
prior to tests or surgery, or inform you about treatment
alternatives or other health related benefits or
services. We may also disclose your PHI to other
providers, doctors, nurses, technicians, medical
students, hospital personnel or other health care
facilities involved in your treatment. We may need to
communicate this PHI to other health care providers
using phone, fax, two-way radio or electronic transfer.
Payment. We may use and disclose your
PHI to obtain payment for services we provide to you.
For example, we may contact your insurance company to
pay for the services you receive, to verify that your
insurer will pay for the services, to coordinate
benefits, or to collect any outstanding accounts.
Health care operations. We may use and
disclose your PHI for health care operations which
include: activities related to evaluating treatment
effectiveness, teaching and learning purposes,
evaluating the quality of our services, investigating
complaints related to service, fundraising activities
and marketing activities.
Other health care providers. We may
also disclose your PHI to other health care providers
when such PHI is required for them to treat you, receive
payment for services you receive or conduct certain
health care operations. For example, we will share your
PHI with an ambulance company so the ambulance company
can be reimbursed for transporting you to the hospital.
Health information exchange. We
participate in a health information exchange (HIE) that
allows us to electronically share protected health
information with local health care providers that are
participating in the HIE to coordinate your care. You
may also access your test results and other PHI
electronically through the HIE. HIEs are being developed
at the hospital, regional, state and national levels so
that providers will have prompt access to your records
for your care. Currently we only share information with
your providers through the HIE, although in the future
we may participate in HIEs with other providers, plans
and billing companies.
Other uses and
disclosures of your PHI for which authorization is not required
Hospital directory. Inpatients are
automatically listed in our hospital directory. The
directory includes your name, room number, general
health condition and religious affiliation. Unless you
disagree or object, information in the directory may be
disclosed to anyone who asks for you by name or to
clergy members of your religious affiliation.
Disclosure to relatives and close friends.
We may disclose your PHI to a family member, other
relative, a close personal friend or any other person if
we: 1) obtain your agreement; 2) provide you with the
opportunity to object to the disclosure; or, 3) we can
reasonably infer that you do not object to the
Incapacity or emergency circumstances.
If you are not present, or the opportunity to agree or
object to a use or disclosure cannot practicably be
provided because of your incapacity or an emergency
circumstance, we may exercise our professional judgment
to determine whether a disclosure to relatives and/or
close friends is in your best interest. If we disclose
information to a family member, other relative or a
close personal friend, we would disclose only
information that is directly relevant to the person’s
involvement with your health care.
Fundraising. We may contact you to
request a contribution to support important activities
of Main Line Health or its entities. In connection with
any fundraising, we may use and disclose your
demographic information as well as the dates on which
you received health care services, the department where
you received your services, your treating physician, and
outcome information related to your care. If you do not
want to receive any fundraising requests, you may
contact us at mainlinehealth.org/optout
Main Line Health Development Office
240 Radnor Chester Road
Radnor, PA 19087
Public health activities. We may
disclose your PHI for public health activities including
Reporting births or deaths
To prevent or control disease, injury or
To report child abuse or neglect
To report reactions to medications or problems
To notify individuals who may have been exposed
to a disease or may be at risk for contracting a
disease or condition
Reporting PHI to your employer as required by
laws addressing work-related illnesses and
injuries or workplace medical surveillance
Victims of abuse, neglect or domestic violence.
If we reasonably believe you are a victim of abuse,
neglect or domestic violence, we may, in accordance with
current Pennsylvania law, disclose your PHI to a
governmental authority, including a social service or
protective services agency, authorized by law to receive
reports of such abuse, neglect, or domestic violence.
Health oversight activities. We may
disclose your PHI to a health oversight agency that is
responsible for ensuring compliance with rules of
government health programs such as Medicare and
Medicaid. These oversight activities include, for
example, audits, investigations, inspections and
Legal proceedings and law enforcement.
We may disclose your PHI in response to a court order,
subpoena, or other lawful process.
Deceased persons. We may release PHI to
a coroner or medical examiner authorized by law to
receive such information.
Organ and tissue donation. We may
disclose your PHI to organizations that obtain organs or
tissues for banking and/or transplantation.
Public safety. We may use or disclose
your PHI to prevent or lessen a serious or imminent
threat to the safety of a person or the public.
Research. Usually, we will ask for your
permission or authorization before using your PHI for
research purposes. However, we may use and disclose your
PHI without your authorization if Main Line Hospital’s
Institutional Review Board (IRB) has waived the
authorization requirement. An IRB is a committee that
oversees and approves research involving human subjects.
Disaster Relief Efforts. We may
disclose your PHI about you to an entity assisting in a
disaster relief effort so that your family can be
notified about your condition, status and location.
Military, national defense and security.
We may release your PHI if required for military,
national defense and security and other special
Workers ’ compensation. We may release
your PHI about you for workers’ compensation or similar
programs. These programs provide benefits for
work-related injuries or illnesses.
Communications from us. We may use or
disclose your PHI to identify health-related services
and products that may be beneficial to your health, such
as notification of a new physician and/or additional
products and services, and then contact you about those
products and services. If you do not wish to receive
information of this type, please contact us at mainlinehealth.org/optout
Main Line Health Marketing Office
240 Radnor Chester Road
Radnor, PA 19087
As required by law. We may use and
disclose your PHI when required to do so by any other
laws not already referenced above.
disclosures requiring your specific authorization
Highly confidential information.
Federal and State laws require special privacy
protections for certain highly confidential information
about you. This includes PHI that is: 1) maintained in
psychotherapy notes; 2) documentation related to mental
health or developmental disabilities services; 3) drug
and alcohol abuse, prevention, treatment and referral
information; 4) information related to HIV status,
testing and treatment as well as any information related
to the treatment or diagnosis of sexually transmitted
diseases; and 5) PHI related to genetic testing.
Generally, we must obtain your authorization to release
this type of PHI. However, there are limited
circumstances under the law when this type of PHI may be
released without your consent. For example, certain
sexually transmitted diseases must be reported to the
Department of Health.
Other uses or disclosures not described in this
Notice. Other uses and disclosures of PHI not
covered by this Notice or the laws that apply to us will
be made only with your written permission. Except as
permitted under this Notice or as permitted by law, we
will seek your written permission prior to using or
sharing your information for marketing purposes or
selling your information. If you provide us permission
to use or disclose your PHI, you may revoke that
permission, in writing, at any time. If you revoke your
permission, we will no longer use or disclose your PHI
for the reasons covered by your written authorization.
You understand that we are unable to take back any
disclosures we have already made with your permission,
and that we are required to retain a record of the care
that we provided to you.
regarding medical information about you
You have the following rights regarding PHI we maintain
Right to inspect and copy. You have the
right to inspect and copy PHI that may be used to make
decisions about your care excluding psychotherapy notes.
You may request an electronic copy of your PHI if we
maintain the PHI in an electronic format.
You must submit your request in writing to the
appropriate Main Line Health office or department. You
may be charged a fee for the costs of copying, mailing
or other supplies associated with your request.
We may deny your request to inspect and copy in certain
very limited circumstances. You may request that the
denial be reviewed. Another licensed health care
professional will review your request and the denial.
The person conducting the review will not be the person
who denied your request. We will comply with the outcome
of the review.
Right to amend. You have the right to
request that we amend the PHI we keep about you in your
medical and billing records. Your request to amend your
medical or billing records must be made in writing and
submitted to the appropriate Main Line Health office or
department. We may deny your request if we believe the
information you wish to amend is accurate, current and
complete, if the PHI was not created by Main Line Health
or if other special circumstances apply.
We will ask your attending physician to review any
amendments to the medical record.
Right to an accounting of disclosures.
You have the right to request a record of all
disclosures of your PHI. We are not required to give you
an accounting of information we have used or disclosed
for treatment, payment or health care operations or
information you authorized us to disclose.
To request this list or accounting of disclosures, you
must submit your request in writing to the appropriate
Main Line Health office or department. Your request may
cover any disclosures made in the six years prior to the
date of your request.
Right to request restrictions. You have
the right to request a restriction or limitation on the
PHI we use or disclose about you for treatment, payment
or health care operations. We are not required to agree
to your request with one exception. We will honor your
request to not share your PHI with your medical insurer
or other third party payer, provided you pay in full for
the health care item or service. If we do agree, we will
comply with your request unless the information is
needed to provide you emergency treatment.
To request restrictions, you must make your request in
writing. In your request, you must tell us (1) what
information you want to limit; (2) whether you want to
limit our use, disclosure or both; and (3) to whom you
want the limits to apply, for example, disclosures to
Right to request confidential communications.
You have the right to request that we communicate with
you about medical matters in a certain way or at a
To request confidential communications, you must make
your request in writing to the appropriate Main Line
Health office or department. We will accommodate all
reasonable requests. Your request must specify how or
where you wish to be contacted.
Right to revoke your authorization. You
may revoke your authorization for us to use and disclose
your PHI at any time by submitting a request in writing
to the appropriate office or department.
We reserve the right to change this Notice. Revised
Notices will be posted in appropriate locations and
online at mainlinehealth.org. We reserve
the right to make the revised or changed Notice
effective for medical information we already have about
you as well as any information we receive in the future.
A copy of the current Notice is available upon request.
If you believe your privacy rights have been violated,
you may file a complaint, in writing, with the Main Line
Health Privacy Officer at:
Privacy Officer, Main Line Health
Bryn Mawr Hospital
130 South Bryn Mawr Avenue
Bryn Mawr, PA 19010
You may also wish to file a complaint with the Director,
Office of Civil Rights of the U.S. Department of Health
and Human Services. The Privacy Officer can supply the
correct address for the Director.
You will not be penalized for filing a
We will notify you in the event of a breach (as defined
by HIPAA) of your PHI.
For more information, call 1.866.CALL.MLH.