Prof. Pietro MORTINI

“Protected Health Information” is information that individually identifies you and that we create or get from you or from another health care provider, health plan, your employer, or a health care clearinghouse and that relates to (1) your past, present, or future physical or mental health or conditions, (2) the provision of health care to you, or (3) the past, present, or future payment for your health care.

How We May Use and Disclose Your Protected Health Information

We may use and disclose your Protected Health Information in the following circumstances:

For Treatment

We may use or disclose your Protected Health Information to give you medical treatment or services and to manage and coordinate your medical care. For example, your Protected Health Information may be provided to a physician or other health care provider (e.g., a specialist or laboratory) to whom you have been referred to ensure that the physician or other health care provider has the necessary information to diagnose or treat you or provide you with a service.

For Health Care Operations

We may use and disclose Protected Health Information for our health care operations. For example, we may use your Protected Health Information to internally review the quality of the treatment and services you receive and to evaluate the performance of our team members in caring for you. We also may disclose information to physicians, nurses, medical technicians, medical students,

Research

We may use and disclose your Protected Health Information for research purposes, but we will only do that if an authorized institutional review board or a privacy board has reviewed and approved the research proposal and has set up protocols to ensure the privacy of your Protected Health Information. Even without that special approval, we may permit researchers to look at Protected Health Information to help them prepare for research, for example, to allow them to identify patients who may be included in their research project, as long as they do not remove, or take a copy of, any Protected Health Information. We may use and disclose a limited data set that does not contain specific readily identifiable information about you for research. However, we will only disclose the limited data set if we enter into a data use agreement with the recipient who must agree to (1) use the data set only for the purposes for which it was provided, (2) ensure the confidentiality and security of the data, and (3) not identify the information or use it to contact any individual.and other authorized personnel for educational and learning purposes.

For Payment. We may use and disclose your Protected Health Information so that we can bill for the treatment and services you receive from us and can collect payment from you, a health plan, or a third party. This use and disclosure may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you, such as making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities. For example, we may need to give your health plan information about your treatment in order for your health plan to agree to pay for that treatment.

Personal data treatment consent

With reference to Italian Legislative Decree n. 196/03, art. 13 (Law about personal data protection), we hereby inform you that your consent to the treatment of your personal data is required. Your personal data will be filed in our archives and processed both by paper and electronic format, in compliance with all the security and confidentially measures fixed by Law, Exhibit B. Your personal data may be transmitted to third party that should carry on all the necessary activities to manage your request. We also specify that art. 7 of the Law attributes specific rights to citizens. In particular, you may obtain the access to your data or obtain their updating, correction , integration, deletion, the turning in anonymous form (if it is possible) or the blocking of any data treated in breach of the law. We should inform you that your refusal to authorize the use of your personal data will not allow us to carry out the requested services.