Patient Privacy and HIPAA Rights

Patient Privacy and HIPAA Rights

Catholic Health Services of Long Island and its affiliated covered entities (collectively, CHS) is committed to ensuring that your medical information is private and secure. CHS protects medical information as required by state laws and the federal privacy rules of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to ensure the security and privacy of your medical records and promote trust between our patients and their health care providers.

Notice of Privacy Practices

CHS maintains a Notice of Privacy Practices that describes the ways in which our covered entities may use and disclose your health information and how you can obtain access to this information. Every patient will be provided with a copy of the Notice when they first come to a CHS provider for treatment and will be asked to sign an acknowledgment that they received a copy of our Notice.  Please download the following documents for detailed information on our privacy practices. 

Patient Forms

Inspecting and Obtaining Copies of Your Medical Records

You are entitled to request that a copy of your medical record be released to you or a designated person by downloading and completing the following request form. All forms requesting medical records must be submitted by mail or in person to the Health Information Management (HIM) Department of the specific CHS facility or practice that treated you. 

For copies of your billing information, please submit your request in writing to the Director of Patient Accounts at CHS. 

Requesting an Amendment to Your Medical Record

You are entitled to request an amendment be made to your medical record by downloading and completing the following request form. This form must be submitted by mail or in person to the Health Information Management (HIM) Department of the specific CHS facility or practice that treated you. 

*Please note that these forms should NOT be sent to Catholic Health Services of Long Island*

The information you are requesting may be available free of charge through CHS MyChart, our secure patient portal. With a CHS MyChart account you can view: test results, immunizations, medication lists, visit and admission summaries, and appointment information from your home computer or compatible smart phone/tablet. Please note: The portal only provides access to portions of the electronic medical record - it is not an all-inclusive medical record. Please ask your doctor about signing up for CHS MyChart. You can also learn how to get started here. Please call (631) 465-6100 if you need assistance.

Click Here for HIM Department Contact Information

Privacy Officer Contact Information

To report a known or suspected violation of a patient’s privacy, please contact the CHS Compliance Hotline by phone at 866-272-0004. You may choose to leave your contact information or report the incident anonymously.

You may also contact the Privacy Officer of the CHS facility or practice directly:

CHS Entity

Privacy Officer

Telephone

Email

CHS Chief Privacy Officer

Lesli Giglio

516-705-3704

Lesli.Giglio@chsli.org

CHS Deputy Privacy Officer

Brian Andrews

516-705-3705

Brian.Andrews@chsli.org

Good Samaritan Hospital Medical Center

 

Cynthia Vigilante

631-376-3582

Cynthia.Vigilante@chsli.org

St. Charles Hospital

Karen Fielder

631-474-6759

Karen.Fielder@chsli.org

St. Catherine of Siena Medical Center

 

Michelle Goldfarb

631-862-3516

MichelleM.Goldfarb@chsli.org

Mercy Medical Center

Rosemarie Povinelli

516-705-2375

Rosemarie.Povinelli@chsli.org

St. Francis Hospital

Tiffany Wickes-Demillio

516-562-6551

Tiffany.Wickes-Demillio@chsli.org

St. Joseph Hospital

Blake Benz

516-520-2776

Blake.Benz@chsli.org

Our Lady of Consolation

Dorothy Scholz

631-587-1600 x 6538

Dorothy.Scholz@chsli.org

Catholic Home Care

Igor Nemov

631-828-7404

Igor.Nemov@chsli.org

Good Shepherd Hospice

Ellen Judson

631-828-7647

Ellen.Judson@chsli.org

Maryhaven Center of Hope

Kristin Glassner

631-474-4117 x 2280

Kristin.Glassner@chsli.org

St. Catherine of Siena Nursing Home & Good Samaritan Nursing & Rehabilitation Care Center

Rosemary Swedenburg-Murphy

516-705-7196

 

Rosemary.Swedenburg-Murphy@chsli.org

CHS Physician Partners, PC

Monique Ford

631-465-4132

Monique.Ford@chsli.org

CHS Physician Partners, IPA

 Linda Iatrou

 516-734-0402

Linda.Iatrou@chsli.org

Click Here for HIM Department Contact Information

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