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Patient Policies

Prescription Medication Policy

We ask that telephone calls for medication refills be made during regular business hours so that your medical record is available for review. When calling, please have your pharmacy telephone number available. We do not refill narcotic prescriptions on weekends or evenings. When you speak to your attending surgeon, be sure you have enough medication to use during these times.


Appointment Cancellation Policy

Our goal is to provide quality care in a timely manner. Our appointment cancellation policy enables us to better use available appointments for our patients in need of medical care. If you need to cancel your appointment, we ask that you provide notice at least 24 hours in advance so that other patients can be accommodated. If your appointment is on a Monday, please call before 10 a.m. on the Friday prior.

Because we are a surgical practice, there are often unforeseeable emergencies where patients require immediate attention, or our surgeons are delayed. This means we may have to re-schedule your appointment at the last minute or your surgeon may be delayed and unable to see you at your scheduled time. We realize that this inconveniences our patients and we apologize; however, we will do our best to see you as soon as possible. We appreciate your patience and understanding during these times.

House Calls Reminder Service

Pioneer Valley Surgical Associates uses House Calls, a calling service that reminds you of your appointment 24 hours before the scheduled time.


Some procedures require before and after pictures. These photographs are for medical purposes only. You will always be asked to sign a release prior to any photograph being used for marketing purposes.

Emergencies/After Hours

We maintain a 24-hour answering service. One of our surgeons is always on-call after-hours and on weekends and holidays, so you can always reach our practice when needed.

Notice of Privacy Policies


Pioneer Valley Surgical Associates, P.C. (PVSA), is required by law to maintain the privacy of your protected health information. This information consists of all records related to your health, including demographic information, either created by PVSA or received by PVSA from other health care providers.

We are required to provide you with notice of our legal duties and privacy practices with respect to your protected health information. These legal duties and privacy practices are described in this Notice. PVSA will abide by the terms of this Notice, or the Notice currently in effect at the time of the use or disclosure of your protected health information.¹

PVSA reserves the right to change the terms of this Notice and to make any new provisions effective for all protected health information that we maintain. Patients will be provided a copy of any revised Notices upon request. An individual may obtain a copy of the current Notice from our office at any time.

Uses and Disclosures of Your Protected Health Information Not Requiring Your Consent

PVSA may use and disclose your protected health information, without your written consent or authorization, for certain treatment, payment and health care operations. There are certain restrictions on uses and disclosures of treatment records, which include registration and all other records concerning individuals who are receiving, or who at any time have received services for mental illness, developmental disabilities, alcoholism, or drug dependence. There are also restrictions on disclosing HIV test results.

Treatment may include:

  • Providing, coordinating, or managing health care and related services by one or more health care providers.
  • Consultations between health care providers concerning a patient
  • Referrals to other providers for treatment.
  • Referrals to nursing homes, foster care homes, or home health agencies.

For example, PVSA may determine that you require the services of a specialist. In referring you to another doctor, PVSA may share or transfer your healthcare information to that doctor.

Payment activities may include:

  • Activities undertaken by PVSA to obtain reimbursement for services provided to you.
  • Determining your eligibility for benefits or health insurance coverage.
  • Managing claims and contacting your insurance company regarding payment.
  • Collection activities to obtain payment for services provided to you.
  • Reviewing health care services and discussing with your insurance company the medical necessity of certain services or procedures, coverage under your health plan, appropriateness of care, or justification of charges.
  • Obtaining pre-certification and pre-authorization of services to be provided to you.

For example, PVSA will submit claims to your insurance company on your behalf. This claim identifies you, your diagnosis, and the services provided to you.

Health care operations may include:

  • Contacting health care providers and patients with information about treatment alternatives.
  • Conducting quality assessment and improvement activities.
  • Conducting outcomes evaluation and development of clinical guidelines.
  • Protocol development, case management or care coordination.
  • Conducting or arranging for medical review, legal services and auditing functions

For example, PVSA may use your diagnosis, treatment and outcome information to measure the quality of the services that we provide, or assess the effectiveness of your treatment when compared to patients in similar situations.

PVSA may contact you, by telephone, SMS (text), email or U.S. mail to provide appointment reminders. You must notify us if you do not wish to receive appointment reminders.

We may not disclose your protected health information to family members or friends who may be involved with your treatment or care without your written permission. Health information may be released without written permission to a parent, guardian or legal custodian of a child; the guardian of an incompetent adult; the health care agent designated in an incapacitated patient’s health care power of attorney; or the personal representative or spouse of a deceased patient.

Additional Situations Affecting Protected Health Information

There are additional situations when PVSA is permitted or required to use or disclose your protected health information without your consent or authorization.

In certain circumstances, we may be required to report individual health information to legal authorities, such as law enforcement officials, court officials or government agencies. For example, we may have to report abuse, neglect, domestic violence or certain physical injuries. We are required to report gunshot wounds or any other wound to law enforcement officials if there is reasonable cause to believe that the wound occurred as a result of a crime.

Mental health records may be disclosed to law enforcement authorities for the purpose of reporting an apparent crime on our premises.

For public health activities:

  • We may release health care records, with the exception of treatment records, to certain government agencies or public health authority authorized by law, upon receipt of written request from that agency.
  • We are required to report positive HIV test results to the state epidemiologist. We may also disclose HIV test results to other providers or persons when there has been or will be risk of exposure.
  • We may report to the state epidemiologist the name of any person known to have been significantly exposed to a patient who tests positive for HIV.
  • We are required by law to report suspected child abuse and neglect and suspected abuse of an unborn child, but cannot disclose HIV test results in connection with the reporting or prosecution of alleged abuse or neglect.
  • We may release health care records, including treatment records and HIV test results, to the Food and Drug Administration when required by federal law.
  • We may disclose health care records, except for HIV test results, for the purpose of reporting elder abuse or neglect, provided the subject of the abuse or neglect agrees, or, if necessary, to prevent serious harm.
  • Records may be released for the reporting of domestic violence, if necessary, to protect the patient or community from imminent and substantial danger.

For health oversight activities:

  • We may disclose health care records, including treatment records, in response to a written request by any federal or state governmental agency to perform legally authorized functions, such as management audits, financial audits, program monitoring and evaluation, and facility or individual licensure or certification.
  • HIV test results may not be released to federal or state governmental agencies, without written permission, except to the state epidemiologist for surveillance, investigation, or to control communicable diseases.

For judicial and administrative proceedings:

Patient healthcare records, including treatment records and HIV test results, may be disclosed pursuant to a lawful court order. A subpoena signed by a judge is sufficient to permit disclosure of all health care records except for HIV test results.

For activities related to death:

  • We may disclose patient health care records, except for treatment records, to a coroner or medical examiner for the purpose of completing a medical certificate or investigating a death.
  • HIV test results may be disclosed under certain circumstances.

For research:

Under certain circumstances, and only after a special approval process, we may use and disclose your health information to help conduct research.

To avoid a serious threat to health or safety:

  • We may report a patient’s name and other relevant data to the Department of Transportation if it is believed the patient’s vision or physical or mental condition affects the patient’s ability to exercise reasonable or ordinary control over a motor vehicle.
  • Health care information, including treatment records and HIV test results, may be disclosed where disclosure is necessary to protect the patient or community from imminent and substantial danger.

For workers’ compensation:

We may disclose your health information to the extent such records are reasonably related to any injury for which workers compensation is claimed.

PVSA will not make any other use or disclosure of your protected health information without your written authorization. You may revoke such authorization at any time, except to the extent that PVSA has taken action in reliance thereon. Any revocation must be in writing.

Your Rights Regarding Your Protected Health Information

You are permitted to request that restrictions be placed on certain uses or disclosures of your protected health information by PVSA to carry out treatment, payment or health care operations.

You must request such a restriction in writing. We are not required to agree to your request, but if we do agree, we must adhere to the restriction, except when your protected health information is needed in an emergency treatment situation. In this event, information may be disclosed only to health care providers treating you. Also, a restriction would not apply when we are required by law to disclose certain health care information.

You have the right to review and/or obtain a copy of your health care records, with the exception of psychotherapy notes, or information compiled for use (or in anticipation for use) in a civil, criminal or administrative action or proceeding. PVSA may deny an access under other circumstances, in which case you have the right to have such a denial reviewed. We may charge a reasonable fee for copying your records.

You may request that PVSA send protected health information, including billing information, to you by alternative means or to alternative locations. You may also request that PVSA not send information to a particular address or location, or contact you at a specific location, such as your place of employment. This request must be submitted in writing. We will accommodate reasonable requests by you.

You have the right to request that PVSA amend portions of your health care records, as long as such information is maintained by us. You must submit this request in writing, and under certain circumstances the request may be denied.

You may request to receive an accounting of the disclosures of your protected health information made by PVSA for the 6 years prior to the date of the request, beginning with disclosures made after April 14, 2003. We are not required, however, to record disclosures we make pursuant to a signed consent or authorization.

You may request and receive a paper copy of this Notice, if you had previously received or agreed to receive the Notice electronically.

Any person or patient may file a complaint with PVSA and/or the Secretary of Health and Human Services if they believe their privacy rights have been violated. To file a complaint with PVSA, please contact the Privacy Officer at the following:

Privacy Officer

Pioneer Valley Surgical Associates, P.C.

2 Medical Center Drive, Suite 404

Springfield, MA 01107

It is the policy of PVSA that no retaliatory action will be made against any individual who submits or conveys a complaint of suspected or actual non-compliance or violation of the privacy standards.

This Notice of Privacy Practices is effective April 14, 2003.

¹This Notice is prepared in accordance with the Health Insurance Portability and Accountability Act, 45 C.F.R. 164.520, and applicable Massachusetts health care privacy laws.