Patient Privacy
Women’s Health Effective Date: April 14, 2003
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully! Protected health information is the information we develop and obtain in providing our professional medical services to you. Such information may include documenting your symptoms, examination, and test results, diagnoses, treatment, and a plan for future care or treatment. It also includes billing documents for those services. Our practice is permitted by federal privacy laws (HIPAA) to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. These uses and disclosures do not require your specific written or verbal authorization. Examples of Uses of Your Health Information for Treatment Purposes are: -Our nurse or medical assistant obtains your medical treatment history from you at an annual gynecologic exam and records it in your medical record.
-During the course of your treatment, your physician or midwife determines s(he) will need to consult with another specialist in the area. S(he) will share the necessary health information with such specialist in order to obtain his/her input about how to best care for you.
-Our practice mails annual exam reminders and other medical care follow-up reminders to your home to make sure important health matters are taken care of. Example of Use of Your Health Information for Payment Purposes: -Our practice submits requests for payment to your health insurance company. The health insurance company (or other business associate helping us obtain payment) requests information from us regarding medical care given to you and your demographic information. We will provide necessary information to them about you and the care we have given in order to receive payment for those services. Example of Use of Your Information for Health Care Operations: -Our practice obtains needed services from business associates in order to conduct our medical practice business. These include such services as quality assessment, quality improvement, outcome evaluation, protocol and clinical guideline development, training programs, credentialing, medical review, legal services, and insurance. We will share necessary information about you with such insurers or other business associates, as necessary, to obtain these services. We contract with business associates specifically to hold them accountable for complying with HIPAA law regarding security and confidentiality of personal health information we share with them for health care operations purposes. Your Health Information Rights The health and billing records we maintain are the physical property of our practice, Women's Health Associates, P.C. The information in it, however, belongs to you, our patient. You have a right to: -Request a restriction on certain uses and disclosures of your health information by delivering the request to our office. We provide you with a form to do this. We are not required to grant the request, but we will comply with any request granted;
-Obtain a paper copy of the current Notice of Privacy Practices for Protected Health Information ("Notice") by making a request at our office. We will ask you to sign an acknowledgment of access to and/or receipt of this Notice;
-Request that you be allowed to inspect and/or receive a copy your health record or billing record – you may exercise this right by delivering the request to our office using our form for this purpose. A clerical fee for fax, copy and postage costs will be charged; an appointment for inspection is made to allow for clerical chaperone of inspection.
-Appeal a denial of access to your protected health information, except in certain circumstances as described by law; if we do not have the requested information in our possession, we will assist the patient in contacting the entity who does.
-Request that your health care record be amended to correct incomplete or incorrect information by delivering a request to our office using our form for this purpose. We may deny your request if you ask us to amend information that:
If your request is denied, you will be informed of the reason for the denial in writing and will have an opportunity to submit a statement of disagreement to be maintained with your records;
-Request that reasonable alternative means or location for communication of your health information be used by delivering the request in writing to our office;
-Obtain an accounting of disclosures of your health information (beginning April 14, 2003) as required to be maintained by law, by delivering a request to our office using our form for this purpose. An accounting will not include:
-Revoke authorizations that you made previously to use or disclose information by delivering a written revocation to our office/hospital, except to the extent information or action has already been taken.
-If you want to exercise or have any questions about any of the above rights, please contact our practice manager in person or in writing, during regular, business hours. [S]he will inform you of the steps that need to be taken to exercise your rights. If s(he) is not present, s(he) will designate someone to act in her stead. Practice Manager (Privacy Officer)
Our Responsibilities Our practice is required to: -Maintain the privacy of your health information as required by law (HIPAA, Colorado State and Federal);
-Provide you with a Notice of our duties and privacy practices and your rights regarding the information we collect and maintain about you; Office copies of the Notice are available in our waiting room and all exam/procedure rooms. Take-home copies are available upon request.
-Abide by the terms of this Notice;
-Notify you if we cannot accommodate a requested restriction or request; and,
-Accommodate your reasonable requests regarding alternate methods to communicate health information with you.
-Except as described in this Notice, Women's Health Associates, P.C. will not use or disclose your health information without your written authorization. You may revoke your authorization in writing at any time except to the extent that action has already been taken.
Changes to this Notice of Privacy Practices -We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the Notice by calling and requesting a copy of our "Notice" or by visiting our office and picking up a copy. To Request Information or File a Complaint -If you have questions, would like additional information, or want to report a problem regarding the handling of your information, you may contact our practice manager.
-Additionally, if you believe your privacy rights have been violated, you may file a written complaint at our office by delivering the written complaint to our practice manager. Practice Manager -You may also file a complaint with: -OR- By contacting any regional Office for Civil Rights: A list of these offices can be found online at: http://www.hhs.gov/ocr/regmail/html
-We cannot, and will not, require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment from the office.
-We cannot, and will not, retaliate against you for filing a complaint with the Secretary of Health and Human Services. It is your legal right to do so.
Other Disclosures and Uses that Do Not Require a Written Authorization Information provided directly to you, our patient
-In the normal course of care for our patients, we provide you with health information about you that we have collected through contact with other health care providers, our examination, treatment, laboratory, radiology and ultrasound testing results. Communication with Family -Using our best judgment, we may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person's involvement in your care or in payment for such care, if you do not object, or in an emergency. It is important for you to inform us of any restrictions you wish to place on this type of disclosure. Notification -Unless you object, we may use or disclose your protected health information to notify, or assist in notifying, a family member, personal representative, or other person responsible for your care, about your location, and about your general condition, or your death. Research -We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information. Disaster Relief -We may use and disclose your protected health information to assist in disaster relief efforts. Organ and Tissue Procurement Organizations -Consistent with applicable law, we may disclose your protected health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs or for the purpose of tissue donation and transplant. Food and Drug Administration (FDA) -We may disclose to the FDA your protected health information relating to adverse events with respect to food, supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacements. Workers Compensation
-If you are seeking compensation through Workers Compensation, we may disclose your protected health information to the extent necessary to comply with laws relating to Workers Compensation. Public Health
-As authorized by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability; to report reactions to medications or problems with products; to notify people of recalls; to notify a person who may have been exposed to a disease or who is at risk for contracting or spreading a disease or condition. Abuse & Neglect
-We may disclose your protected health information to public authorities as allowed by law to report abuse or neglect. Employers
-We may release health information about you to your employer if we provide health care services to you at the request of your employer, and the health care services are provided either to conduct an evaluation relating to medical surveillance of the workplace or to evaluate whether you have a work-related illness or injury. In such circumstances, we will give you written notice of such release of information to your employer. Any other disclosures to your employer will be made only if you execute a specific authorization for the release of that information to your employer. Correctional Institutions
-If you are an inmate of a correctional institution, we may disclose to the institution or its agents the protected health information necessary for your health and the health and safety of other individuals. Law Enforcement -We may disclose your protected health information for law enforcement purposes as required by law, such as when required by a court order, or in cases involving felony prosecution, or to the extent an individual is in the custody of law enforcement, including laws that require reporting of certain types of wounds or personal injuries. Health Oversight
-Federal law allows us to release your protected health information to appropriate health oversight agencies or for health oversight activities, to include audits, licensure, inspections, investigations. Judicial/Administrative Proceedings
-We may disclose your protected health information in the course of any judicial or administrative proceeding as allowed or required by law, with your authorization, or as directed by a proper legal process, court order, subpoena, discovery request or administrative tribunal.
Serious Threat to Health or Safety
-To avert a serious threat to health or safety, we may disclose your protected health information consistent with applicable law to prevent or lessen a serious, imminent threat to the health or safety of a person or the public.
For Specialized Governmental Functions
-We may disclose your protected health information for specialized government functions as authorized by law such as to Armed Forces personnel, for national security purposes, or to public assistance program personnel. Coroners, Medical Examiners, and Funeral Directors
-We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information about patients to funeral directors as necessary for them to carry out their duties. Other Uses as Required by Law
-Other uses and disclosures, besides those identified in this Notice, will be made only as otherwise required by law or with your written authorization and you may revoke the authorization as previously provided in this Notice under "Your Health Information Rights." Website
-If, in the future, we maintain a website that provides information about our entity, this Notice will be on the website. Change of Ownership
-In the event Women's Health Associates, P.C. is sold or merged with another organization, your health information/medical record will become the property of the new owner.
Women's Health believes in your rights as a patient regarding your personal health information. We have trained our staff to assist you in exercising your rights. Our practice manager and designees are pleased to meet with you or visit over the phone about your questions and concerns.
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