Privacy Policy

Notice of Privacy Practices

 

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.

 

Your Rights

You have the right to:

• Get a copy of your paper or electronic medical record

• Correct your paper or electronic medical record

• Request confidential communication

• Ask us to limit the information we share

• Get a list of those with whom we’ve shared your information

• Get a copy of this privacy notice

• Choose someone to act for you

• File a complaint if you believe your privacy rights have been violated

 

Your Choices

You have some choices in the way that we use and share information as we:

• Tell family and friends about your condition

• Provide disaster relief

• Provide mental health care

• Market our services and use your information

• Raise funds

 

Our Uses and Disclosures

We may use and share your information as we:

• Treat you

• Run our organization

• Help with public health and safety issues

• Do research

• Comply with the law

• Address worker’s compensation, law enforcement, and other government requests

• Respond to lawsuits and legal actions

Your Rights

 

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. 

 

Get an electronic or paper copy of your medical record.

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.

• We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

 

Ask us to correct your medical record

• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this

• We may say “no” to your request, but we’ll tell you why within 60 days.

 

Request confidential communications

• You can ask us to contact you in a specific way (for example, home of office phone) or to send mail to a different address.

• We will say “yes” to all reasonable requests

 

Ask us to limit what we use or share

• You can ask us not to use or share certain health information for treatment or our operations. We may say “no” if it would affect your care

• We may not be able to limit information shared with law enforcement if state law requires it.

 

Get a list of those with whom we’ve shared information

• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.

• We will give you a list of where and when we have shared your information within 60 days of your request

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Get a copy of this privacy notice

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive this notice electronically. We will provide you with a paper copy promptly.

 

Choose someone to act for you

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

• We will make sure the person has this authority and can act for you before we take any action.

 

File a complaint if you feel your rights are violated

• You can complain if you feel we have violated your rights by contacting us.

• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. 

• We will not retaliate against you for filing a complaint.

 

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share hour information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

 

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care

• Share information in a disaster relief situation

If you are not able to tell us about your preferences, for example you are unconscious; we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. We would give only necessary information to emergency medical personnel if you are unable to give it yourself.

In these cases, we never share your information unless you give us written permission:

• Marketing purposes

• Sale of your information

 

In case of fundraising:

• We may contact you for fundraising efforts, but you can tell us not to contact you again.

 

Our uses and Disclosures

How do we typically use or share your health information?

We use your health information and share it with other professionals who are treating you. Example: a doctor treating you asks another doctor about your overall health condition.

 

Treat you

We use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services 

 

Advertising and promotion

For advertising and promotion, we may use your story and ultrasound images with all identifying information removed or de-identified to protect your privacy.

    www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

 

Help with public health and safety issues

    We can share health information about you for certain situations such as:

• Preventing disease

• Helping with product recalls

• Reporting adverse reactions to medications

• Reporting suspected abuse, neglect, or domestic violence

• Preventing or reducing a serious threat to anyone’s health and safety

 

Do research

    We can use or share your information for health research.

 

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see if we are complying whit federal privacy law.

Address workers’ compensation, law enforcement, and other government requests

    We can use or share health information about you:

• For workers compensation claims

• For law enforcement purposes or with a law enforcement official

• With health oversight agencies for activities authorized by law

• For special government functions such as military or national security

 

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

 

Our Responsibilities:

• We are required by law to maintain the privacy and security of your protected health information.

• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

• We must follow the duties and privacy practices described in this notice and give you a copy of it.

• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

 

For more information: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

 

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.