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.
This notice describes the privacy practices of Art and Science of OB-GYN P.C., including its physicians, nurses and all other members of its workforce (sometimes referred to as “us” or “we”). All of our locations follow the terms of this notice and may share medical information with each other for treatment, payment or operations purposes described in this notice.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION.
The following categories describe the ways that we use and disclose your health-related information. For each category of uses or disclosures, we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
For Treatment. We may use and disclose information about you to provide you with medical treatment or services. We may disclose information about you to physicians, nurses, technicians, medical students, or other personnel who are involved in your care. For example, our personnel may need to communicate with hospital personnel or another physician’s office regarding your condition so that you may receive proper medical treatment. Health care providers will also record actions taken by them in the course of your treatment and note how you respond. Our office personnel may also share medical information about you in order to coordinate the things you need, such as prescriptions, lab work and x-rays. We also may disclose medical information about you to people who may be involved in your medical care, such as family members, clergy or others who provide services that are part of your care.
For Payment. We may use and disclose health information about you to others for the purpose of receiving payment for the treatment and services you receive. For example, a bill may be sent to you or a third party payor, such as an insurance company or health plan. This bill may contain information about your diagnosis and treatment. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
For Health Care Operations. We may use and disclose information about you for normal medical practice operations. For example, your health information may be disclosed to our medical and billing personnel, risk or quality improvement personnel and others to:
Evaluate the performance of our staff; assess the quality of care and outcomes in your cases and similar cases; Learn how to improve our facilities and services; and Determine how to continually improve the quality and effectiveness of the healthcare we provide.
- Appointments. We may use and disclose information to contact you as a reminder that you have an appointment for treatment.
Treatment Alternatives and Health-Related Benefits and Services. We may use and disclose information to recommend or tell you about treatment alternatives and health-related benefits or services that may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care. We may release information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. Before releasing such information, we try to obtain your written permission but are not required to do so, particularly if it is an emergency situation.
Special Situations Public Health Risks. We will disclose information about you for public health activities as required by law. These activities generally include, but are not limited to the following: (a) to prevent or control disease, injury or disability; (b) to report reactions to medications or problems with products; (c) to notify people of recalls of products they may be using; (d) to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and (e) to notify the appropriate government authority if we believe you have been the victim of abuse, neglect or domestic violence and (f) to report child abuse or neglect. Health Oversight Activities. We will disclose information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with applicable laws. Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose information about you in response to a court or administrative order. We may also disclose information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if satisfactory efforts have been made to tell you about the request or to obtain an order protecting the information requested.
We may release information if asked to do so by a law enforcement official (a) in response to a court order, subpoena, warrant, summons or similar process; (b) to identify or locate a suspect, fugitive, material witness, or missing person; (c) about the victim of a crime if, under certain limited circumstances, we are unable to obtain the patient agreement; (d) about a death we believe may be the result of criminal conduct; and (e) in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime. Coroners, Medical Examiners and Funeral Directors. We will release information to a coroner or medical examiner to identify a deceased person or determine the cause of death. We will also release information to funeral directors as necessary to carry out their duties.
YOUR HEALTH INFORMATION RIGHTS
You have the following rights regarding your health information:
Right to Inspect and Copy. You have the right to inspect and copy health information that may be used to make decisions about your care. To inspect and copy your medical information you must submit your request to us in writing. If you request a copy of the information, we will charge a fee for the costs of copying, mailing or other supplies associated with your request.
We may deny your request to inspect and copy your medical information in certain limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by us will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for us. Your request for amendment must be submitted to us in writing. In addition, you must provide a reason that supports your request. Under certain circumstances provided by law, we may deny your request for an amendment.
Right to an Accounting of Disclosures. You have the right to request an accounting (list) of certain types of disclosures we have made of medical information about you. We are not required to account for certain disclosures such as: disclosures you authorize; disclosures to carry out treatment, payment and healthcare operations; and disclosures to persons involved in your care. To request an accounting of disclosures, you must submit your request to us in writing. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper or electronically). The first list you request within a 12-month period will be free. For additional lists, we will charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction or limitation on our use or disclosure of information about you for treatment, payment or health care operations. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment. If you want to request a restriction, you must submit a written request that includes (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply (for example, disclosures to your spouse or other family members). By law, we have up to 60 days to reply.
Right to Request Confidential Communications. You have the right to request that we communicate with you in a certain way or at a certain location. (For example, you can ask that we only contact you at work or by mail). If you want to request confidential or alternative communications, please notify us in writing. We will not ask the reason for your request. We will accommodate all reasonable requests. Your request must include the address and/or telephone number where you want to be contacted.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice at any time. You may obtain a copy of this notice at any of our offices.
OBLIGATIONS OF Art and Science of OB-GYN PC
WE ARE REQUIRED BY LAW TO:
Maintain the privacy of protected health care information; Provide you with this notice of its legal duties and privacy practices with respect to your health information; Abide by the terms of this notice; Notify you if we are unable to agree to a requested restriction on how your information by alternative means or at alternative locations; and Obtain your written authorization to use or disclose your health information for reasons other than those listed above and permitted under law.
CHANGES TO THIS NOTICE
We reserve the right to change this notice at any time. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in various locations indicating the effective date. Revised copies of this notice will be provided at your next visit.
If you believe your privacy rights have been violated, you may file a complaint with the facility or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with the facility, contact Art and Science of OB-GYN PC, Attn: Privacy Officer, 1101 First Colonial Road Suite 100, Virginia Beach Virginia 23454. All complaints must be submitted in writing. You will not be penalized for filing a complaint