NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY HAVE ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice applies to all of the records of your care created by the Women's Clinic and Family Counseling Center, whether made by the practice or an associated facility.
This notice describes our clinic policies, which include:
- Any health care professional authorized to enter information into your chart (including Physicians, RNP's, and CA's, etc.)
- All areas of the practice (front desk, administration, and billing, etc.);
- All employees, staff and other personnel that work for or with our facility;
- Our business associates (including billing services, or other facilities to which we refer patients to) and as by law.
The practice provides this Notice to comply with the Privacy Regulations issued by the Department of Heath and Human Services in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
OUR THOUGHTS ABOUT YOUR PROTECTED HEALTH INFORMATION:
We understand that your medical information is personal to you, and we are committed to protecting the information about you. As our patient, we form paper and electronic medical records about your health, our care for you, and/or items we provide to you as our patient. We need this record to provide for your care and to comply with certain legal requirements.
By signing this consent you, as our patient, understand that Women's Clinic and Family Counseling Center has a Notice of Privacy Practices, in which you have the opportunity to review at any time. As our Patient you also understand that:
- We may use and disclose your protected health information (PHI) for treatment, payment, and healthcare operations (TPO) as well as other times to provide you with first-rate service.
- You have the right to inspect, copy, and amend your PHI. You have the right to request restrictions on the use of your PHI. You have the right to an accounting of the disclosures of your PHI for other the TPO.
- You can receive a full Notice of Privacy Practices (NPP) by request. Please read it and if you have any questions, please feel free to meet with our privacy officer for clarification or assistance.
Updated 12-1-09