Privacy Practices

DOCTORS OF WOMEN
Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW PROTECTED MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

DOCTORS OF WOMEN is permitted to make uses and disclosures of protected health information for treatment, payment and health care operations, as described in the following examples:

  1. For treatment – Doctors of Women can disclose your PHI (Protected Health Information) to physicians and other licensed health care providers who provide you with health care services or are involved in your care. For example, if you’re being treated by a Urologist, Doctors of Women can disclose your PHI in order to coordinate your care.
  2. For payment – Doctors of Women can use and disclose your PHI to bill and collect payment for the treatment and services provided by Doctors of Women to you. For example, Doctors of Women may send your PHI to your insurance company or health plan to get paid for the health services that Doctors of Women have provided to you.
  3. For health care operations – Doctors of Women can disclose your PHI to operate the practice. For example, Doctors of Women might use your PHI to evaluate the quality of health care services that you received or to evaluate the performance of the health care professionals who provided such services to you.

DOCTORS OF WOMEN is permitted or required, under specific circumstances, to use or disclose protected health information without the individual’s written authorization.

  1. Protected health information: When Disclosure is required by federal law, state or local law; judicial or administrative proceedings; or, law enforcement.
  2. For Public health activities.
  3. To avoid harm.
  4. For specific government functions.
  5. For workers’ compensation purposes.
  6. Appointment reminders and health related benefits or services.

Other uses and disclosures will be made only with the Individual’s written authorization, and the individual may revoke such authorization.
DOCTORS OF WOMEN intends to engage in (n)one or more of the following activities:

  1. DOCTORS OF WOMEN may contact the individual to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to the individual or patient.
  2. A group health plan, or a health insurance issuer or HMO with respect to a group health plan, may disclose protected health information to the sponsor of the plan.

The Individual has the following rights regarding

  1. The right to request restrictions on certain uses and disclosures of protected health information. DOCTORS OF WOMEN is not required to agree to a requested restriction, however.
  2. The right to receive confidential communications of protected health information, as applicable.
  3. The right to inspect and copy protected health information, as provided in the Privacy Regulation.
  4. The right to amend protected health information, as provided in the Privacy Regulation.
  5. The right to receive an accounting of disclosures of protected health information.
  6. The right to obtain a paper copy of the Notice from the covered entity upon request. The right extends to an individual who has agreed to receive the Notice electronically.

DOCTORS OF WOMEN is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and Privacy practices with respect to protected health information.
DOCTORS OF WOMEN is required to abide by the terms of the Notice currently in effect.
DOCTORS OF WOMEN reserves the right to change the terms of this Notice. The new Notice provisions will be effective for all protected health information that it maintains.
Individuals may complain to DOCTORS OF WOMEN and to the Secretary of the Department of Health and Human Services, without fear of retaliation by the organization, if they believe their privacy rights have been violated. A brief description of how the individual may file a complaint follows: If you think that Doctors of Women may have violated your privacy rights or you disagreed with a decision Doctors of Women made about access to your PHI, you may file a complaint with Doctors of Women’s Administrator. You may also send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Ave. SW, Washington D.C. 20201. Doctors of Women will not take retaliatory action against you if you file a complaint about our privacy practices.
This Notice is first in effect on April 14, 2003.

 

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