Privacy Statement

Your individually identifiable health information is information collected from you that we have either created, or received by our practice that related to the past, present, or future physical or mental health condition of an you as well as the provision of healthcare to an individual and identifies the individual or as to which there is a reasonable basis to believe the information can be used to identify the individual

Disclosure of Personal Health Information

Personal Health Information (PHI) must be disclosed in only two circumstances without consent from the individual: to the individual who requests their own information, or to the Department of Health and Human Services for purposes of investigating and determining compliance with standards.

In the normal course of our business operations we may send your personal health information to other providers in the coordination or care, or as a referral to another health care provider for your treatment. You will not have to sign another consent or authorization for this use of your personal health information. If information is sent to another provider on your behalf, we will have an accounting of the information available to you within 1 work week of a written request from you.

Accounting of Disclosure of PHI.

You have the right to inspect your own personal health information; you may also request an accounting of your own PHI. This means if we disclose your PHI to anyone outside of Partners in Womens Health P.C. we will keep a record of where and when your information was sent.

If you want to personally inspect your own records, you must give us 1 work week notice, you need to set up an appointment with the front desk, and a member of Partners in Womens Health P.C. staff will accompany you while you inspect your records.

Record Copy

You may request a copy of your records; we will make a copy of your records for you. You must request the copy in writing, and give us 1 work week to complete the copy. You can pick up the copy in the office or we will mail the copy to your home. We will charge you $0.10 per page for the cost of copying your records.

Amendment Protocol

If you would like to see an amendment made to your record: you must submit in writing the request for the amendment to the office manager. Your request will be reviewed by your provider and the office manager within 30 days of receipt of the written request for the amendment. You will receive in writing a response from the office manager and provider if your amendment to you record has been accepted and made to your personal health information, or if it has been refused. Upon refusal of the amendment you may write again to the Board of Directors of the corporation, you have 30 days to respond to the original denial of amendment. The Board of Directors then will have 30 days to respond to your request for amendment. You will receive in writing a response from the Board of Directors either acceptance or denial of the amendment.

Consent

You have signed a consent which we have a direct treatment relationship with you. We will use your information for the treatment, payment or health care operation. Treatment includes: the provision, coordination, or management of health care and related services by one or more health care providers, including the coordination of management of healthreferral of a patient from one provider to another. Payment encompasses a range of activities from coordination of benefits, billing, collection, utilization review, to risk adjusting amounts. This list is not exhaustive. For a complete list of definitions see: HIPAA federal regulation 45 C.F.R.164.501.

Health care operations includes many activities relating to the daily operations of a physician practice including but not limited to contacting patients and providers, case management, legal services, and compliance. Again this list if not exhaustive for a complete list see HIPAA federal regulation 45 C.F.R.164.501.

Your personal health information may be transmitted without consent in the following instances:

When we have an indirect treatment relationship with the individual (e.g. radiologist or pathologist).

When a health plan has requested information

The provider created or received health information in the course of providing health care to an individual who is an inmate.

If we attempt but can not obtain consent due to substantial barriers in communicating with you, and the provider, in the exercise of professional judgment, determines that consent would be given, if clearly inferred from the circumstances.

In emergency situations if the covered health care provider attempts to obtain such consent as soon as reasonable practicable after the delivery of such treatment.

We may disclose to a family member, a close personal friend or any other person identified by you. If that information is directly relevant to the person’s involvement in the individual’s care and payment. If the patient is present, we need only obtain individual’s oral agreement or failure to object, to share personal health information with other person/family member. Example: individual visits a provider and brings their spouse to an appointment; personal health information will be shared with the spouse as well as the individual at the time of the visit. The spouse then may also contact the office at a later date and will receive personal health information.

If the individual is incapacitated or it is an emergency situation, the provider may share personal health information about an individual with a family member, or close personal friend upon a determination by the provider that such a disclosure is in the individuals best interest, e.g. car accident, individual is incapacitated, but needs pharmaceutical supplies, provider may decide is it appropriate to ask family member to obtain Rx.

Your personal health information may be disclosed in the following instances:

Uses and disclosures are required by law; Public Health Activities;Public Health reporting; Child Abuse and Neglect; F.D.A.; Communicable diseases; Employer Medical Surveillance; Disclosures about victims of abuse, neglect, or domestic violence; Health Oversight Activities; Judicial and Administrative Proceedings; Law Enforcement Purposes; Coroners, Medical examiners and funeral directors; Cadaveric, Organ, eye, and tissue donation; Research; To avert a serious threat to health or safety; Specialized government functions; or Worker’s compensation.

Business Associates

Any personal health information that is sent to another entity in the treatment, payment or business operations of Partners in Womens Health PC has been identified. Those individuals needing access to the information has signed a business associate contract with Partners in Womens Health PC agreeing to safeguard information and prevent use or disclosure of the information as provided by its contract. Business associates will report to Partners in Womens Health PC any disclosure of personal health information that is not provided for in its contract when it becomes aware of any violations of disclosure. Partners in Womens Health PC has agreed with all of it’s business associates to the same restrictions and conditions that it operates to the business associate with respect to the protection of the personal health information. Any violation on the behalf of a business associate and personal health information is grounds for termination of the relationship with Partners in Womens Health PC. Any breaches of personal health information by a business associate will first try to remedy the situation, and then if unable to remedy, Partners in Womens Health PC will terminate the contract with the Business Associate and report the breach to the D.H.H.S Secretary.

Appointment Reminders

In the normal course of our business operations you may receive appointment reminder cards in the mail. These cards are utilized to assist you when you need to return for an appointment with our providers.

We may also phone you and leave messages reminding you of an appointment or the need for a follow up appointment.

Retention of Medical Records

As long as you are an active patient with the practice, your medical records will be maintained continually.

If you are an inactive patient (you are no longer seeing the providers in this practice) we maintain a copy of your medical records for 10 years. After 10 years we are no longer obligated to maintain a copy of your records and will destroy them.

As an inactive patient, your records will be stored in our office for three years, then are moved to an off site storage facility until 10 years has lapsed. The records will then be marked for destruction. If you want to have copies of your medical records you may request them from us until your last visit is less than 10 years.

We maintain your records in a locked confidential site either here in our office, or utilizing our offsite facility. When we destroy records, they are shredded and then recycled using a local company for confidential secured recycling methods. When we destroy records we will have an index of files that were destroyed, including a date of destruction, method of destruction, patient name, date of birth, and dates of service.