HIPPA Disclosure
Notice of Privacy Practices
Summary Notice
Effective April 14, 2003 - April 25, 2024
This notice describes how Health Information about you (as a patient of this practice) may be used and disclosed, and how you can get access to your individual identifiable health information.
Our practice, Total Women's Health Care, is providing you with this Notice of Privacy Practices summary. This Summary Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected Health Information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. This Summary Notice provides a summary of the Notice of Privacy Practices and briefly states:
- How your health information may be disclosed
- Your rights regarding your health information; and
- Our legal duty to protect the privacy of your health information
For a more complete description of our privacy practices you may request a Detailed Notice of Privacy Practices. This Summary Notice does not modify or limit the Detailed Notice of Privacy Practices.
Your Health Information: Health information is any information we create or receive about you and your past, present or future.
How We May Use and Disclose Your Health Information: In most cases, your written authorization is needed for us to use or disclose your health information. However, Federal law allows us to use and disclose your health information without your permission for certain purposes, including the following:
Treatment: We will use and disclose your protected health information to provide, coordinate, and manage your health care and any related services. This includes the coordination or management of your health care with a third party.
Payment: Your protected health information will be used, as needed to obtain payment for your health care services. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission.
Healthcare Operations: We may use or disclose, as needed, your protected health information in order to support the business activities of your physician's practice. These activities include but are not limited to quality assessment activities, training, licensing and conducting or arranging for other business activities. For example, we may use your name to call you from the waiting room when your physician is ready to see you. We may use or disclose your protected health information as necessary, to contact you to remind you of your appointment.
We may use or disclose your protected health information in the following situations without your authorization. These situations include, As Required By Law, Eligibility and Enrollment for Health Benefits, Law Enforcement, Coroner or Funeral Activities (with limitation), Public Health, Judicial or Administrative Proceedings, National Security, Research (with strict limitations), Services, Health Care Oversight, Abuse Reporting, Correctional Facilities, Military Activities, Workers' Compensation, When Required By Law, Health or Safety Activities, Patient Directories, Family Members or Others involved in your Care (with limitations).
A more detailed description of each use and disclosure purpose is included in the Detailed Notice of Privacy Practices.
All other uses and disclosures of your health information will not be made without your prior written authorization.
Your Privacy Rights: You have the right to:
- Review your health information;
- Obtain a copy of your health information;
- Request your health information be amended or corrected;
- Request that we not use or disclose health information;
- Request that we provide your health information to you in an alternative way or at an alternative location in a confidential manner;
- An accounting or list of disclosures of your health information; and
- Receive our Notice of Privacy Practices upon request
Changes: we reserve the right to change the notice of Privacy Practices. The revised privacy practices will be effective for all health information we already have about you, as well as information we receive in the future.
Complaints: If you are concerned that your privacy rights have been violated, you may file a complaint with us by notifying our privacy contact or the Secretary of Health and Human Services. We will not retaliate against you for filing a complaint.
This notice was published and becomes effective on/or before April 14, 2003.
We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protected health information. If you have any objections to this form, please ask to speak with our HIPPA Compliance Officer in person or by phone.