THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
How We May Use and Disclose Your Protected Health Information (PHI)
We use and disclose PHI for a variety of reasons. For some of those uses and disclosures, we will need your consent or specific authorization. Other uses and disclosures will not need your consent or specific authorization, including the categories which are described immediately below.
Appointment Reminders: We will use only the modes of communication (phone, voicemail, text, e-mail, mail) for which you have given us permission.
Emergency Treatment: We may disclose your health information if it is required for emergency treatment and you are unable to communicate with us (for example, if you are unconscious).
Treatment: We may disclose your PHI to doctors, nurses, and other personnel who are involved in providing your health care. For example, if you receive a positive pregnancy test, we may disclose those test results to your client mentor. Your PHI may be shared with outside entities performing services which are ancillary to your treatment.
Family, Friends, or Partners: If you choose to invite them into the counseling and ultrasound exam rooms, your health information will only be shared orally with family, friends, partners, and/or significant others.. Otherwise, no information is shared orally or in writing without your authorized written consent.
Healthcare Operations & Oversight: We may use and disclose your PHI as may be reasonably necessary in the course of operating this facility and to provide oversight for quality assessment and improvement activities. We may also provide your health information to our attorneys, consultants, and others, in order to ensure we are complying with the laws that affect us.
Legal or Regulatory Compliance: We may share PHI when required by the Secretary of Health and Human Services to determine compliance with HIPAA regulations. We may share PHI when required by federal, state, or local law, for law enforcement, or for national security or intelligence purposes. For example, we may disclose information to law enforcement personnel about victims of abuse, neglect, or domestic violence, or we may disclose PHI to avoid the threat of harm to you or another person.
Public Health: We may disclose PHI when required for public health purposes – for example, the reporting of certain communicable diseases. Additionally, we may disclose PHI in certain situations involving product recalls, adverse reactions to medications, public health or research.
Fundraising Purposes: We may disclose non-identifying general information about our clients for fundraising purposes that are directly related to our mission and non-profit medical work. Comments about our services that you leave on Exit Surveys may be shared anonymously. No identifying information (photos, contact information, names) will be used without the client’s express advance permission. Any pictures, stories, correspondence, or thank you notes sent to us become the property of Metro Women’s Care. We respect your privacy and assure you that no identifying information or photos that you send to us will ever be publicly used without your consent.
Other Disclosures: We may disclose PHI in connection with Workers Compensation claims, when required by coroners or medical examiners in order to carry out their duties with respect to a decedent, for organ procurement organizations, or in response to a court order. Disclosure of PHI may be made without your consent or authorization when required by law or when other circumstances may require or reasonably warrant such disclosure.
For uses beyond those listed above, we will ordinarily seek to obtain your authorization before disclosure. You may revoke such authorization, at any time, in writing. Revocation will not apply to health information released prior to the revocation.
Our Commitment to Safeguard Your Protected Health Information
Because we are a medical clinic that does not engage in any transactions that invoke coverage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the privacy practices described in this notice are voluntarily undertaken in order to safeguard your protected health information (PHI). Nothing in this notice should be construed as creating any contractual or legal rights on behalf of clients. We reserve the right to modify our privacy practices and this notice at any time. We will let you know promptly if any privacy breach occurs that may have compromised the safety and security of your information. You can request a copy of this notice or view the notice on our website (www.metrowomensva.com) at any time.
Your Access to and Control of Your Protected Health Information
The following is a description of your choices in accessing or controlling your PHI:
To request restrictions on uses/disclosures: You may ask in writing that we limit how we use or disclose your PHI. We will consider your request, but we are not legally bound to agree to the restriction. To the extent that we do agree to such restrictions, we will abide by such restrictions, except in emergency situations. We cannot agree to limit uses/disclosures that are required by law.
To choose how we contact you: You may ask that we send you information at an alternative address or by alternative means. We will agree to your request as long as we can easily provide it in the requested format.
To access and receive your PHI: Generally, you will be permitted to access, inspect, and receive copies of your protected health information upon written request. We will respond to your written request within 15 days. With the exception of psychotherapy notes, information compiled for legal proceedings, laboratory results to which the Clinical Laboratory Improvement Act (CLIA) prohibits access, and restrictions for clear and documented treatment reasons, you will be permitted to access, inspect, and receive your PHI. If we deny your request for access, we will give you written reasons for the denial. You may designate selected portions of your PHI for copying.
To request amendment of your PHI: If you believe that there is a mistake or missing information in our record of your PHI, you may request in writing that we correct or add to the record. We may deny your request in writing with reasons for such denial if the PHI is correct and complete, not created by us, not allowed to be disclosed, or not a part of our records. Any denial will state the reasons for the denial. If we approve the request for amendment, we will change the PHI and so inform you. We will also inform any others who have a need to know about such changes.
To learn what disclosures have been made: You may request a list of certain PHI disclosures which we have made.
To receive this notice: You may receive a paper or electronic copy of this notice upon request.
Privacy Official: If you have any questions or concerns about our privacy practices, please contact the Center’s Nurse Manager during the Center’s business hours (703-354-7272).
Effective Date: This notice goes into effect on October 1, 2019.
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