Notice of Privacy Practices

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

We are required by law to provide you with this notice that explains our privacy practices with regard to your protected health information and how we use and disclose your protected health information for treatment, payment and for health operations, as well as for other purposes that are permitted or required by law.  You have certain rights regarding the privacy of your protected health information and we also describe them in this notice.

OUR RESPONSIBILITIES:

We are required by law to:

We reserve the right to change our privacy practices and the terms of this Notice at any time and make a new notice apply to health information we already have as well as any information we receive in the future.  We will post a copy of our current notice at our office and on our website, www.womensmd.com.

WAYS IN WHICH WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION:

The following paragraphs describe different ways that we use and disclose your protected health information.

Treatment.  We may use and disclose your protected health information to provide, coordinate, or manage your health care and any related services.  We may also disclose your health information to other physicians who may be treating you.  Additionally we may from time to time disclose your health information to another physician who we have requested to be involved in your care.

Payment.  We will use and disclose your protected health information to obtain payment for the health care services we provide.

Health Care Operations.  We may use and disclose your protected health information to operate our business.  Healthcare operations may include quality assessment and improvement activities, reviewing the qualifications of healthcare professionals, conducting training programs, accreditation, certification, licensing or credentialing activities.

Appointment Reminders, Treatment Alternatives and Health Related Benefits and Services.  We may use and disclose health information to contact you and to remind you that you have an appointment.  We also may use and disclose health information to tell you about treatment alternatives or health-related benefits and services that may be of interest to you.

Others involved in your care.  When appropriate, we may use or disclose your protected health information to a family member, a relative, a close friend or any other person you identify that is involved in your medical care or payment for care.  If you are present, we will provide you with an opportunity to object to such uses or disclosures.  If you are not present, we will only disclose health information when, using our professional judgment and our experience, we determine that such disclosure is in your best interest.

Research.  We may use and disclose health information for research under certain circumstances.

As Required by Law.  We may use and disclose your protected health information to the Secretary of the Department of Health and Human Services and to others, as required by federal, state or local laws.  If you are involved in a lawsuit or dispute we may disclose health information in response to a court or administrative order or subpoena, subject to certain procedural requirements.

To Avert a Serious Threat to Public Health or Safety.  We may use and disclose your protected health information to a public health authority that is permitted to collect or receive the information for the purpose of controlling disease, injury, or disability.

Workers’ compensation.  We may use and disclose your protected health information for worker’s compensation or similar programs that provide benefits for work-related injuries or illness.

Government Agencies.  We may disclose your protected health information to government agencies so that they can monitor, investigate, inspect, discipline or license those who work in the health care system or for government benefit programs.

Law Enforcement Officials.  We may disclose your protected health information to law enforcement officials to report or prevent a crime, locate or identify a suspect, fugitive or material witness or assist a victim of a crime.

Specialized Government Functions.  If you are a member of the armed forces, we may disclose your protected health information as required by military command authorities or to evaluate your eligibility for veterans benefits.  We also may disclose your health information for conducting national security and intelligence activities, including providing protective services to the President or other persons provided protective services under Federal law.

Coroners, Medical Examiners and Funeral Directors.  We may disclose your protected health information to coroners, medical examiners and funeral directors so they can carry out their duties or for purposes of identification or determining cause of death.

Organ Donation.  We may disclose your protected health information to people involved with obtaining, storing or transplanting organs, eyes or tissues for donation purposes.

Business Associates.  We may share your protected health information with third party “business associates” that perform various services for us.  For example, we may disclose your medical information to third parties to provide billing services.  To protect you, however, we require our business associates to safeguard your health information.

YOUR HEALTH INFORMATION RIGHTS:

Although your health record is the physical property of our practice, the information belongs to you.  You have the following rights with respect to your health information:

Right to Inspect and Copy.  You have the right to inspect the protected health information that may be used to make decisions about your care or payment for your care for as long as we maintain that information with certain exceptions.  This includes medical and billing records.  To inspect this health information, you must make your request in writing to the practice manager.  We may charge you a fee for the costs of copying, mailing, labor and other supplies used in fulfilling your request.  Your request must be submitted in writing.  We will have 30 days to respond to your request for information maintained at our practice site.  If the information is stored off-site, we are allowed up to 60 days to respond but must inform you of this delay.

Right to Amend.  If you feel that health information we have is incorrect or incomplete, you may ask us to amend the information.  You have the right to request an amendment for as long as the information is kept by or for our office.  We may deny your request under certain circumstances.  Your request must be in writing and it must explain why the information should be amended.

Right to an Accounting of Disclosures.  You have the right to request a list of certain disclosures of your health information we have made outside our practice that were not for treatment, payment or health care operations.  Your request must be made in writing and must state the time period for the requested information.  You may not include information for dates prior to April 14, 2003 (compliance date for the federal regulation), nor for a period of time greater than six years (our legal obligation to retain information).  Your first request for a list of disclosures within a 12-month period will be free, however, if you request an additional list within 12 months, we may charge a fee for the subsequent listing.

Right to Request Confidential Communication.  You have the right to request that we communicate with you in a certain way or at a certain location to preserve your privacy.  Your request must be made in writing, specifying how or where you wish to be contacted.  We will accommodate reasonable requests.

Right to Request Restrictions.  You have the right to request a restriction or limitation of how we use your disclose your health information.  Such restrictions must be requested in writing.  We are not required to agree with your request, but if we agree, we will comply with your request unless that information is needed for emergency treatment.

Right to File a Complaint.  If you believe we have violated your health information privacy rights, you have the right to file a complaint with our practice manager or directly to the Secretary of Health and Human Services.  To file a complaint with our manager, file a written complaint with as much detail as you can about the suspected violation by sending it to:  Practice Manager, Obstetrical Associates of St. Louis, Inc., 224 South Woods Mill Road, Suite 750, Chesterfield, MO 63017.  Please be advised that there will be no retaliation for filing a complaint.

USES OR DISCLOSURES NOT COVERED:

Uses or disclosures of your health information not covered by this notice or the laws that apply to us may only be made with your written authorization.  You may revoke such authorization in writing at any time and we will no longer disclose health information about you for the reasons stated in your written authorization.  Disclosures made in reliance on the authorization prior to the revocation are not affected by the revocation.

If you have questions or would like more information about our privacy practices, you may contact the practice office manager at (314) 576-9797.

 

Effective April 14, 2003