Information for understanding our legal requirements pertaining to your personal information.

To help make our legal requirements pertaining to your personal information, we’re providing you with the following information:

  • How we may use and disclose your IIHI
  • Your privacy rights in your IIHI
  • Our obligations concerning the use and disclosure of your IIHI

The terms of this Notice apply to all records containing your IIHI that are created or retained by Physicians for Women. We reserve the right to revise or amend our Notice of Privacy Practices at any time. Any revision or amendment to this Notice will be effective for all records our practice has created or maintained in the past, and for any of your records we may create or maintain in the future. Our practice will post a copy of our current Notice in a visible location, and you may request a copy of it for your own personal files.

Disclosure of your IIHI

We have the ability to use and disclose your IIHI in the following situations:

  1. Treatment: We may use your IIHI to provide you with treatment. For example, we may ask you to have laboratory tests conducted, such as blood or urine tests, and we may use the results to help us reach a diagnosis. We might use your IIHI in order to write a prescription for you, or we might disclose your IIHI to a pharmacy when we order a prescription for you. Additionally, your IIHI may be disclosed to others assisting in your care, such as your spouse, children or parents. Finally, we may also disclose your IIHI to other healthcare providers for purposes related to your treatment.
  2. Payment: At Physicians for Women, we may use and disclose your IIHI in order to bill and collect payment for the services you receive from us. For example, if we contact your health insurance provider to verify your benefits, we may provide your insurer with details regarding your treatment to determine if they will cover the cost. Your IIHI can be disclosed to obtain payment from third parties that may be responsible for such costs, such as family members. It may also be used to bill you directly for services and items. We may disclose your IIHI to collection agencies or attorneys to obtain collection of payment. We may disclose your IIHI to the NC Insurance Commissioner if we need to report your particular insurance company to them. We may disclose your IIHI to other health care providers and entities to assist in their billing and collection efforts.
  3. Appointment Reminders: We may use and disclose your IIHI to contact you and remind you of an appointment by phone or mail.
  4. Test Results: Physicians for Women may use and disclose your IIHI to contact you about test results by phone or mail.
  5. Treatment Options: We may use and disclose your IIHI to inform you of potential treatment options or alternatives.
  6. Health-Related Benefits and Services: We may use and disclose your IIHI to inform you of health-related benefits or services that may be of interest to you.
  7. Release of Information to Family/Friends: We may release your IIHI to a friend or family member that is involved in your care, or who assists in taking care of you.
  8. Disclosures Required By Law: Physicians for Women will use and disclose your IIHI when we are required to do so by federal, state or local law.

The following categories describe unique scenarios in which we may use or disclose your identifiable health information:

  1. Public Health Risks: Our practice may disclose your IIHI to public health authorities that are authorized by law to collect information for the purpose of:
    • maintaining vital records, such as births and deaths
    • reporting child abuse or neglect
    • preventing or controlling disease, injury or disability
    • notifying a person regarding potential exposure to a communicable disease
    • notifying a person regarding a potential risk for spreading or contracting a disease or condition
    • reporting reactions to drugs or problems with products or devices
    • notifying individuals if a product or device they may be using has been recalled
    • notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse or neglect of an adult patient (including domestic violence); however, we will only disclose this information if the patient agrees or we are required or authorized by law to disclose this information
    • notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance.
  2. Health Oversight Activities: We may disclose your IIHI to a Health Oversight Agency for activities authorized by law. Oversight activities can include, investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the healthcare system in general.
  3. Lawsuits and Similar Proceedings: Our practice may use and disclose your IIHI in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We also may disclose your IIHI in response to a discovery request, subpoena or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.
  4. Law Enforcement: We may release IIHI if asked to do so by a law enforcement official:
    • Regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement
    • Concerning a death we believe has resulted from criminal conduct
    • Regarding criminal conduct at our offices
    • In response to a warrant, summons, court order, subpoena or similar legal process
    • To identify/locate a suspect, material witness, fugitive or missing person
    • In an emergency, to report a crime
  5. Deceased Patients: Our practice may release your IIHI to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necessary, we also may release information in order for funeral directors to perform their jobs.
  6. Organ and Tissue Donation: Our practice may release your IIHI to organizations that handle organ, eye or tissue procurement or transplantation, including organ donation banks, as necessary to facilitate organ or tissue donation and transplantation if you are an organ donor.
  7. Research: Our Practice may use and disclose your IIHI for research purposes in certain limited circumstances. We will obtain your written authorization to use your IIHI for these purposes, except when an Institutional Review Board or Privacy Board has determined the waiver of your authorization satisfies the following: (i) the use or disclosure involves no more than a minimal risk to your privacy based on the following: (A) an adequate plan to protect the identifiers from improper use and disclosures: (B) an adequate plan to destroy the identifiers at the earliest opportunity consistent with the research (unless there is a health or research justification for retaining the identifiers or such retention is otherwise required by law); and (C) adequate written assurances that the PHI will not be re-used or disclosed to any other person or entity (except as required by law) for authorized oversight of the research study, or for other research for which the use or disclosure would otherwise be permitted; (ii) the research could not practicably be conducted without the waiver; and (iii) the research could not practicably be conducted without access to and use of the PHI.
  8. Serious Threats to Health or Safety: Physicians for Women may use and disclose your IIHI when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.
  9. Military: Our practice may disclose your IIHI if you are a member of U.S. or foreign military forces and if it is required by the appropriate authorities.
  10. National Security: Our practice may disclose your IIHI to federal officials for intelligence and national security activities authorized by law. We also may disclose your IIHI to federal officials in order to protect the President, other officials or foreign heads of state, or to conduct investigations.
  11. Inmates: We may disclose your IIHI to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: for the institution to provide health care services to you, for the safety and security of the institution, and/or to protect your health and safety or the health and safety of other individuals.
  12. Workers’ Compensation: Our practice may release your IIHI for workers’ compensation and similar programs.

Your Rights Regarding Your IIHI You have the following rights regarding the IIHI that we maintain about you:

    1. Confidential Communications: You have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work.
    2. Requesting Restrictions: You have the right to request a restriction in our use or disclosure of your IIHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your IIHI to only certain individuals involved in your care or the payment for your care, such as family members and friends. Your request must describe in a clear and concise fashion:
      • the information you wish restricted
      • whether you are requesting to limit our practice’s use, disclosure or both
      • to whom you want the limits to apply.
    3. Inspection and Copies: You have the right to inspect and obtain a copy of the IIHI that may be used to make decisions about you, including patient medical records and billing records.
    4. Accounting of Disclosures: All of our patients have the right to request an Accounting of Disclosures. An Accounting of Disclosures is a list of certain non-routine disclosures our practice has made of your IIHI for non-treatment, non-payment or non-operations purposes. Use of your IIHI as part of the routine patient care in our practice is not required to be documented. For example, the doctor sharing information with the nurse; or the billing department using your information to file your insurance claim.
    5. Right to a Paper Copy of This Notice: You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time.
    6. Right to File a Complaint: If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services.
    7. Right to Provide an Authorization for Other Uses and Disclosures: Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your IIHI may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your IIHI for the reasons described in the authorization. Please note, we are required to retain records of your care.