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.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do
- We will provide a copy or a summary of your health information, usually within 30 days of your We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different
- We will say “yes” to all reasonable
Ask us to limit what we use or share
- You can ask us not to use or share certain health information for treatment or our
- We are not required to agree to your request, and we may say “no” if it would affect your
Get a list of those with whom we’ve shared information
- You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and
- We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free.
Get a copy of this privacy notice
- You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically, we will provide you with a paper copy
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health
- We will make sure the person has this authority and can act for you before we take any
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting
- You can file a complaint with the S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
- We will not retaliate against you for filing a
Your Choices
For your health information, you can tell us your choices about what we share.
If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us. We never share your information in these situations unless you give us written permission which you may withdraw at any time.
- Share with your family, close friends, or others involved in your
- Share your information for marketing
Our Uses and Disclosures
How do we typically use or share your health information?
We use or share your health information in the following ways:
Treat you
We use your health information and share it with other professionals who are treating you.
Example: A Choices staff member will share your information with the RN who is performing your pregnancy test and ultrasound.
Run our organization
We use and share your health information internally to run our organization, improve your care, and contact you when necessary.
Example: A Choices staff member may share your information (as de-identified as possible) with other staff in order to improve our services.
Advertising & Promotion
For advertising and promotion, we may use your story and ultrasound images with all identifying information removed to protect your privacy. www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
- Reporting suspected abuse, neglect, or domestic
- Preventing or reducing a serious threat to anyone’s health or
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Address law enforcement and other government requests
We can use or share health information about you:
- For law enforcement purposes or with a law enforcement
- With health oversight agencies for activities authorized by
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our websites.
Veronica Edwards, Privacy Officer
admin@choices4.me
217.345.8000
Effective Date: 10/15/2022
