EFFECTIVE DATE: 5/2018
NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
PLEASE READ IT CAREFULLY
EMW Women’s Surgical Center and staff are committed to protection the privacy of your health record and the confidentiality of your visit. In accordance with the Federal Health Information Portability and Accountability Act (HIPAA), our commitment to your privacy EXCEEDS the requirements of the law.
Your healthcare record, known as a chart, and the information it contains will not be disclosed or released to any one outside this office without your written authorization except as allowed by state or federal law.
NO ONE, including your parent or spouse, will be allowed access to your information without your written authorization except when required by law. Whenever possible, the information will be “de-identified,” that means your name, address, and other identifying information will be removed.
EMW Women’s Surgical Center will use your health information for the purpose of:
For example, information obtained by us will be used by staff members to determine the best treatment for you. When you choose to give us personal information, we keep it confidential, and solely for scheduling your requested appointment.
If you want to submit a claim to your insurance company for reimbursement, EMW Women’s Surgical Center as a courtesy will do so for you or we can assist you in preparing the necessary forms.Most insurance companies include full range reproductive health care in their policies, but your employer may have excluded pregnancy related services or family planning because of recent Supreme court rulings putting a businesses rights above their employees, but every policy is different so please ask your policy’s Customer Service representative.
Regular Healthcare Operations
For example, members of our staff may use some information in your chart to assess the care you received and the outcomes for the purpose of our Continuous Quality Improvement Program.
EMW Women’s Surgical Center may share information with our insurance company in response to litigation. De-identified statistical information may be released to the National Abortion Federation (NAF) and other organizations to improve the quality of our care. Any outside agency will also be required to safeguard your information.
Disclosures Required by Law
EMW Women’s Surgical Center may be required by law and United States Government to report health information related to adverse events with regard to defective products to the Food and Drug Administration (FDA), the Centers for Disease Control (CDC) or the Health and Human Services Administration (HHS).
State of Kentucky
The state requires reporting of statistical information regarding abortions, including gestational age, age, race, marital and educational status, and city or county of residence. We WILL NOT release your name, address, or any other identifying information.
EMW Women’s Surgical Center may be required by law to report health information related to preventing certain communicable diseases, injury or disability.
EMW Women’s Surgical Center may be required to report health information in response to a valid subpoena such as in cases of abuse or other crimes.
We do not sell, rent, share, or otherwise disclose mailing lists or other personally identifiable information. We maintain medical records of former patients should you need to contact us in the future for up to 5 years as required by law.
File a complaint if you feel your rights are violated
You can complain if you feel we have violated your privacy rights by contacting EMW Women’s Surgical Center at (502) 589-2124 and requesting to speak with the HIPAA Privacy Officer.
If you feel we have been unable to provide satisfactory resolution, you can file a complaint with the U.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
1-877-696-6775 or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
We will not retaliate against you for filing a complaint.
Changes to the Terms of this Notice