Our promises to you as our patient:
- Your pregnancy decision is your decision.
- You will always be treated with respect and dignity, regardless of your pregnancy decision.
- Women of all economic, social, racial, and faith backgrounds are welcome.
- Clinic Services are extended to women of all ages.
- All services are complimentary. You won’t be billed for any reason.
- You are guaranteed confidentiality. No one has access to your records unless you say it’s okay.
- All advice is truthful, forthright, and medically accurate.
- Medical care is provided by trained and licensed medical professionals.
Notice of Privacy Practices
Virginia law requires that all healthcare providers protect health records in their possession. If you receive services through ComfortCare Women’s Health, federal law and the Health Insurance Portability and Accountability Act of 1996 (HIPPA), also protect your health information. In addition, HIPAA requires that we provide you this Notice of Privacy Rights. It tells you how we may use and disclose your health information as well as your rights regarding the health information we have in our possession.
Health Information That We Maintain About You:
· Your name and telephone number
· The condition that brought you to ComfortCare Women’s Health
· The date the nurse reviewed your chart with you. Clinical findings related to the condition such as results of blood tests, pregnancy tests, and any other diagnostic or monitoring tests to ensure your safety.
To request restrictions on uses/disclosures: You may ask that we limit how we use or disclose your Personal Health Information (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 your information to an alternative address or by alternative means. We will agree to your request as long as it is reasonable for us to accomplish.
To inspect and copy your PHI: Unless your access is restricted for clear and documented treatment reasons, you will be permitted to inspect your protected health information upon written request. We will respond to your request within 30 days. If we deny your request for access, we will give you written reasons for the denial. If you want copies of your PHI, we will make reasonable efforts to accommodate any such request. 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 will respond within 60 days of receiving your request. If denied, we will state the reasons for the denial. If we approve the request for amendment, we will amend the PHI and will inform you. We will also notify any others who have a need to know about such changes.
To find out what disclosures have been made: You may request for us to provide you with a list of all disclosures of your PHI which have been made except for such disclosures as have been made in connection with your treatment, our healthcare operations, or as specifically required by law. We will respond to your request within 60 days of receiving it.
How We Use and Disclose Your Health Information
Treatment: We may use your health information for our treatment activities, such as disclosing to other healthcare providers that may treat you as a client.
Healthcare Operations: We may use and disclose your health information to manage our program operations, such as reviewing the quality of services you receive.
Business Associates: We may disclose your health information to organizations that help us with our work. We have a written agreement that requires these organizations to use your health information for only the reasons necessary to do the work, and to protect it from other uses or disclosures.
To Contact You: We may use the information in your health records to contact you if we have information about treatment or other health-related benefits or services that may be of interest to you.
Other Permitted Uses and Disclosures
HIPAA specifically permits us to use or disclose your health information for other purposes without your consent of authorization. In our experience such disclosures are rare, and the limited information we maintain is generally not applicable. However, when authorized by law, and to the extent we may have the information, HIPAA permits us to disclose it to:
*Comply with the requirements of federal, state, or local laws, court orders or other lawful processes and for administrative or court proceedings
*Report to a public health authority for the purpose of preventing or controlling disease, injury or disability
*Report to the FDA for the quality, safety, or effectiveness of FDA-regulated products or activities
*Notify a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition
*Report abuse, neglect, or domestic violence to a government authority
*Provide necessary information to health oversight agencies for activities, audits, investigations, inspections, licensure of the healthcare system, government benefit programs, and regulated entities
*Report to a law enforcement official for specified law enforcement purposes
*Report to researchers conducting studies approved by an Institutional “Review Board”
*Prevent or lessen a serious and imminent threat to the health of safety of a person or to the general public
*Report to authorized federal officials for specialized government functions such as military and veterans activities; national security and intelligence activities; protective services for the president; medical suitability determinations; correctional institutions, or government entities providing public benefits and to comply with worker’s compensation laws
Uses and Disclosures with Your Authorization
Other uses and disclosures of your personal information require your written authorization. You may revoke your authorization at any time by doing so in writing.
Additional Protections for Certain Information
*Confidential HIV-related information
*Alcohol or substance abuse treatment information
*Mental health treatment information for which additional protections are provided by state law.
To receive this notice: You may receive a paper or electronic copy of this notice upon request.
Contact Person: If you have any questions or concerns about our privacy practices, contact:
Wanda Crosby, RN (540) 885-7448 ext 302, PO Box 924, Staunton, VA, 24402
TEXT DISCLAIMER: This text is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged and confidential. If the reader of this text is not the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is prohibited. If you have received this text in error, please notify the sender and destroy/delete all copies of the transmittal. If you wish to not receive text from this entity, please revoke your consent as soon as possible in written form to firstname.lastname@example.org.