American Women's Services is dedicated to your
privacy and the confidentiality of your care. Your health records and all
communications with our offices will be kept confidential, unless the law
requires disclosure of your information. American Women’s Services maintains
the strictest confidentiality policies and practices. If you have any
questions or concerns about the privacy of your treatment, please contact
the office you plan to visit or e-mail us.
Notice of Health Information Privacy Practices
Effective date: April 14, 2003
American Women's Services
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION
ABOUT YOU WILL NOT BE USED OR DISCLOSED BY AMERICAN WOMEN'S SERVICES WITHOUT
YOUR WRITTEN PERMISSION EXCEPT TO COMPLY WITH THE LAW. THIS NOTICE ALSO DESCRIBES
HOW YOU CAN ACCESS YOUR INFORMATION.
American Women's Services is dedicated to maintaining the
privacy of your individually identifiable health information (also called protected
health information or PHI). In providing services to you, we create records of
the services and treatments provided. Our documentation is necessary for many
purposes, including, but not limited to, ensuring continuity of medical care;
supporting that our standards of care are met; communicating with other members
of our health care team; and supporting insurance billing. Our first concern is
for your health and for keeping your health information confidential.
The Health Insurance Portability and Accountability Act
(HIPAA) is a federal law to protect the privacy of your health information.
HIPAA requires us to provide you with the following information:
How we may use and disclose your PHI.
Your privacy rights regarding your PHI.
Our obligations concerning the use and disclosure of your PHI.
This Notice applies to all the health records created
or retained in the AWS office, including records from other health care providers.
We reserve the right to revise or amend this Notice. Any revision or amendment
to this Notice will be effective for all of your records that are created or
maintained in the past or created or maintained in the future. A copy of the
current Notice will be posted in a visible location at all times. You may also
request a copy of our most current Notice.
Please Review this Notice. If you have any questions,
please contact the AWS Privacy Official at 1-800-742-0230.
AWS WILL NOT USE AND DISCLOSE PROTECED
HEALTH INFORMATION ABOUT YOU WITHOUT YOUR PERMISSION EXCEPT IN SPECIFIC WAYS
There are several categories that describe how we will
use or disclose health information about you. This Notice describes the general
categories your information will be used for and disclosed by your consent to
the provision of services to you. There are also times when you must give your
authorization to use or disclose your health information. Your health information
may be used and/or disclosed in the following ways without your specific authorization:
- Treatment - We may use health information about you to provide you with healthcare treatment and services. Your health information may be disclosed to the doctors, clinicians, nurses, technicians, volunteers, and other staff who are providing care to you. These healthcare providers include those working in the AWS offices, at a hospital if you are hospitalized under our supervision, or at another doctor’s office, lab, pharmacy, or other healthcare provider that you are referred to for consultation, diagnostic tests, lab tests, pharmacies, or for other treatment purposes.
- Payment - Your health information may be used and disclosed so that the treatment and services provided by us may be billed to your insurance company, Medicaid agency or other third party for payment. Frequently it is necessary to disclose information to your insurance plan to obtain prior approval of payment for the service. If you pay for your health care by cash, then there is no need to use or disclose your health information for payment purposes.
- Healthcare Operations – Your health information may be used to assist us in managing the office and continuing to provide the highest quality services available to all our patients.
- Disclosures Required by Law – We will disclose health information about you only when required to do so by federal, state, or local law. We will attempt, to the best of our legal abilities, to quash any subpoena from governmental agencies for your medical records. We will resist using or disclosing, to the best of our legal abilities, your health information to any investigations, inquiries, etc.
- To Avoid a Serious Threat to Your Health or Safety – We may use and disclose health information about you to prevent a serious threat to your health and safety or to the health and safety of others. Your information would only be disclosed to someone able to help prevent the threat.
- Public Health Risks – Your health information may be disclosed to public health authorities that are authorized by law to collect information for the purposes 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) if we believe a patient has been the victim of abuse, neglect, or domestic violence. 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.
- Health Oversight Activities - We may be required to disclose your health information 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 health care system in general. We will make every effort to resist any such oversight activities that will disclose your identity.
- Lawsuits and Similar Proceedings - We may be required to use and disclose your health information when requested by court or administrative order, if you are involved in a lawsuit or similar proceeding. We also may also be required to disclose your health information in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute. We will make every effort to legally resist disclosing information about you and we will also notify you prior to disclosing your health information.
- Law Enforcement - We may be required to disclose your health information if ordered to do so by a judge in certain situations. These include:
- Regarding a crime victim if we are unable to obtain the person’s agreement
- Concerning a death if we believe has resulted from criminal conduct
- Regarding criminal conduct in 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 (including the location or victim(s) or the crime, or the description, identity or location of the perpetrator).
We will resist, to the best of our legal abilities, any and all such law
enforcement attempts to learn your identity.
- Inmates - Your health information may be disclosed to correctional institutions or law enforcement officials if you are an inmate or required to be under the custody of a law enforcement official. Disclosure for these purposes would be required: (a) for the institution to provide health care services to you, (b) for the safety and security of the institution, and/or (c) to protect your health and safety or the health and safety of other individuals.
- Workers’ Compensation - We may be required to release your health information for workers’ compensation and other similar programs, if you have a claim.
Minors have all the rights described in this Notice regarding health information
relating to reproductive healthcare, except in some states for abortion and in emergency situations or
when the law requires reporting of abuse and neglect. In the case of abortion, if a parent consents to
your abortion, the parent has all the rights outlined in this Notice. However, if you obtain a judicial
bypass of the consent requirement (in our Pennsylvania, Maryland, and Virginia offices), you have the same
rights as an adult regarding the health information related to your abortion. If you are a minor or a
person with a guardian obtaining healthcare that is not related to reproductive health, your parent or
legal guardian may have the right to access your medical record and make certain decisions regarding the
uses and disclosures of your health information.
YOUR RIGHTS REGARDING YOUR PERSONAL HEALTH INFORMATION
You have the following rights regarding the PHI we maintain about you:
- Right to Use a Pseudo name – You have the right to protect
your identity by using a fictitious name. This right only applies to patients who pay directly for
their care. However, if at any time you want your health information released, you will have to
sign that you utilized a fictitious name and what name you used. Your signature for that name must
match the signature in the medical record.
- Confidential Communications - You have the right to request that our staff communicate with you about your health and related issues in a particular manner
or at a certain location. An example is requesting that we contact you at home, rather than work.
You will be asked to write the method of how we may contact you as part of the paperwork you will
be completing as part of the office visit.
- Restriction Requests - You have the right to request
a restriction in our use or disclosure of your health information for treatment, payment
or health care operations. Additionally, you have the right to request that we restrict our
disclosure of your health information to only certain individuals involved in your care or the
payment for your care. We are not required to agree to your request; however, if we do agree,
we are bound by our agreement except when otherwise required by law, in emergencies or when
the information is necessary to treat you. In order to request a restriction in our use or
disclosure of you health information, you must make your request in writing to the AWS Privacy
Official, 1-800-742-0230. Your request must describe the following:
- The information you wish restricted
- Whether you are requesting to limit our use, disclosure or both
- To whom you want the limits to apply.
- Inspection and Copies - You have the right to inspect and
obtain a copy of the health information that may be used to make decisions about you, including
patient medical records and billing records. You must submit your request in writing to the AWS,
in order to inspect and/or obtain a copy of your health information. We may charge a fee for
the costs of copying, mailing, labor
and supplies associated with your request. We may deny your request to inspect and/or copy in
certain limited circumstances. If so, you may request a review of our denial. Another licensed
health care professional chosen by us will conduct reviews.
- Amendment - You may ask us to amend your health information
if you believe it is incorrect or incomplete, and you may request an amendment for as long as
the information is kept by or for the office. To request an amendment, your request must be made
in writing and submitted to the AWS Privacy Official, 1-800-742-0230. You must provide us with
a reason that supports your request for the amendment. Your request will be denied if you fail
to submit your request and the reason for amendment in writing. Also, we may deny your request
if you ask us to amend information that is in our opinion:
unless the individual or entity that created the information is not available to amend the
- (a) accurate and complete;
- (b) not part of the health information kept by or for our office;
- (c) not part of the of the health information which you would be permitted to inspect and copy;
- (d) not created by our staff
- Accounting 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 office has made of your
health information for purposes not related to treatment, payment or operations. Use of your
health information as part of the routine patient care in our office is not required to be
documented. In order to obtain an “accounting of disclosures,” you must submit
your request in writing to the AWS Privacy Official, 1-800-742-0230. All requests for an &accounting
of disclosures” must state a time period, which may not be longer than six (6) years
from the date of disclosure and may not include dates before April 14, 2003.
- Right to a Paper Copy of this Notice - You are entitled to
receive a paper copy of our Notice of Health Information Practices. You may ask us to
give you a copy of this Notice at any time or you may contact the AWS Privacy Official
- Right to File a Complaint - If you believe your
privacy rights have been violated, you may file a complaint with our office or with
the Secretary of the Department of Health and Human Services. To file a complaint with
our office, contact the AWS Privacy Official, 1-800-742-0230. All complaints must be
submitted in writing. You will not be penalized for filing a complaint.
- Right to Provide an Authorization for Other Uses and Disclosures
- Our office 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 health information may be revoked by you at any
time in writing. After you revoke your authorization, we will no longer use or disclose your
health information for the reasons described in your authorization. Please note that in some
states we are required to retain records of your care for a specified period of time by law.
Again, if you have any questions, please contact the AWS Privacy Official at