Lebanon Valley Midwifery

Privacy Policy

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.

OUR LEGAL DUTY

We are legally required to protect the privacy of your protected health information and to provide you with this Notice about our legal duties, our privacy practices, and your rights concerning your protected health information.  “Protected health information” is information about you that may identify you and that relates to your past, present or future physical or mental health or condition and related healthcare services.

This Notice describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law.  It also describes your rights to access and control your protected health information.

We are required to abide by the terms of this Notice of Privacy Practices.  We may change our privacy practices and the terms of this Notice at any time.  The revised Notice will be effective for information we already have about you as well as any information we receive in the future.  You may obtain a copy of any revised Notice of Privacy Practices by asking for the revised Notice the next time you are in our offices.

YOUR RIGHTS WITH RESPECT TO YOUR PROTECTED HEALTH INFORMATION

You have the right to:

  1. request limits on uses and disclosures of your protected health information.  You have the right to ask that we limit how we use and disclose your protected health information. We will consider your request, but are not legally required to accept it.  If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make.
  2. choose how we send protected health information to you. You have the right to ask that we send information to you to an alternate address or by alternate means. For example, you may ask us to send information to your work address, rather than your home address, or e-mail, instead of regular mail.
  3. see and obtain copies of your protected health information. In most cases, you have the right to review or obtain copies of your protected health information that is in our possession, but you must make this request in writing. In certain situations, we may deny your request. If we do, we will inform you, in writing, of our reasons for the denial and explain your right to have the denial reviewed.
  4. obtain a list of the disclosures we have made. You have the right to obtain a list of instances in which we have disclosed your protected health information. The list will not include uses or disclosures that you have already consented to, such as those made for treatment, payment, or healthcare operations, directly to you or to your family, or pursuant to your authorization. We will respond within 60 days of receiving your request. The list we will provide to you will include disclosures made in the last six years, if applicable, unless you request a shorter time period. 
  5. correct or update your protected health information. If you believe that there is a mistake in your protected health information or that a piece of important information is missing, you have the right to request that we correct the existing information or add the missing information. You must provide the request and your reason for the request in writing. We will respond within 60 days of receiving your request. We may deny your request in writing, if the protected health information is: 1) correct and complete, 2) not created by us, 3) not allowed to be disclosed, or 4) not part of our records. Our written denial will state the reasons for the denial and explain your rights to file a written statement of disagreement with the denial.

HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION

We may use and disclose your protected health information for Treatment, Payment, and Health Care Operations.

For Treatment.  We may disclose your protected health information to other healthcare providers who are involved in your care and treatment for the purpose of providing healthcare services to you. For example, we may provide your protected health information to our back up physicians. 

To Obtain Payment for Services.  We may use and disclose your protected health information in order to bill and collect payment for the services we have provided for you.  For example, we may provide portions of your protected health information to your health plan to obtain payment for the services we provide to you.  This may include certain activities that your health insurance plan may undertake before it approves or pays for the healthcare services we provide for you such as making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities. 

For Healthcare Operations.  We may disclose your protected health information as needed for our healthcare operations.  For example, we may use portions of your protected health information to assess the quality of the services we provide, to review the competence of our employees, for conducting training, and for accreditation, certification, licensing and credentialing activities. We also may call you by name in the waiting room.  We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment.

To Business Associates.  We may provide your protected health information to our business associates such as accountants, attorneys, consultants and others in order to support our operations efforts and to confirm that we are complying with the laws that affect us.  Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information.

OTHER USES AND DISCLOSURES FOR WHICH AUTHORIZATION IS NOT REQUIRED

In addition to our use of your protected health information for Treatment, Payment, and Healthcare Operations, we may use and disclose your protected health information without your authorization for the following purposes:

As required by law. For example, we make disclosure when a law requires that we report information to government agencies and law enforcement personnel or when ordered in a judicial or administrative proceeding.

For public health activities.  For example, we may assist and provide data for reporting information to the our professional organization in charge of collecting that information and may provide additional information to other agencies regarding specific public health issues such as child abuse or neglect.

Workplace medical surveillance.  If we perform a health service at the request of your employer, we may disclose your protected health information to your employer for purposes of workplace medical surveillance or the evaluation of work-related illness and injuries to the extent your employer needs that information to comply with OSHA or the requirements of laws having a similar purpose. We will provide you with written notice that the information will be disclosed to your employer (or the notice may be posted at your workplace).

For workers’ compensation purposes.  We may disclose protected health information as authorized by and to the extent necessary to comply with workers’ compensation laws.

Disclosures to family, friends, or others.  We may provide your protected health information to a family member, friend, or other person that you indicate is involved in your care or the payment for your healthcare, unless you object in whole or in part.

Other permitted uses and disclosures. We also may use or disclose your protected health information without your authorization for the following purposes if certain conditions are met:

  1. to report abuse, neglect or domestic violence to a government authority authorized by law to receive such reports;
  2. for health oversight activities;
  3. for judicial and administrative proceedings;
  4. for law enforcement purposes;
  5. for research purposes;
  6. to avert a serious threat to health or safety;
  7. to identify a decedent or cause of death;
  8. for specialized government functions.

State specific requirements.  Some states have separate privacy laws that may apply additional legal requirements.  If the State privacy laws are more stringent than the Federal privacy laws, the State law will control.

USES & DISCLOSURES OF PROTECTED HEALTH INFORMATION BASED ON YOUR WRITTEN AUTHORIZTION

Other uses and disclosures of protected health information not covered by this Notice or the laws that apply to us will be made only with your written authorization.  If you give us written authorization to use or disclose your protected health information, you may revoke that authorization, in writing, at any time.  If you revoke your authorization, we will no longer use or disclose protected health information for any reasons other than those described in this Notice. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES

If you have any questions about our privacy practices or this Notice, please contact us.

  • If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your protected health information or in response to a request you made to amend or restrict the use or disclosure of your protected health information, you may file a complaint with us using the contact information listed at the end of this Notice.   You also may submit a written complaint to the Secretary of the U.S. Department of Health and Human Services.  We will provide you with the address to file your complaint with the U. S. Department of Health and Human Services upon request.
  • We support your right to the privacy of your protected health information.  We will not retaliate in any way if you file a complaint with us or with the U. S. Department of Health and Human Services.

Civil Rights Notice

Service is provided, referrals are made, and employment actions are made without regard to race, sex, color, national origin, ancestry, religious creed, handicap, or age.