Women's Health Partnership, PC
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Women’s Health Partnership, P.C

NOTICE OF PRIVACY PRACTICES

As Required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU (AS A PATIENT OF THIS PRACTICE) MAY BE USED AND DISCLOSED, AND HOW YOU CAN OBTAIN ACCESS TO YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION.

A. OUR COMMITMENT TO YOUR PRIVACY

Our practice is dedicated to maintaining the privacy of your individually identifiable health information (IIHI). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning your IIHI. By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at the time.

The terms of this notice apply to all records containing your IIHI that are created or retained by our practice. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this notice will be effective for all of your records that our practice has created or maintained in the past, and for any of your records that we may create or maintain in the future. A copy of our current Notice is posted in our offices and on our website www.whp.com.

B. IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:

Privacy Officer
Women’s Health Partnership, P.C.
11595 North Meridian Street, Suite 110
Carmel, IN 46032
317-575-7300 ext 222
privacy@whp.com

C. WE MAY USE AND DISCLOSE YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (IIHI) IN THE FOLLOWING WAYS

1. Treatment. Our practice may use your IIHI to treat you. Example: We may ask you to have laboratory tests and we may use the results to help us reach a diagnosis and determine treatment options. We may use your IIHI in order to write a prescription for you, or we may disclose your IIHI to a pharmacy when we order a prescription. We may also disclose your PHI to other healthcare providers in an effort to ensure continuity of care.

2. Payment. Our practice may use and disclose your IIHI in order to bill and collect payment for the services and items you may receive from us. Example: We may contact your health insurer to certify that you are eligible for benefits and for payment of your treatment. We also may use and disclose your IIHI to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use your IIHI to bill you directly for services and items.

3. Health Care Operations. Our practice may use and disclose your IIHI to operate our business. Example: Evaluate the quality of care you received from us, or to conduct cost-management and business planning activities for our practice. We may use or disclose, your IIHI in order to support the business activities of our practice. Example: Students, licensing, and employee review activities. We may share your IIHI with third party “business associates”. Example: Transcription services, legal services, and courier services. Whenever an arrangement between our office and a business associate involves the use or disclosure of your IIHI, we will have a written contract that contains terms that will protect the privacy of your IIHI. We may use a sign-in sheet at the registration desk, call you by name in the waiting room, contact you by phone for appointment reminders, and leave a message of minimal content on your voice mail box.

4. Public Health Risks. Our practice may disclose your IIHI to public health authorities that are authorized by law to collect information for the purpose of:

  • maintaining vital records
  • 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) regarding the potential abuse or neglect of a patient (including domestic violence); however, we will only disclose this information if the patient agrees or we are required or authorized by law to disclose this information

    5. Lawsuits and Similar Proceedings. Our practice may use and disclose your IIHI in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We also may disclose your IIHI in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.

    6. Disclosures Required By Law Enforcement. We may release IIHI if asked to do so by a law enforcement official when required to do so by federal, state or local law.

    7. Workers’ Compensation. Our practice may release your IIHI for workers’ compensation and similar programs.

    D. YOUR RIGHTS REGARDING YOUR IIHI

    1. Confidential Communications. You have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make a written request to the Practice Manager of your physician’s office listed below, specifying the requested method of contact, or the location where you wish to be contacted. Our practice will accommodate reasonable requests. You do not need to give a reason for your request.

    2. Requesting Restrictions. You have the right to request a restriction in our use or disclosure of your IIHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your IIHI to only certain individuals involved in your care or the payment for your care, such as family members and friends. 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 your IIHI, you must make your request in writing to the Practice Manager of your physician’s office listed below. Your request must describe in a clear and concise fashion:

    (a) the information you wish restricted;
    (b) whether you are requesting to limit our practice’s use, disclosure or both; and
    (c) to whom you want the limits to apply.

    3. Inspection and Copies. You have the right to inspect and obtain a copy of the IIHI that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to the Practice Manager of your physician’s office listed below in order to inspect and/or obtain a copy of your IIHI. Our practice will charge a fee for the costs of copying, mailing, labor and supplies associated with your request. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. Another licensed health care professional chosen by us will conduct reviews.

    4. 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 our practice. To request an amendment, your request must be made in writing and submitted to the Practice Manager of your physician’s office listed below. You must provide us with a reason that supports your request for amendment. We may deny your request if you ask us to amend information that is in our opinion: (a) accurate and complete; (b) not part of the IIHI kept by or for the practice; (c) not part of the IIHI which you would be permitted to inspect and copy; or (d) not created by our practice, unless the individual or entity that created the information is not available to amend the information.

    5. Accounting of 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 practice has made of your IIHI for non-treatment or operations purposes. Use of your IIHI as part of the routine patient care in our practice is not required to be documented. Example, the doctor sharing information with the nurse; or the billing department using your information to file your insurance claim. In order to obtain an accounting of disclosures, you must submit your request in writing to the Practice Manager of your physician’s office listed below. 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. The first list you request within a 12-month period is free of charge, but our practice may charge you for additional lists within the same 12-month period. Our practice will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs.

    6. Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a written complaint with our practice, contact Privacy Officer, Women’s Health Partnership P.C. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

    7. Right to Provide an Authorization for Other Uses and Disclosures. Our practice 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 IIHI may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your IIHI for the reasons described in the authorization. Please note, we are required to retain records of your care.

    8. Right to a Paper Copy of This Notice. You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact the Practice Manager of your physician’s office listed below or obtain from our website www.whp.com.

    Please contact the office of where your medical records are maintained.

    Beacon OB/GYN 317-872-1415
    Beech Grove OB/GYN 317-859-2535
    Carmel OB/GYN 317-573-7050
    Carmel OB/GYN at Fishers 317-841-3744
    Clearvista Women’s Care 317-577-7444
    Indianapolis Physicians for Women 317-872-3459
    Northwest OB/GYN Associates 317-872-9680
    Northwest OB/GYN at Hazel Del 317-843-9352
    OB-GYN Associates 317-297-3774

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