Genetics & IVF Institute
Notice OF Privacy Practices for Patients
Effective April 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by Genetics & IVF Institute in any form, whether electronically, on paper, or orally be kept confidential to maintain the privacy of your protected health information. This Act gives you, the patient, significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information.
As required by HIPAA, we have prepared this Notice of Privacy Practices (NPP) which describes how Genetics & IVF Institute (GIVF) is required to maintain the privacy of your health information and how we may use and disclose your protected health information.
We may use and disclose your medical records only for each of the following purposes: treatment, payment, or health care operations.
Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. Examples of this would include related care and treatment services by health care providers, scheduling surgery, other exams or appointments with other providers, calling in prescriptions and refills, consultation between health care providers relating to a patient for coordination of care and physician to staff discussions for coordination of care, and the referral of a patient for health care from one health care provider to another.
Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, related data processing, and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment.
Health care operations include the business aspects of running our practice on a daily basis, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. An example would be an internal quality assessment review.
Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.
We reserve the right to update these practices at any time. The revised notice will be posted in our patient waiting areas and you will have the opportunity to request a paper or electronic copy of the revised notice from our privacy officer, the front desk staff, or by accessing our website.
We may also create and distribute de-identified health information by removing all references to individually identifiable information.
We may contact you to confirm your appointments or communicate with you in connection with care management or coordination.
You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the Privacy Officer.
- The right to request restrictions on certain uses and disclosures of protected health information, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to revoke it.
- The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations.
- The right to inspect and copy your protected health information.
- The right to amend your protected health information.
- The right to receive an accounting of disclosures of protected health information.
- The right to obtain a paper copy of this notice from us upon request.
We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information.
This notice is effective as of April 14, 2003 and we are required to abide by the terms of the Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain. We will post and you may request a written copy of the revised Notice of Privacy Practices from this office.
You have recourse if you feel that your privacy protections have been violated. You have the right to file a formal, written complaint with our office or with the Department of Health & Human Services, Office of Civil Rights, about violations of the provisions of this notice or the policies and procedures of our office. We will not retaliate against you for filing a complaint.
Please contact us for more information by asking to speak to Cheryl Richardson, our Privacy Officer. If you prefer to submit a written inquiry, please send it to her at the address below:
Genetics & IVF Institute
3015 Williams Drive
Fairfax, VA 22031
For more information about HIPAA or to file a complaint:
The U. S. Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue, SW
Washington, DC 20201
202-619-0257 or 1-877-696-6775