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Planned Parenthood® of Southern New Jersey
strives to protect your privacy and confidentiality. We understand that
health information about you and your healthcare is personal. We are
committed to protecting health information about you. We will create a
record of the care and services you receive from us. We do so to provide
you with quality care and to comply with any legal or regulatory
requirements.
This Notice applies to all of the records generated or
received by Planned Parenthood® of Southern New Jersey, whether
we documented the health information, or another doctor forwarded it to
us. This Notice will tell you the ways in which we may use or disclose
health information about you. This Notice also describes your rights to
the health information we keep about you, and describe certain obligations
we have regarding the use and disclosure of your health information.
Our pledge regarding your health information is backed-up
by Federal law. The privacy and security provisions of the Health
Insurance Portability and Accountability Act (“HIPAA”) require us to:
· Make
sure that health information that identifies you is kept private;
· Make
available this notice of our legal duties and privacy practices with
respect to health information about you; and
· Follow
the terms of the notice that is currently in effect.
HOW WE MAY USE AND
DISCLOSE HEALTH INFORMATION ABOUT YOU
The following
categories describe different ways that we may use or disclose health
information about you. Unless otherwise noted each of these uses and
disclosures may be made without your permission. For each category of use
or disclosure, we will explain what we mean and give some examples. Not
every use or disclosure in a category will be listed. However, unless we
ask for a separate authorization, all of the ways we are permitted to use
and disclose information will fall within one of the categories.
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Ways health
information may be shared. |
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For Treatment.
We may use health information about you to provide you with healthcare
treatment and services. We may disclose health information about you
to doctors, nurses, technicians, health students, volunteers or other
personnel who are involved in taking care of you. They may work at
our offices, at a hospital , or at another doctor’s office, lab,
pharmacy, or other healthcare provider to whom we may refer you for
consultation, to take x-rays, to perform lab tests, to have
prescriptions filled, or for other treatment purposes.
We may share the information you have given us on the
forms you fill out with other health care providers in the course of
providing you health care. |
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For Payment:
We may use and disclose health information about you so that the
treatment and services you receive from us may be billed to and
payment collected from you, an insurance company, a state Medicaid
agency or a third party. If you are using
insurance or Medicaid to pay for your visit, we must give them
information about the treatment you received or are going to receive
so they can determine what your plan will pay for. |
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For Healthcare
Operations:
We may use and disclose health information about you for operations of
our healthcare practice. These uses and disclosures are necessary to
run our practice and make sure that all of our patients receive
quality care.
We may use health information about you ( or any of our
clients) to find ways to improve the care and service we provide.
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Appointment
Reminders:
We may use and disclose health information to contact you as a
reminder that you have an appointment. Please let us know if you do
not wish to have us contact you concerning your appointment. |
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Research.
There may be situations where we want to use and disclose health
information about you for research purposes For any research project
that uses your health information, we will either obtain an
authorization from you or ask an Institutional Review or Privacy Board
to waive the requirement to obtain authorization from you. A waiver
of authorization will be based upon assurances from a review board
that the researchers will adequately protect your health information.
For example, a research project may involve comparing
the efficacy of one medication over another. |
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As Required By
Law.
We will disclose health information about you when required to do so
by federal, state, or local law.
If your records
are subpoenaed by the courts. See law enforcement below. |
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To Avert a
Serious Threat to Health or Safety.
We may use and disclose health information about you when necessary to
prevent a serious threat to your health and safety or the health and
safety of the public or another person. Any disclosure, however,
would only be to someone able to help prevent the threat. |
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Military and
Veterans.
If you are a member of the armed forces or are separated/discharged
from military services, we may release health information about you as
required by military command authorities or the Department of Veterans
Affairs as may be applicable. We may also release health information
about foreign military personnel to the appropriate foreign military
authorities. |
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Workers'
Compensation.
We may release health information about you for workers' compensation
or similar programs. These programs provide benefits for work-related
injuries or illness. |
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Public Health
Risks.
We may disclose health information about you for public health
activities. These activities generally include the following:
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To prevent or control
disease, injury or disability;
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To report births and deaths;
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To report child abuse or
neglect;
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To report reactions to
medications or problems with products;
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To notify people of recalls
of products they may be using;
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To notify a person who may
have been exposed to a disease or may be at risk for contracting or
spreading a disease or condition;
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To notify the appropriate
government authority if we believe a patient has been the victim of
abuse, neglect, or domestic violence. We will only make this
disclosure if you agree or when required or authorized by law. |
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Health Oversight
Activities.
We may disclose health information to a health oversight agency for
activities authorized by law. These activities are necessary for
the government to monitor the health care system, government programs,
and compliance with civil rights laws.
These oversight
activities include, for example, audits, investigations, inspections,
and licensure |
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Lawsuits and
Disputes.
If
you are involved in a lawsuit or a dispute, we may disclose health
information about you in response to an order issued by a court or
administrative tribunal. We may also disclose health information
about you in response to a subpoena, discovery request, or other
lawful process by someone else involved in the dispute, but only after
efforts have been made to tell you about the request and you have time
to obtain an order protecting the information requested. |
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Law Enforcement.
We may release health information if asked to do so by a law
enforcement official:
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In response to a court
order, subpoena, warrant, summons or similar process;
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To identify or locate a
suspect, fugitive, material witness, or missing person;
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If you are the victim of a
crime and we are unable to obtain your consent;
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About a death we believe may
be the result of criminal conduct;
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In an instance of criminal
conduct at our facility; and
·
In emergency circumstances
to report a crime; the location of the crime or victims; or the
identity, description, or location of the person who committed the
crime.
Such releases of
information will be made only after efforts have been made to tell you
about the request and you have time to obtain an order protecting the
information requested. |
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Coroners, Health
Examiners and Funeral Directors.
We may release health information to a coroner or health examiner.
We may also release health information about patients to funeral
directors as necessary to carry out their duties.
This may be
necessary, for example, to identify a deceased person or determine the
cause of death |
Inmates.
If you are an inmate of a correctional institution or under the
custody of a law enforcement official, we may release health
information about you to the correctional institution or law
enforcement official.
This release would be necessary: (1) for the
institution to provide you with healthcare; (2) to protect your health
and safety or the health and safety of others; or (3) for the safety
and security of the correctional institution. |
YOUR RIGHTS REGARDING HEALTH INFORMATION
ABOUT YOU
You have the
right to inspect and copy health information that may be used to
make decisions about your care. Usually, this includes health and billing
records. This does not include psychotherapy notes.
To do so, you must
submit your request in writing on a form provided by us to: “The Privacy
Official at Planned Parenthood of Southern New Jersey”. We may charge a
fee for the costs of locating, copying, mailing or other supplies and
services associated with your request.
We may deny your
request to inspect and copy in certain very limited circumstances. If you
are denied access to health information, you may in certain instances
request that the denial be reviewed.
Another licensed healthcare professional chosen by our practice will
review your request and the denial. The person conducting the review will
not be the person who denied your initial request. We will comply with
the outcome of the review.
If you feel that
health information we have about you is incorrect or incomplete, you have
the right to amend the information for as long as we keep
the information. To request an amendment, your request must be made in
writing on a form provided by us and submitted to: “The Privacy Official
at Planned Parenthood of Southern New Jersey.
We may deny your
request for an amendment if it is not the form provided by us and does not
include a reason to support the request. In addition, we may deny your
request if you ask us to amend information that:
· Was not created by
us, unless the person or entity that created the information is no longer
available to make the amendment;
· Is not part of the
health information kept by or for our practice;
· Is not part of the
information which you would be permitted to inspect and copy; or
· Is accurate and
complete.
Any amendment we make
to your health information will be disclosed to those with whom we
disclose information as previously specified.
You have the right to request a list (accounting) of any
disclosures of your health information we have made, except for
uses and disclosures for treatment, payment, and health care operations,
as previously described. To request this list of disclosures, you must
submit your request on a form that we will provide to you.
You have the
right to request a restriction or limitation on the health
information we use or disclose about you for treatment, payment, or health
care operations. You also have the right to request a limit on the health
information we disclose about you to someone who is involved in your care
or the payment for your care. For example, you could ask that access to
your health information be denied to a particular member of our workforce
who is known to you personally.
While
we will try to accommodate your request for restrictions, we are not
required to do so
if it is not feasible for us to ensure our compliance with law or we
believe it will negatively impact the care we may provide you. If we do
agree, we will comply with your request unless the information is needed
to provide you emergency treatment. To request a restriction, you must
make your request on a form
that we will provide you.
In your request, you must tell us what information you want to limit and
to whom you want the limits to apply.
You have the right
to request confidential communications about your health matters For
example, you can ask that we only contact you at work or by mail to a post
office box. During our intake process, we will ask you how you wish to
receive communications about your health care or for any other
instructions on notifying you about your health information. We will
accommodate all reasonable requests.
Minors
and persons with Guardians
have all the rights outlined in this Notice with respect to health
information relating to reproductive healthcare, except in emergency
situations or when the law requires reporting of abuse and neglect. 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.
We
reserve the right to change this Notice
and the right to make the revised or changed Notice effective for health
information we already have about you as well as any information we
receive in the future. We will post a copy of the current Notice in our
facility. The Notice contains the effective date on the first page. In
addition, each time you register for treatment or healthcare services, we
will offer you a copy of the current Notice in effect.
You may request a copy of this Notice at any time.
If
you believe your privacy rights have been violated, you may file a
complaint with us or with the Secretary of the Department of Health
and Human Services. To file a complaint with us, contact : “The Privacy
Official at Planned Parenthood of Southern New Jersey.” All complaints
must be submitted in writing. You will not be penalized for filing a
complaint.
OTHER
USES OF HEALTH INFORMATION
Other uses and disclosures of health information not covered by this
Notice or the laws that apply to us will be made only with your written
permission. If you provide us permission to use or disclose health
information about you, you may revoke that permission, in writing, at any
time. If you revoke your permission, we will no longer use or disclose
health information about you for the reasons covered by your written
authorization. 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 the records of the care that we provided to you.
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