Privacy Practices

The passage in August 1996 of the Health Insurance Portability and Accountability Act (HIPAA) occurred, in part, to improve the efficiency and effectiveness of the healthcare system by standardizing the transmission of certain administrative and financial information and by protecting the privacy and security of personal health information.

The Privacy Rule essentially controls the use and disclosure of what is known as protected health information (PHI). It affords the patient greater knowledge of the content of their medical record and how that content (PHI) is used. The rule enables the patient to control the disclosure of his or her protected health information to certain entities.

The Security Rule focuses on requirements for covered entities (including medical practices) to protect and safeguard the confidentiality of medical information. The Security Rule specifically addresses the transmission, storage and receipt of data.

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. PLEASE REVIEW IT CAREFULLY.

Uses and Disclosures

Treatment. Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.

Payment. Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.

Health care operations. Your health information may be used as necessary to support the day-to-day activities and management of Fertility Physicians of Northern California and/or Fertility and Reproductive Health Institute. For example, information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.

Law enforcement. Your health information may be disclosed to law enforce-ment agencies to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government mandated reporting.

Public health reporting. Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.

Appointment reminders. Your health information will be used by our staff to send you appointment reminders.

Other uses and disclosures require your authorization. Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information you may submit a writ-ten revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision to revoke your authorization.

Individual Rights
You have certain rights under the federal privacy standards. These include:

The right to request restrictions on the use and disclosure of your protected health information

The right to receive confidential communcations concerning your medical condition and treatment

The right to inspect and copy your protected health information

The right to amend or submit corrections to your protected health information

The right to receive an accounting of how and to whom your protected health information has been disclosed

The right to receive a printed copy of this notice

Fertility Physicians of Northern California Duties
We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices.

We also are required to abide by the privacy policies and practices that are outlined in this notice.

Right to Revise Privacy Practices
As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practices will be applied to all pro-tected health information we maintain.

Requests to Inspect Protected Health Information
You may generally inspect or copy the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting the front office receptionist. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.

Contact Person
The name and address of the person you can contact for further information concerning our privacy practices is:

Katherine A. Buffington, FACMPE
Administrator
Fertility Physicians of Northern California
2516 Samaritan Dr., Suite A
San Jose, CA 95124

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