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WOMEN'S HEALTH CONSULTANTS
NOTICE OF PRIVACY PRACTICES
Effective April 14, 2003

This notice describes how medical information and other private information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

You have privacy rights under the Minnesota Government Data Practices Act (MGDPA) and the federal Health Insurance Portability and Accountability Act (HIPAA). These laws protect your privacy but also let Women's Health Consultants ("WHC") give information about you to others if the law requires it. WHC may tell you before we give the information. These laws require WHC to keep your health information private and to give you notice of our legal duties and practices to protect private information. WHC must follow the terms that WHC has agreed to in this notice. However, WHC can choose to change the terms of this notice. If WHC changes the terms of this notice, those changes will be applied to all present and future information that we collect about you. Should our information practices change, we will make a revised copy available to you at the time of service and by posting a revised copy in our lobby.

Understanding Your Health Record

The legal medical record contains personally identifiable health information and is utilized and maintained for the following purposes:

• To describe the patient's health history and health status, and to provide a method of clinical communication among healthcare practitioners serving the patient.
• To serve as a legal document describing healthcare services provided and to protect the legal interests
  of the facility.
• To be a source of data for clinical, quality improvement, and outcomes research.
• To document the specific services received by the patient for reimbursement purposes.
• To serve as a resource for healthcare practitioner education, and care evaluation.

Your Health Information Rights

Although your health record is the physical property of Women's Health Consultants, the information belongs to you. You have the right to:

• Request to inspect and obtain copies of your health records. A fee may be charged for copying records
• Request a restriction on certain uses and disclosures of your information. WHC is not required to agree to these requests
• Request amendments to your health records. WHC is not required to agree to these requests.
• Request an accounting of disclosures of your health information except for those disclosures that were made for treatment, payment or health care operations, disclosures made directly to you, or disclosures previously authorized by you.
• Request communications of your health information by alternative means or to alternate locations.
• You may give other people permission to see and have copies of private information about you.
• You may question the accuracy of any information WHC has about you. If you believe the information WHC has about you is wrong send your concerns in writing to WHC, telling why the information is not accurate or complete. You may send your own explanation of the facts. Your explanation will be attached any time that information is shared with another agency.

Examples of disclosures for treatment, payment and health operations

We will use your health information for treatment. For example, information obtained by a healthcare practitioner will be recorded in your health record and used to determine the course of treatment that should best work for you. Your physician may document in your medical record their expectations of members of your healthcare team. Members of your healthcare team will then record the actions they took and their observations. We will also provide other consulting practitioners with copies of various reports that should assist them in treating you.

We will use your health information for payment. For example, a bill may be sent to you or a third party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures and supplies used.

We will use your health information for healthcare operations. For example, members of the medical staff and/or quality improvement team may use information in your health record to assess the care and outcomes of your case and similar cases. This information will be used in an effort to continually improve the quality and effectiveness of the healthcare services we provide.

Business Associates:
There are some services provided at WHC through contracts with business associates. Examples include medical records and copying services and transcription services. We may disclose your health information to our business associates so that they can perform the job we have asked them to do. For your protection, however, we require the business associate to appropriately safeguard your information.
Communication with Family:
Healthcare professionals, using their best judgment, may disclose to a family member, other relatives, or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care.
Research:
We may disclose information to external researchers. You will not be enrolled in a study without your consent to participate.
Funeral Directors, Coroners, Medical Examiners:
We may disclose health information as allowed by law to funeral directors, coroners, and medical examiners.
Marketing:
We may contact you to provide you information about treatment alternatives or other health related benefits and services that may be of interest to you. We may also contact you to provide appointment reminders.
Workers Compensation:
We will disclose health information to the extent authorized by and/or required to comply with laws relating to workers compensation or other similar programs established by law.
Public Health:
We will disclose your health information as required by law to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Correctional Institution:
If you are an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary to protect the health and safety of you and others.
Law Enforcement:
We will disclose health information for law enforcement purposes as required by law or in response to court order, warrant, or summons.

Filing Complaints About Your Health Information Privacy Rights

If you believe that your health information privacy rights have been violated, call the Clinic Manager at Women's Health Consultants at (612) 333-4822. You may also write to the Minnesota Department of Human Services, or to the U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint.

If you do not understand this information, you may ask to have it explained to you.