Genetics & IVF Institute
Notice of Privacy Practices for Patients
Effective September 15, 2013

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 (GIVF) 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.

 

We respect your right to privacy and understand that your medical information is personal to you. In order to provide medical services to you, we create paper and electronic records about your health and the care we provide. Your personal health information is confidential and this Notice of Privacy Practices (NPP) is intended to help you understand how GIVF uses and discloses your personal health information and what rights you have with respect to your medical information.

 

We may use and disclose your medical records only for each of the following purposes:

 

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.

 

Healthcare 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. Specific types of disclosures that require your authorization include: disclosures of psychotherapy notes; disclosures for marketing purposes for which GIVF receives remuneration; and the sale of your protected health information. 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.

 

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• 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 unless it is a request to restrict disclosure of your protected health information to your insurance company for services/products for which you have paid out-of-pocket and in full, and that are unrelated to treatment and not required by law. If we do agree to a restriction, we must abide by it except in limited circumstances or unless you agree in writing to revoke it.
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• The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations.
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• The right to inspect and copy your protected health information.
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• The right to amend your protected health information.
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• The right to receive an accounting of disclosures of protected health information.
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• 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. We are also required to notify you if there is a breach of your unsecured health information.

 

This notice is effective as of September 15, 2013 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 (HHS), Office of Civil Rights (OCR), 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.

 

For more information or to submit a written inquiry or complaint, please contact our Privacy Officer:

 

Genetics & IVF Institute
Cheryl Richardson, Privacy Officer
3015 Williams Drive
Fairfax, VA 22031
001-703-698-3948 - 001-703-698-3963 (fax)
E-mail: hipaa@givf.com

 

For HIPAA information or to file a complaint:

 

US Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue, SW
Washington, DC 20201
001-202-619-0257