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Comprehensive Gynecological & Obstetrical Care
Quality, convenient care from the providers who know you best.

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.

The Health Insurance Portability and Accountability Act (HIPAA; the “Act”) of 1996, revised in 2013, requires us as your health care provider to maintain the privacy of your protected health information, to provide you with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information. We are required to maintain these records of your health care and to maintain confidentiality of these records.

The Act also allows us to use your information for treatment, payment, and certain health operations unless otherwise prohibited by law and without your authorization.

Uses and Disclosures of Protected Health Information

Treatment

We may disclose your protected health information to you, to our staff, or to other health care providers in order to get you the care you need. This includes information that may go to the pharmacy to get your prescription filled, to a diagnostic center to assist with your diagnosis, or to the hospital should you need to be admitted. If necessary to ensure that you get this care, we may also discuss the minimum necessary with friends or family members involved in your care unless you request otherwise.

Payment

We may send information to you or to your health plan in order to receive payment for the service or item we delivered. We may discuss the minimum necessary with friends or family members involved in your payment unless you request otherwise.

Health Operations

We are allowed to use or disclose your protected health information to train new health care workers, to evaluate the health care delivered, to improve our business development, or for other internal needs.

Required Disclosures

We are required to disclose information as required by law, such as public health regulations, health care oversight activities, certain lawsuits, and law enforcement.

Uses and Disclosures Requiring Authorization

Certain uses or disclosures of your protected health information require your written authorization, including:

  • Disclosure of psychotherapy notes

  • Use or disclosure of your information for marketing

  • Disclosures or uses that constitute a sale of protected health information

  • Any other uses or disclosures not described in this Notice of Privacy Practices (NPP)

We cannot disclose your protected health information to your employer or to your school without your authorization unless required by law.

You will receive a copy of your authorization and may revoke it in writing. We will honor that revocation beginning on the date we receive the written, signed revocation.

Your Rights Regarding Protected Health Information

Please inform our office when you wish to exercise any of these rights so that we may provide the proper form for documenting your request.

Right to Access Your Records

You may access and/or receive a copy of your records (except psychotherapy notes).

  • Your request must be in writing.

  • We must verify your identity before granting access.

  • We must provide access or a copy within 30 days.

  • Copies may be electronic or hard copy.

  • We may charge cost-based fees for providing copies.

  • If access is denied, you may request a review by a licensed health care provider.

Right to Request Restrictions

You may request restrictions on how your protected health information is used for treatment, payment, or health operations.

  • We are not required to agree, but if we do, we must comply—except in emergencies.

  • Restrictions may be terminated when necessary for treatment or payment.

Mandatory Restrictions:
We must grant your request if:

  1. The restriction applies only to information that would be sent to a health plan for payment,

  2. You have paid in full out of pocket, and

  3. The restriction is not otherwise prohibited by law.

We must have documentation of the restriction prior to providing the service.

Right to Request Confidential Communications

You may request that we contact you at an alternate location or by alternate means (e.g., calling your cell phone instead of your home).

  • Requests must be in writing.

  • Requests may be revoked in writing.

  • You must provide a workable communication method.

  • Additional costs (if any) will be your responsibility.

Right to Request an Amendment

You may request an amendment to your medical records.

  • Requests must be in writing.

  • We are not required to grant the request.

Right to an Accounting of Disclosures

You may request a list of how your protected health information has been used or disclosed.
We are required to notify you of any breach that may have affected your information.

Right to Receive a Copy of This Notice

You may receive this notice electronically, on paper, or both.

Right to Opt Out of Fundraising Communications

Questions or Complaints

If you have questions about our privacy practices, please contact our Privacy Officer.

You have the right to file a complaint with us or with the Office for Civil Rights. We will not discriminate or retaliate against you for filing a complaint.

Contact Information

Privacy Officer: Ryan D. Brown
Mailing Address: 28 White Bridge Pike, Suite 111, Nashville, Tennessee 37205
Telephone: 615.986.6153
Fax: 615.234.1515
Email: Ryan.Brown@OurAdvancedHEALTH.com

Office for Civil Rights:
http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html

We are required to abide by the policies stated in this Notice of Privacy Practices, effective 10/01/09.