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Privacy Practice Notice

Arizona Perinatal Care Centers

Notice of Privacy Practices for Protected Health Information

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.

Arizona Perinatal Care Centers (we, us) are required by law, to maintain the privacy and confidentiality of your health information and to provide our patients with this notice of our legal duties and privacy practices with respect to this protected health information.

Disclosure of your health care information:

Treatment - We may disclose your health care information to other health care professionals within our practice for the purpose of treatment, payment or health care operations.

Payment – We may disclose our health information to your insurance provider for the purpose of payment or health care operations.

Workers’ compensation – We may disclose your health information as necessary to comply with State Workers’ Compensation laws.

Emergencies – We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your care about your medical condition or in the event of an emergency or your death.

Public health – As required by law, we may disclose your health information to the public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.

Judicial and administrative proceedings – We may disclose our health information in the course of any administrative or judicial proceedings.

Law enforcement – We may disclose your health information to a law enforcement official for the purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, and other law enforcement purposes.

Deceased persons – We may disclose your health information to coroners or medical examiners.

Organ donation – We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissue.

Research – We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board.

Public safety – It may be necessary to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.

Specialized government agency – We may disclose your health information for military, national security, prisoner and government benefits purposes.

Your health information rights:

You have the right to request restrictions on certain uses and disclosures of your health information. However, we are not required to agree to the restriction that you request. You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery. You have the right to inspect and copy your health information. You have the right to request that we amend your protected health information, however, we are not required to do so. If we deny your request you will be provided with an explanation of our denial reason(s). You have a right to receive an account of disclosures of your health information and to a paper copy of this Notice of Privacy Practices in its entirety upon request. We reserve the right to change this notice and inform you of any changes. You have the right to object or withdraw as provided in this notice.

 

Complaints – you may complain to us or the Secretary of Health and Human Services if you believe that your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact on your complaints. We will not retaliate for filing a complaint. This notice became effective August 7, 2014.

Name of Contact Person: Amy Munoz, Arizona Perinatal Care Centers

Telephone 623-362-2266

Address 18699 N 67th Avenue Suite 310

Glendale, AZ 85308