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HIPAA OMNIBUS
NOTICE OF
PRIVACY PRACTICES

DoctorsNow Walk-In Care
PO Box 1250
Johnston, IA 50131
(515) 270-1000

Effective October 22, 2020

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

This Notice of Privacy Practices is NOT an authorization. This Notice of Privacy Practices describes how we, our Business Associates and their subcontractors, may use and disclose your protected health information (PHI) to carry out treatment, payment, or health care operations (TPO) and other purposes permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and relate to your past, present, or future physical or mental health condition and related health care services.


YOUR RIGHTS

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record:

  • You can ask to see or get an electronic or paper copy of your medical history and other health information we have about you. Ask us how to do this.

  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record:

  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.

  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications:

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.

  • We will say “yes” to all reasonable requests.

Ask us to limit what we use or share:

  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.

  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information:

  • You can ask for a list (accounting) of the times we’ve shared your health information for six years before the date you asked, who we shared it with, and why.

  • We will include all the disclosures except those about treatment, payment, health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but charge a reasonable, cost-based fee if you request another within 12 months.

Get a copy of this privacy notice:

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the information electronically. We will provide you with a paper copy promptly.

Choose someone to act for you:

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

  • We will ensure the person has this authority and can act for you before we act.

File a complaint if you feel your rights are violated:

  • If you believe we have violated your privacy rights, you may file a complaint with us by notifying our Compliance Officer of your complaint. We will not retaliate against you for filing a complaint. You may also complain to us or the Secretary of Health and Human Services.

    HIPAA Compliance Officer: Peter Medina
    Phone: 515-480-4408
    Email: pete@doctorsnow.com

  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

YOUR CHOICES

You can tell us your choices about what we share for specific health information. Talk to us if you have a clear preference for how we share your information in the situations described below. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care

  • Share information in a disaster relief situation

  • Include your information in a hospital directory

If you cannot tell us your preference, for example, if you are unconscious, we may share your information if it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases, we never share your information unless you give us written permission:

  • Marketing purposes

  • Sale of your information

  • Most sharing of psychotherapy notes

In the case of fundraising:

  • We may contact you for fundraising efforts, but you can tell us not to contact you again.


OUR USES AND DISCLOSURES

How do we typically use or share your health information? We typically use or share your health information in the following ways.

Treat You

We can use your health information and share it with other professionals treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run Our Organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

Bill For Services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before sharing your information for these purposes.

Help With Public Health and Safety Issues

We can share health information about you for certain situations, such as:

  • Preventing disease

  • Helping with product recalls

  • Reporting adverse reactions to medications

  • Reporting suspected abuse, neglect, or domestic violence

  • Preventing or reducing a serious threat to anyone’s health or safety

Research

We can use or share your information for health research.

Comply With the Law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we comply with federal privacy law.

Respond to Organ and Tissue Donation Requests

We can share health information about you with organ procurement organizations.

Work With a Medical Examiner or Funeral Director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address Workers’ Compensation, Law Enforcement, and Other Government Requests

We can use or share health information about you:

  • For workers’ compensation claims

  • For law enforcement purposes or with a law enforcement official

  • With health oversight agencies for activities authorized by law

  • For special government functions such as military, national security, and presidential protective services

Respond to Lawsuits and Legal Actions

We can share health information about you in response to a court or administrative order or in response to a subpoena.

OUR RESPONSIBILITIES

  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind anytime. Let us know in writing if you change your mind.

  • We are required by law to maintain the privacy and security of your protected health information.

  • We will let you know promptly if a breach may have compromised your information's privacy or security.

  • We must follow the duties and privacy practices described in this notice and give you a copy.

  • We will never share any substance abuse treatment records without your written permission.

CHANGES TO THE TERMS OF THIS NOTICE

We can change the terms of this notice, which will apply to all information we have about you.

The new notice will be available upon request in our office and on our website. We are required by law to maintain the privacy of and provide individuals with this notice of our legal duties and privacy practices concerning protected health information. We must also abide by the terms of the notice currently in effect. If you have any questions about this notice, please ask to speak with our HIPAA Compliance Officer in person or by phone at our main phone number.

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