MOM’S MILK B/CS
NOTICE OF PRIVACY PRACTICES
EFFECTIVE DATE: AUGUST 27, 2020
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.
We will keep a file to record your consult, but we promise you that your private, protected health information (PHI) will be kept confidential.
We can freely share all the details of your PHI for the purposes of “treatment, payment, and health care operations.” That means that we can talk about your situation and discuss it with your other health care providers. If you are referred to other specialists, we can send the information on to them. We can also share your PHI with your health insurance company if they need it. The law also requires us to share your PHI under other very precise situations: for example, if a subpoena has been served on me to turn over medical records, or a federal agency is investigating a complaint that I have not been protecting your privacy.
Any other time we share your PHI, it has to be with your specific authorization: You have to okay it in writing first. For example you may want us to send PHI about your consultation to the Human Resources Department where you work so they can reimburse you under their workplace lactation support program. When you do give us permission to turn over your PHI, we can give out only the minimum amount of information needed to get the job done.
You have four rights under this policy:
1. Access (you can ask your Mom’s Milk B/CS consultant to see all the PHI she has about you)
2. Amendment (you can ask your Mom’s Milk B/CS consultant to change her files to amend inaccurate PHI)
3. Disclosure Accounting (you can ask to whom your Mom’s Milk B/CS consultant has given your PHI)
4. Restriction Request (you can put limits on your Mom’s Milk B/CS consultant’s use and sharing of your PHI)
Our duty is to give you this notice so you understand we have promised to keep your PHI confidential. If we change this notice in the future, we‘ll give you a new copy.
Kimberly Hill, the owner of Moms’ Milk B/CS (and Lactation Consultant) is the Privacy Officer. My e-mail address is email@example.com. I will answer your questions or concerns about how I protect the privacy of your PHI.
You can complain if you think your privacy hasn’t been protected by your Moms’ Milk B/CS consultant and we have a duty to try to resolve things. I am the privacy officer, so the first step would be to complain to me. I have a duty to address the complaint. We can’t penalize you for making a complaint. If we don’t address your complaint adequately, you can make a report to the Office of Civil Rights of the Federal Health and Human Services (HHS) Department to ask that a formal investigation be made.