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Gwinnett OB/GYN Associates, P.C.
1700 Tree Lane Rd., Ste 290
Snellville, GA 30078
Notice Of Privacy Practices
As Required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU (AS A PATIENT
OF THIS PRACTICE) MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET
ACCESS TO YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION.
PLEASE REVIEW THIS NOTICE CAREFULLY.
A.
OUR COMMITMENT TO YOUR PRIVACY
Our practice is dedicated to maintaining the privacy of your individually identifiable health information (IIHI). In conducting our business, we will create
records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information
that identifies you. We also are required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in our
practice concerning your IIHI. By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at the time.
We realize that these laws are complicated, but we must provide you with the following important information:
•
How we may use and disclose your IIHI
•
Your privacy rights in your IIHI
•
Our obligations concerning the use and disclosure of your IIHI
The terms of this notice apply to all records containing your IIHI that are created or retained by our practice. We reserve the right to revise or
amend this Notice of Privacy Practices, Any revision or amendment to this notice will be effective for all of your records that our practice has
created or maintained in the past, and for any of your records that we may create or maintain in the future. Our practice will post a copy of
our current Notice in our offices as a visible location at all times, and you may request a copy of our most current Notice at any time.
B.
IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:
The Office Manager or Practice Administrator at (770) 972.0330.
C.
WE MAY USE AND DISCLOSE YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (IIHI) IN THE FOLLOWING WAYS:
The following categories describe the different ways in which we may use and disclose your IIHI.
1.
Treatment. Our practice may use your IIHI to treat you. For example, we may ask you to have laboratory tests (such as blood or urine tests), and
we may use the results to help us reach a diagnosis. We might use your IIHI in order to write a prescription for you, or we might disclose your IIHI
to a pharmacy when we order a prescription for you. Many of the people who work for our practice – including, but not limited to, our doctors and
nurses – may use or disclose your IIHI in order to treat you or to assist others in your treatment. Additionally, we may disclose your IIHI to others
who may assist in your care, such as your spouse, children or parents. Finally, we may also disclose your IIHI to other health care providers for
purposes related to your treatment.
2.
Payment. Our practice may use and disclose your IIHI in order to bill and collect payment for the services and items you may receive from us. For
example, we may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your
insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. We also may use and disclose your
IIHI to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use your IIHI to bill you
directly for services and items. We may disclose your IIHI to other health care providers and entities to assist in their billing and collection efforts.
3.
Health Care Operations. Our practice may use and disclose your IIHI to operate our business. As examples of the ways in which we may use
and disclose your information for our operations, our practice may use your IIHI to evaluate the quality of care you received from us, or to conduct
cost-management and business planning activities for our practice. We may disclose your IIHI to other health care providers and entities to assist
in their health care operations.
4.
Disclosures Required By Law. Our practice will use and disclose your IIHI when we are required to do so by federal, state or local law.
D. USE AND DISCLOSURE OF YOUR IIHI IN CERTAIN SPECIAL CIRCUMSTANCES:
The following categories describe unique scenarios in which we may use or disclose your identifiable health information:
1.
Public Health Risks. Our practice may disclose your IIHI to public health authorities that are authorized by law to collect information for the
purpose of:
•
maintaining vital records, such as births and deaths
•
reporting child abuse or neglect
•
preventing or controlling disease, injury or disability
•
notifying a person regarding potential exposure to a communicable disease
•
notifying a person regarding a potential risk for spreading or contracting a disease or condition
•
reporting reactions to drugs or problems with products or devices
•
notifying individuals if a product or device they maybe using has been recalled
•
notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse or neglect of an adult patient (including
domestic violence); however, we will only disclose this information if the patient agrees or we are required or authorized by law to disclose
this information
•
notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance
2.
Health Oversight Activities. Our practice may disclose your IIHI to a health oversight agency for activities authorized by law. Oversight activities
can include, for example, investigations inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal
procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the
health care system in general.
3.
Lawsuits and Similar Proceedings. Our practice may use and disclose your IIHI in response to a court or administrative order, if you are
involved in a lawsuit or similar proceeding. We also may disclose your IIHI in response to a discovery request, subpoena, or other lawful process
by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the
information the party has requested.

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