OUR PRIVACY RESPONSIBILITIES UNDER HIPAA
Illinois law requires that all Health Care Providers (Medical Pregnancy Centers) protect health records in our possession. If you receive services through Hope Pregnancy Center, federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), also protects your health information. In addition, HIPAA requires that we provide you this Notice of Privacy Rights. It lets you know how we may use and disclose your health information and your rights regarding the health information we have in our possession.
HEALTH INFORMATION THAT WE MAINTAIN ABOUT YOU
We maintain records of:
Your name and (if different) the name and relationship of the person receiving treatment
Your billing address
Your telephone number
Your (or the patient's, if different) condition that brings you to the Hope Pregnancy Center
The date the Doctor reviewed your chart
Clinical findings related to the condition such as results of pregnancy tests and any other diagnostic
or monitoring test to ensure your safety
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the right to:
Request restrictions on certain uses and disclosures
Receive communications of protected health information by alternative means or at alternative
Inspect, copy, and amend your protected health information held at Hope Pregnancy Center and
receive and accounting of certain disclosures of your protected health information
Receive a paper copy of this notice even if you have received it electronically
HOW WE USE AND DISCLOSE YOUR HEALTH INFORMATION
We only use or disclose your health information as state and federal laws require or permit. In some cases, the law requires that you authorize the disclosure. In other cases, the law allows us to disclose your health information without your authorization.
USE AND DISCLOSURE NOT REQUIRING YOUR AUTHORIZATION
Treatment: We may use your health information for our treatment activities, such as disclosing it to other healthcare providers as helpful to treat you.
Payment: We may use and disclose your health information for our payment and collection activities, such as sending claims to insurance companies for the payment of certain covered medical services that Hope Pregnancy Center may provide.
Healthcare Operations: We may use and disclose your health information to manage our program operations, such as reviewing the quality of services your receive.
Business Associates: We may use and disclose your health information to organizations that help us with our work, such as the billing service we use to process claims to your health insurance company. We have a written agreement that requires these organizations to use your health information for only the reasons necessary to do the work, and protect it from other uses or disclosures, just like we do.
To Contact You: We may use the information in your health records to contact you if we have information about treatment or other health-related benefits and services that may be of interest to you.
OTHER PERMITTED USES AND DISCLOSURES
HIPAA specifically permits us to use ore disclose your health information for other purposes without your consent or authorization. In our experience such disclosures are rare, and the limited information we maintain is generally not applicable. However, when authorized by law, and to the extent we may have the information, HIPAA permits us to disclose it to:
Comply with the requirements of federal, state, or local laws, court orders or other lawful process
and for administrative or court proceedings
Report to a public health authority for the purpose of preventing or controlling disease, injury, or
Report to the FDA for the quality, safety or effectiveness of FDA-regulated products or activities
Notify a person who may have been exposed to a communicable disease or may otherwise be at
risk of contracting or spreading a disease or condition
Report abuse, neglect, or domestic violence to a government authority
Provide necessary information to a health oversight agency for activities such as audits, programs,
and regulated entities
A law enforcement official for specified law enforcement purposes
Coroners or medical examiners for identification or determining cause of death
Funeral directors to carry our their duties with respect to the decedent
Organ procurement organizations for facilitating donation and transplantation
Researchers conducting studies approved by an Institutional Review Board
Prevent or lessen a serious and imminent threat to the health or safety of a person or the public
Authorized federal officials for specialized government functions such as military and veteran's
activities; national security and intelligence activities; protective services for the president;
medical suitability determinations; correctional institutions; government entities providing
public benefits and comply with workers' compensation laws
USES AND DISCLOSURES WITH YOUR AUTHORIZATION
Other uses and disclosures of your personal information require your written authorization. You may revoke your authorization at any time by doing so in writing.
HOW YOU CAN REACH US
If you want additional information about our privacy practices or if you believe that Hope Pregnancy Center has violated your privacy rights, you may file a complaint by contacting the Hope Pregnancy Center's HIPAA Privacy/Compliance Officer at: 202 N Main St PO Box 417 Pontiac, IL 61764
Hope Pregnancy Center does not retaliate against people who file a complaint.
ADDITIONAL PROTECTIONS FOR CERTAIN INFORMATION
Confidential HIV related information for which additional protections are provided by state law
Alcohol or Substance Abuse Treatment information for which additional protections are provided
by state law
Mental Health Treatment information for which additional protections are provided by state law
Don't hesitate to send us a message.
202 N Main St, Pontiac, IL 61764
Hours of Operation:
Monday & Thursday 10am - 6pm, and Tuesday 9:30am - 4pm