Notice of Privacy Practices

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.

Organizations Covered by This Notice

This Notice applies to the privacy practices of Agape' Birth Service and Birth Center, Inc., Kathy LeBaron, CPM,  Michelle Bartlett, CPM., and any other healthcare providers with admitting privileges at the birth center. These entities participate in an organized healthcare arrangement.

Summary of Privacy Practices

We respect your privacy. We understand that your personal health information is very sensitive. We will not disclose your information to others unless you tell us to do so, or unless the law authorizes or requires us to do so.

The law protects the privacy of the health information we create and obtain in providing our care and services to you (HIPAA). For example, your protected health information includes your symptoms, test results, diagnoses, treatment, health information from other providers, and billing and payment information relating to these services. Federal and state law allows us to use and disclose your protected health information for purposes of treatment and health care operations. Your authorization is required to disclose information for payment purposes.

Examples of Use and Disclosures of Protected Health Information for Treatment, Payment and Health Operations

For Treatment:

     •   Information obtained by a nurse, physician, or other members of our healthcare team will be recorded in your medical record and used to help decide what care may be right for you.

     •   We may also provide information to others providing you care. This will help them stay informed about your care.

For Payment:

     •  We request payment from your health insurance plan. Health plans need information from us about your medical care. Information provided to health plans may include your diagnoses, procedures performed or recommended care.

For Health Care Operations:

     •   We use your medical records to assess quality, improve services and train staff.

     •   We may use and disclose medical records to review qualifications and performance of our health care providers.

     •   We may contact you about appointments and give you information about health-related issues.

     •   We may use and disclose your information to conduct or arrange for services, including medical quality review by your health plan; accounting, legal, risk management, and insurance services; audit functions, including fraud and abuse detection and compliance programs.

     •   We may contact you by phone to discuss protected health information. If you are not available to answer the phone, we may leave a message on your answering machine.

     •   It is our practice to organize and participate in fund-raising events, both for the birth center and for the broader community. We may send you a letter, postcard or invitation, or call your home to invite you to participate. We may use your demographic information, your type of insurance, and your child's place and date of birth for fund-raising purposes. You have the right to opt out if you wish.

     •   We send thank you cards to clients and birth announcement cards to legislators.

Your Health Information Rights

The health and billing records we create and store are the property of the practice/health care facility. The protected health information in it, however, generally belongs to you. You have the right to:

     •   Receive, read and ask questions about this Notice.

     •   Ask us to restrict certain uses and disclosures. You must deliver this request in writing to us.

     •   Request that you be allowed to see and get a copy of your protected health information. You may make this request in writing.

     •   Ask us in writing to change your health information.

     •   Cancel prior authorizations to use or disclose health information by giving us a written revocation.

Our Responsibilities

We are required to:

     •   Keep your protected health information private.

     •   Give you this Notice.

     •   Follow the terms of this Notice.

We have the right to change our practices regarding the protected health information we maintain. If we make changes, we will update this Notice. You may receive the most recent copy of this Notice by calling and asking for it or by visiting the birth center to pick it up.

To Ask for Help or Complain

If you have questions, want more information or want to report a problem of the handling of your protected health information, you may contact Christine Garcia.

If you believe your privacy rights have been violated, you may discuss your concerns with any staff member. You may also file a complaint with the U.S. Secretary of Health and Human Services. You can access their website online.

Other Disclosures and Uses of Protected Health Information

Unless you object, we may release health information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. Information may be provided to people who ask for you by name. We may use and disclose your name, location, and general condition. You have the right to object to this use or disclosure of your information. If you object we will not disclose it.

We may use and disclose your protected health information without your authorization as follows:

     •   To funeral directors/coroners consistent with their duties

     •   For public health and safety purposes as allowed or required by law, to protect the public health and safety, to prevent or control disease, injury or disability, and to report vital statistics such as births or deaths

     •   To report abuse or neglect to public authorities

     •   For law enforcement purposes such as subpoenas, court orders, or other legal processes

     •   For health and safety oversight activities with the Dept. of Health

     •   For disaster relief purposes, e.g. notification of our condition to family or others

To view the HIPAA laws, go to:  www.HIPAA.org