Notice of Information Practices
This notice describes how medical information about you may be used and disclosed and about how you can get access to this information. Please review it carefully.
The policy of Montgomery Women’s Health Associates is to protect the confidentiality, integrity and security of the protected health and personal information of our patients and to prevent unauthorized access to, or the use or disclosure of such information. This policy applies to patients who are current or former patients of Montgomery Women’s Health Associates.
Individually identifiable health and personal information are any information obtained by Montgomery Women’s Health Associates in connection with providing healthcare treatment, obtaining payment and related health care operations. This relates to past, present or future information that Montgomery Women’s Health Associates receives from you as our patient.
Montgomery Women’s Health Associates collects personal information in order to learn about your medical history, medical conditions, render treatment and collect payment for our services. We gather this information from your patient forms, health questionnaires and other forms you will be asked to complete from time-to-time. In addition, we will assemble information based on our discussions and conversations with you, your personal representative and family members. Your healthcare plan or insurance carrier may provide information to our office.
We will use this information to provide caring and quality medical care to you. Examples include diagnosis, treatment and communications such as follow up and appointment reminders. As part of our standard healthcare operations, we may share information with a facility such as a hospital, laboratory, diagnostic service or healthcare provider to efficiently coordinate your treatment plan. For contracted insurers, your information will be used for claims management and to obtain payment from your insurance carrier. As required by your insurance contractor, we will exchange data with your insurance carrier for activities such as eligibility, benefit and overage determinations, precertification and utilization review.
Your information is maintained in our office in our practice management computer system. We also maintain information about you in your medical chart. Montgomery Women’s Health associates limits the access to your protected health information to those employees and business associates who need to know that information. With some limitations, you have the right to inspect, amend, copy and receive an accounting of disclosures of your medical and billing records.
We do not disclose personal information to third parties unless one of the following exceptions applies:
- We receive explicit authorization from your to release individually identifiable information. This authorization must be in writing and give exact details regarding to whom the disclosure applies, the nature of the data to be released, the applicable dates and signed by the patient (or guardian).
- Federal, state or other applicable law requires us to share protected information or records.
If, at anytime in the future, it is necessary to disclose any of your personal information in a way that is materially different from this policy, Montgomery Women’s Health Associates will give you advance notice of the proposed change so that you will have the opportunity to choose whether or not to participate.
You have a right to review your health information, amend your records, request special accommodations and restrictions of your health information and receive an accounting of the disclosures of your information. Montgomery Women’s Health Associates is not obligated to agree to any requested restrictions.
If you have a complaint about the management of your health information, contact Wendy Tatum at 334.281.1191. There will be no retaliation for filing a complaint.