Please note that we reserve the right to revise our practices with respect to Protected Health Information and to amend this notice. Any revision or amendment to the Notice will be effective for all of the records our practice has created or maintained in the past and for any records we may create or maintain in the future. We will post a copy of our current Notice and any amended Notice in our offices in a prominent place, in addition to this notice on our website. A paper copy of this Notice is available from any receptionist.
Effective Date: This notice became effective Feb. 16, 2026
Protected Health Information (PHI)
While receiving care from our facility, information regarding your medical history, treatment, and payment for your health care may be originated and/or received by us. Information that can be used to identify you and which relates to your medical care or your payment for medical care is protected by state and federal law; this is known as “Protected Health Information” (PHI).
Your Rights
Federal law grants you certain rights with respect to your PHI. Specifically, you have the right to:
- Access, review, and copy your PHI. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. All requests must be submitted to PCI Health Information Services. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable,cost-based fee. This request may be denied in certain limited situations. request that your PHI be amended. You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
- Request receipt of communications in a confidential manner, which may be reasonably accommodated by alternative means or at an alternative location. We will say “yes” to all reasonable requests.
- Request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. We are not required to agree to your request, and we may say “no” if it could affect your care. If we agree to your request, we may still share this information in the event that you need emergency treatment. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
- Obtain an accounting (list) of certain disclosures of your PHI. You can ask for a list of the times we have shared your health information for six (6) years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free, but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
- Receive a paper copy of this notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
- Choose someone to act for you. If someone has the authority to act as your personal representative, such as if someone has your medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care or payment for your care
- Share information in a disaster relief situation
If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
Other Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
Treatment
Your PHI may be used or disclosed to provide, coordinate, or manage your care. For example, we may communicate and share your PHI with other healthcare providers and their staff within and outside PCI to ensure continuity of care. At times, unless you object in advance, we may access your PHI to contact you regarding the need to set up an appointment or a reminder about future appointments.
Our practice may use and disclose your PHI to inform you of potential treatment options or alternatives, or health-related benefits or services that may be of interest to you.
Payment
Your PHI may be used or disclosed to create bills and collect payment from you, your insurance company, or other third-party payor. For example, this may include providing information such as dates of service, symptoms, and diagnosis to your insurance company to show we provided medical services to you.
Health Care Operations
Your PHI may be used or disclosed for facility operations, which are necessary to ensure that our facility provides the highest quality of care. For example, this may include quality assessment and improvement activities, medical/legal reviews, and auditing functions. We may use HIPAA-compliant artificial intelligence tools as part of health care operations, subject to the same privacy protections described herein.
How else can we use or share your health information?
Federal Law allows us to use or disclose your protected health information without your permission for the following purposes listed below. We have to meet many conditions in the law before we can share your information for these purposes.
Any other use or disclosure of your PHI not described in this Notice will require your written authorization. You may revoke any authorization you have provided at any time, in writing, to Physicians’ Clinic of Iowa, Attn: Privacy Officer, 202 10th St. SE, Cedar Rapids, IA, 52403, except to the extent we have already taken action in reliance on your authorization.
When state or other federal laws provide greater privacy protections or rights than HIPAA, we will follow the more protective, stringent laws.
When we disclose PHI to others pursuant to this Notice, it may be redisclosed by the recipient and may no longer be protected by HIPAA, except where a law such as 42 CFR Part 2 or a stricter state law continues to protect the information.
Communication with Family/Others. Unless you object, we may exercise professional judgment to determine when disclosures of relevant PHI to a family member, friend, or another person are in your best interest. This person would be someone you have identified and indicated as having an active interest and/or involvement with your healthcare or payment for your healthcare. This may include disclosures of information after you are deceased to those who were involved in your care prior to death, unless you objected.
Uses and Disclosures Required by Law. PHI may be used or disclosed for other purposes to the extent required or mandated by law. For example, to comply with the ADA, HIPAA privacy or security rule investigation, or review by DHS.
Public Health Activities. Public Health authorities (i.e. FDA & CDC) are legally permitted to collect and/or receive information for their approved activities, including: prevention or control of disease, injury or disability; reporting of reaction to medications or problems with products; notify people of product recalls; notify people who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
Victims of Abuse, Neglect, or Domestic Violence. In a manner consistent with the requirements of applicable federal and state laws, we may use or disclose PHI to a protective services or social services agency if we reasonably believe you have been the victim of abuse, neglect, or domestic violence. This reporting is for the health and safety of the victim.
Health Oversight Activities. Federal and state agencies may access your PHI to oversee the healthcare activities rendered by our facility or our facility’s compliance with certain laws and regulations.
Judicial and Administrative Proceedings. We may release PHI in response to a valid court or administrative order, or in response to certain types of subpoena, discovery requests, or other lawful process.
Law Enforcement. We may release PHI to law enforcement for the following purposes: in response to a court order, warrant, subpoena, summons or similar process; to identify/locate a suspect, fugitive, material witness or missing person; regarding a crime victim if, under certain limited circumstances, we are unable to obtain the person’s agreement; regarding a decedent, if we believe the individual’s death was the result of criminal conduct; regarding criminal conduct at PCI; in emergency circumstances to report a crime, the location of a crime or victims, or the identity, description or location of the person who committed a crime.
However, if the information is subject to substance use disorder confidentiality protections, a special court order meeting federal requirements may be necessary.
Coroners, Medical Examiners, and Funeral Directors. We may disclose PHI to a coroner or medical examiner for purposes of identifying a deceased person, determining the cause of death, or other duties as authorized by law. We may also disclose PHI to funeral directors, consistent with applicable law, as necessary to carry out their duties with respect to the decedent.
Organ, Eye, or Tissue Donations. PHI may be used or disclosed by us to entities engaged in the procurement, banking, or transplantation of organs, eyes, or tissues for the purpose of facilitating such donation and transplantation.
Research Purposes. All research projects are subject to a special approval process that will evaluate the precautions used to protect patient medical information.
Serious Threat to Health Safety. PHI may be used or disclosed when necessary to prevent or lessen a serious threat to the health and/or safety of the public, yourself, or another person.
Specialized Government Functions. PHI may be used or disclosed for the following variety of government functions subject to some limitations: military and veterans activities; national security and intelligence activities; protective service of the President and others; medical suitability determinations for Department of State officials; correctional institutions and law enforcement custodial situations; or provision of public benefits.
Workers’ Compensation. PHI may be used or disclosed as authorized and to the extent necessary to comply with laws relating to workers’ compensation or other programs providing benefits for work-related injuries or illness without regard to fault.
Certain Uses and Disclosures that are Prohibited or Require Extra Protections
Sensitive Information. Iowa law provides additional protections for certain categories of specially protected health information, including mental health, HIV/AIDS, and genetic information. We will not disclose these Specially Protected health records except as permitted by Iowa law.
Minors. Under Iowa law, minors who consent to their own treatment in certain circumstances (such as treatment for sexually transmitted diseases, substance abuse, or mental health services) may have confidentiality rights that limit disclosure of their health information to parents or guardians. We will comply with applicable Iowa law regarding the confidentiality of minor patients’ health information.
Part 2 Substance Use Disorder Records. Although Physicians’ Clinic of Iowa is not itself a Part 2 Program, we may receive or maintain Part 2 records from other providers as part of your integrated medical record. When we hold such records, we must comply with both HIPAA and 42 CFR Part 2. In general, Part 2 records may not be used or disclosed by us for treatment, payment, or health care operations, or for most other purposes, unless you sign a specific written consent that meets Part 2 requirements. Uses and disclosures will reflect the more stringent requirements of Part 2, including prohibitions or material limitations on uses or disclosures otherwise permitted by HIPAA. Part 2 records, testimony, or other information that would identify you as having a substance use disorder generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a court order that complies with Part 2. In the case where we receive SUD records from an Iowa-licensed SUD program that is not federally-assisted, we will apply Part 2 standards to those SUD records we receive.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described in this notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information, see:
hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Marketing and Communications Activities
We may use basic demographic information limited to your name, address, phone number, and dates you received services to contact you regarding treatment alternatives, health-related benefits, services, or community efforts we feel may be of interest to you. These communications are considered health care operations and are not marketing requiring authorization. If you do not wish to be contacted as part of our marketing and communications efforts, please notify us in writing at:
Physicians’ Clinic of Iowa, PC
Attn: Marketing Department
202 10th Street SE, Cedar Rapids, IA 52403
At Physicians’ Clinic of Iowa, providing the very best in healthcare is our top priority. As a promise to continually improve our services, we ask for your feedback both in areas where we can improve and where you think we do well. We may contact you via telephone, text message, or e-mail in order for you to rate your experiences with your healthcare provider. It is our mission to take this feedback and improve the patient experience for you and others. If you are not interested in participating in this process, please talk with one of our registration staff members to opt out.
File a Complaint if You Feel Your Rights Have Been Violated
If you believe your privacy rights have been violated, you may file a complaint with our office by contacting the Privacy Officer at (319) 247-3006 or khamers@pcofiowa.com. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/hipaa/filing-a-complaint/index.html.
There will be no retaliation for the filing of a complaint.
Changes to the Terms of this Notice
Health Information and to amend this notice. Any revision or amendment to the Notice will be effective for all of the records our practice has created or maintained in the past and for any records we may create or maintain in the future. Any new or amended Notice will be posted in our offices in a prominent place, on our website, and available from any receptionist.
Important Contact Information
This notice has been provided to you as a summary of how we will use PHI and your rights with respect to your PHI. If you have questions or desire more information regarding your PHI, please contact reception at the front desk or the Privacy Officer at (319) 247-3006.