Have a great experience? Could things have gone better? Take a minute to tell us about it. Our goal is to continuously improve the service and care we provide for you and your family.
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. We have also posted this Notice below. A paper copy of this Notice is available from any receptionist.
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 which 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).
Federal law grants you certain rights with respect to your PHI. Specifically, you have the right to:
All requests must be in writing. We will follow our written policies and notify you of our decision. Contact Health Information to obtain request forms.
Federal law also imposes certain obligations and duties upon us with respect to your PHI. Specifically we are required to:
Federal Law allows us to use or disclose your protected health information without your permission for the following purposes:
Other than the uses and disclosures described herein, we will not use or disclose your protected health information without your written authorization. Specifically, if we do not list a use or disclosure, we will seek your authorization to use or disclose the information.
Communication with Significant Others
Unless you object, we may exercise professional judgment to determine when disclosures of relevant PHI to a family member, friend or another person is in your best interest. This person would be someone you have identified and indicated as having active interest and/or involvement with your healthcare or payment for your healthcare.
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. 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
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.
If you believe your privacy rights have been violated, you may file a complaint with our office by contacting the Quality Improvement Department at 319-247-3006. You may also file a complaint with the Secretary of Health and Human Services. There will be no retaliation for the filing of a complaint.
This notice became effective on April 14, 2003.
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 Quality Improvement department at (319) 247-3006.
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