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Privacy Statement

This notice of privacy practice describes how your confidential information may be used and disclosed and how you may access this information. We may, on occasion, amend our privacy practices and policies, but will always inform you of any changes that might affect your rights. Mary's Center is dedicated to protecting the privacy rights of our patients and the confidential information entrusted to us. Although our clinic shares electronic medical record information with other community-based clinics and government agencies, all partners are required, by law, to protect the privacy of your personal healthcare information. A principle concept of our practice is our commitment to ensuring that your medical (including any HIV/AIDS information), mental health, alcohol and any other substance abuse information is never compromised.

Protecting Your Personal Healthcare Information
We use and disclose the information we collect from you only as allowed by the Health Insurance Portability and Accountability Act (HIPAA). This includes issues related to your treatment, payment, healthcare operations and research. Your personal information will not be given to anyone- even family members- without your written consent. You may, however, give written consent for us to disclose your personal health information to anyone you chose, for any purpose. Our offices and electronic systems are secure from unauthorized access and our employees are trained to make certain that the confidentiality of our records is always protected. Our privacy practices and policies apply to all former, current and future patients, so you can be confident that your protected health information will never be improperly disclosed, or released.

Collecting Protected Health Information
We will only request personal information needed to provide our standard of quality healthcare, implement payment activities, conduct normal healthcare operations and comply with the law. This information may include your name, address, telephone number(s), Social Security Number (or similar document), employment data, medical history, health records, etc. While most information may be collected from you, we may also obtain information from third parties if it is deemed necessary. Regardless of the source, your personal information will always be protected to the full extent of the law.

Disclosure of Your Protected Health Information
As stated above, we may disclose information as required by law. When we disclose information to other persons and/or agencies, to perform services for us, we will require them to protect your privacy. By law, we are obligated to provide information to law enforcement and governmental officials under certain circumstances. We may also use and/or disclose your health information to communicate reminders about your appointments which may include voicemail messages, answering machines and postcards. You may revoke your authorization in writing, at any time, and we will discontinue future uses and disclosures of your health information for the reasons covered by your authorization. However, we are unable to take back any previous disclosures made with your former written consent.

Patient Rights

  • You have the right to request, in writing, restrictions on certain uses and disclosures of your health information. Although all requests are considered, we are not legally required to accept them all. If we deny your request, you will receive a written explanation that lists our reasons for denying your request. As a patient, you do have the right to have your denial reviewed. If the request is accepted, we will comply with it, except if you need emergency treatment.
  • You have the right to see and request, in writing, copies of your protected health information, except for psychotherapy notes and certain other circumstances where we may deny your request. As mentioned before, if a request is denied, you have the right to have your denial reviewed.
  • You have the right to choose how you receive your protected health information. If you wish us to forward the documents to an alternate address, or by some other method of contact, we can do so. All such requests must be in writing and we may charge you for copies in an amount allowed by law.
  • You have the right to request, in writing, a list of instances in which we, or our business associates, have disclosed your protected health information. The list will not contain disclosures made prior to October 27, 2003. Furthermore, this list will not contain disclosures made for the following purposes: treatment, payment, health care operations, disclosures to correctional institutions and/or law enforcement agencies and disclosures authorized by the patient.

    • You have the right to request that your record be amended, but we may deny your request for the following reasons: if the information was not created by our clinic; if the information is located in records that, by law, you are not permitted to see; or if we believe that the information is not already accurate and complete. If we accept your amendment, we will place it in your chart, but we will not delete any information that already exists in your record.