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690 W. Campbell Road, Suite 150, Richardson, Texas 75080

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Notice of Privacy Practices


Prestonwood Pregnancy Center/Community Mobile Sonogram (PPC/CMS) is committed to protecting your personal health information. Personal health information that we maintain about you includes: your name, address, telephone number, date the medical staff reviewed you chart with you, clinical findings/medical notes related to the condition that brings you to PPC/CMS, laboratory or diagnostic test results related to the condition. Federal law (HIPAA) and Texas Law (Privacy and Security Regulations) requires that we provide you this Notice of Privacy Rights. It lets you know how we may use and disclose your health information and your rights regarding the health information we have in our possession.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

HOW WE USE AND DISCLOSE YOUR HEALTH INFORMATION

We only use or disclose your health information as state and federal laws require or permit. In some cases, the law requires that you authorize the disclosure. In other cases, the law allows us to disclose your health information without your authorization.

USE AND DISCLOSURE NOT REQUIRING YOUR AUTHORIZATION

TREATMENT: We may use and disclose your health information to a physician or healthcare provider providing treatment to you.

PAYMENT: We may use and disclose your health information for our payment and collection activities, such as sending claims to insurance companies for the payment of certain covered medical services that PPC/CMS may provide.

HEALTHCARE OPERATIONS: We may use and disclose your health information to allow us to improve the quality of care PPC/CMS provides and to reduce health care costs, which may include training programs for our staff.

BUSINESS ASSOCIATES: We may disclose your health information to organizations that help us with our work. We have a written agreement that requires these organizations to use your health information for only reasons necessary to do the work, and protect it from other uses or disclosures, just like we do.

TO CONTACT YOU: We may use the information in your health records to contact you if we have information about treatment or other health-related benefits and services that may be of interest to you.

OTHER PERMITTED USES AND DISCLOSURES

HIPAA specifically permits us to use or disclose your health information for other purposes without your consent or authorization. Federal and state laws specifically permit us to use or disclose your health information for other purposes without your consent or authorization. In our experience such disclosures are minimal, and the limited information we maintain is generally not applicable. However, when authorized by law and to the extent we may have the information, Federal and state laws permit us to disclose it to:

USES AND DISCLOSURES WITH YOUR AUTHORIZATION

Other uses and disclosures of your personal information require your written authorization. You may revoke your authorization at any time by doing so in writing.

RESERVATION OF RIGHT TO CHANGE PRIVACY PRACTICES

Prestonwood Pregnancy Center/ Community Mobile Sonogram reserves the right to modify the privacy practices outlined in the notice. The updated privacy practices will be posted in the reception area.

HOW YOU CAN REACH US

You and your family should feel you can always voice your concerns. If you want additional information about our privacy practices or if you believe Prestonwood Pregnancy Center/ Community Mobile Sonogram has violated your privacy rights, you may file a complaint by contacting our HIPAA Privacy Officer at 690 W. Campbell Road, Suite 150, Richardson, TX 75080 or call 972-386-4015. If you have concerns that are not resolved, please contact the Executive Director at 972-386- 4015.

Prestonwood Pregnancy Center/ Community Mobile Sonogram do not retaliate against people who file a complaint.

Should you continue to remain concerned after contacting the Executive Director, you may contact the Texas State Department of Health and Human Services.

ADDITIONAL PROTECTIONS FOR CERTAIN INFORMATION

EFFECTIVE SEPTEMBER 1, 2013