Waggoner Pediatrics of Central Iowa
Notice of Privacy Practices
Effective Date: 01 January 2017

This notice describes how medical information about you and your child may be used and disclosed, and how you can access this information. Please review it carefully.

Our Commitment to Your Privacy

At Waggoner Pediatrics of Central Iowa (referred to as “we” or “our practice”), we are committed to protecting the privacy and confidentiality of your health information. We are required by law to maintain the privacy and security of your protected health information (PHI) and to provide you with this Notice of our legal duties and privacy practices concerning your PHI, in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

We must follow the terms of this Notice of Privacy Practices and make it available upon request. The Notice applies to all records of your health care and services maintained by our practice.

How We May Use and Disclose Your Health Information

Your health information is used for a variety of reasons related to your medical care, payment for care, and the operation of our practice. Below are examples of how we may use and disclose your information without your prior written authorization.

Treatment

We may use and disclose your PHI to provide, coordinate, or manage the medical care and related services that your child receives. This includes sharing information with other healthcare professionals, such as doctors, nurses, and specialists who are involved in your care. For example:

  • We may consult with a specialist regarding your child’s treatment and share relevant medical information.

  • We may share your health information with pharmacies when issuing a prescription or with laboratories when ordering tests.

Payment

We may use and disclose your PHI to obtain payment for the healthcare services we provide to you. This may involve contacting your health insurance plan or third-party payer to verify coverage, authorize services, or process payment. For example:

  • We may disclose your PHI to your insurance company to confirm eligibility for benefits, obtain prior authorization, or process claims.

  • If someone else is responsible for your child’s bill (such as a guardian), we may disclose your health information to them for billing purposes.

Healthcare Operations

We may use and disclose your PHI for purposes related to the day-to-day operations of our practice. These activities are essential to ensuring high-quality care and may include:

  • Quality assessment and improvement activities (such as reviewing care provided to patients and improving our services).

  • Administrative activities, including training and evaluating healthcare professionals, auditing, and legal services.

  • Business planning and management, such as managing the practice and securing financing.

  • Internal investigations of compliance or complaints.

Appointment Reminders and Notifications

We may use and disclose your PHI to contact you with appointment reminders or to notify you about important healthcare-related information. This may be done via phone calls, voicemail messages, text messages, emails, or postal mail.

Business Associates

Certain functions of our practice may be performed by third-party “business associates” (e.g., billing companies, legal or accounting firms, or information technology vendors). We may share your PHI with these business associates so they can perform their services on our behalf. All business associates are required by law and through contracts to safeguard your information and use it only for the intended purpose.

Special Situations for Use and Disclosure of PHI

There are situations where we may be required or permitted to disclose your PHI without your authorization, including:

Public Health Activities

We may disclose your PHI for public health activities, such as:

  • Reporting suspected abuse or neglect.

  • Preventing or controlling disease, injury, or disability.

  • Reporting adverse events related to medications or medical devices.

  • Notifying individuals about recalls of products they may be using.

Legal and Law Enforcement Purposes

We may disclose PHI in response to a court order, subpoena, or other legal proceedings, or when required by law for law enforcement purposes. For example:

  • We may share your PHI with a law enforcement official when necessary to identify or locate a suspect, fugitive, or missing person.

  • We may share your PHI with coroners, medical examiners, or funeral directors in the event of a death.

Health Oversight Activities

We may share PHI with government or regulatory agencies responsible for overseeing healthcare activities to conduct audits, inspections, or investigations related to the healthcare system and ensure compliance with applicable laws.

Research

We may use or disclose your PHI for research purposes when the research is approved by an institutional review board or privacy board and complies with HIPAA requirements. Researchers must take precautions to protect the privacy of your PHI.

To Prevent a Serious Threat to Health or Safety

We may disclose your PHI to prevent or lessen a serious threat to your health or safety or the health and safety of others. This may include disclosures to law enforcement or other individuals to prevent harm.

Organ and Tissue Donation

If you are an organ donor, we may disclose your PHI to organizations involved in organ, eye, or tissue transplantation.

Workers’ Compensation

We may share your PHI as required by laws governing workers’ compensation programs or similar work-related injury programs.

Military, National Security, and Intelligence Activities

If you are a member of the armed forces or involved in national security or intelligence activities, we may be required to disclose your PHI to military authorities or authorized federal officials for specific purposes.

Other Uses Requiring Authorization

For uses and disclosures not listed in this Notice, we will obtain your written authorization. This includes:

  • Psychotherapy Notes: In most cases, we need your authorization before using or disclosing psychotherapy notes.

  • Marketing Purposes: We must obtain your authorization to use your PHI for marketing purposes, unless the communication is face-to-face or involves a promotional gift of nominal value.

  • Sale of PHI: We will not sell your PHI without your prior written authorization.

You may revoke any authorization you have given us at any time by providing a written request. However, we may have already used or disclosed your information based on your authorization prior to revocation.

Your Rights Regarding Your Health Information

You have the following rights concerning your PHI:

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your health information. This includes medical records, billing records, and other health-related information used to make decisions about your care. You may request an electronic or paper copy. We may charge a reasonable fee for the cost of copying, mailing, or other supplies. In certain limited circumstances, we may deny your request, but you have the right to request a review of the denial.

Right to Request an Amendment

If you believe that the PHI we have is incorrect or incomplete, you may request an amendment. Your request must be in writing and provide a reason for the amendment. We may deny your request if we believe the information is accurate and complete or if the information was not created by us.

Right to an Accounting of Disclosures

You have the right to request an “accounting of disclosures,” which lists certain disclosures of your PHI made by us in the last six years. This does not include disclosures made for treatment, payment, or healthcare operations, or disclosures you authorized.

Right to Request Restrictions

You may request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations. We are not required to agree to your request, but if we do, we will comply unless the information is needed for emergency treatment.

Right to Request Confidential Communications

You have the right to request that we communicate with you about your PHI in a specific way or at a specific location (e.g., sending communications to your work address instead of your home address). We will accommodate reasonable requests.

Right to a Paper or Electronic Copy of This Notice

You have the right to obtain a paper copy of this Notice at any time, even if you have agreed to receive it electronically. You may request a copy by contacting us or visiting our office.

Changes to This Notice

We reserve the right to make changes to this Notice of Privacy Practices and to apply the revised notice to all PHI we maintain. A copy of the revised Notice will be posted in our office, on our website, and made available upon request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services. To file a complaint with us, contact:

Waggoner Pediatrics of Central Iowa
2555 Berkshire Pkwy, Ste A
Clive, IA 50325
Phone: 515-987-0051

You will not be penalized for filing a complaint. All complaints must be submitted in writing.

Contact Information

For more information or to request additional details about our privacy practices, you may contact us at:

Waggoner Pediatrics of Central Iowa
2555 Berkshire Pkwy, Ste A
Clive, IA 50325
Phone: 515-987-0051