• NOTICE OF PRIVACY PRACTICES

Associated Physicians, LLP
4410 Regent Street, Madison, WI 53705
(608) 233-9746


Notice of Privacy Practices
Your Information. Your Rights. Our Responsibilities.
This Notice is effective November 27th, 2015 and describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Any questions regarding this Notice should be directed to Associated Physicians, LLP’s Privacy Officer, Ia Xiong, who can be reached at         
                Associated Physicians, LLP
                4410 Regent Street
                Madison, WI  53705
                608-233-9746
                Upper level Fax (608)233-0026
 
Your Rights
You have the right to:
  • Get a copy of your paper or electronic medical record
  • Correct your paper or electronic medical record
  • Request confidential communication
  • Ask us to limit the information we share
  • Get a list of those with whom we’ve shared your information
  • Get a copy of this privacy notice
  • Choose someone to act for you
  • File a complaint if you believe your privacy rights have been violated
Your Choices
You have some choices in the way that we use and share information as we:
  • Tell family and friends about your condition
  • Provide disaster relief
  • Include you in a hospital directory (we do not maintain nor contribute to a hospital directory at Associated Physicians.)
  • Provide mental health care (we do not generate psychotherapy notes at Associated Physicians.)
  • Market our services and sell your information (we never market or sell personal information at Associated Physicians.)
  • Raise funds
Our Uses and Disclosures
We may use and share your information as we:
  • Treat you
  • Run our organization
  • Bill for your services
  • Help with public health and safety issues
  • Do research
  • Comply with the law
  • Respond to organ and tissue donation requests
  • Work with a medical examiner or funeral director
  • Address workers’ compensation, law enforcement, and other government requests
  • Respond to lawsuits and legal actions
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • 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.
Ask us to correct your medical record
  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
  • 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.
Get a list of those with whom we’ve shared information
  • You can ask for a list (accounting) of the times we’ve shared your health information for six 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’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy 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 you have given someone 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.
File a complaint if you feel your rights are violated
  • You can complain if you feel we have violated your rights by contacting the Privacy Officer identified on page 1.
  • You can 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 www.hhs.gov/ocr/privacy/hipaa/complaints/.
  • We will not retaliate against you for filing a complaint.
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
  • Share information in a disaster relief situation
  • Include your information in a hospital directory
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
In the case of fundraising:
  • We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our 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.
Treat you
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
 

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety
Do research
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
 
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 here 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.
 
 
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you.  The new notice will be available upon request, in our office, and on our web site.
 

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.


  Effective Date: This Notice of Privacy Practice is effective as of September 23, 2013.

About Our Nurses
The personalized medical care we provide for our patients at Associated Physicians, LLP is supported exclusively by experienced and respected Registered Nurses who have worked in their specialties for years. So you see the same attentive doctor and the same compassionate, highly skilled nurses, year in and year out and you get the assurance of a health-care team who knows you and your health care needs very, very well.
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“Thank you for the amazing care you gave me. It was a long, difficult road, but your care and compassion really helped. The kiddos are
doing great!”
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“I had come to terms with the fact that I would have to have C-sections with all of my pregnancies. When you suggested VBAC as an option, everything changed. Thank you for helping me fulfill my dream.”
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“Thanks to you I spent my pregnancy feeling excited and hopeful. My labor and delivery went better than I ever thought it would. The support I received from you was incredible.”
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“The doctors at Associated Physicians make a point of trying to see you when you call, and that’s what I really appreciate. The doctors know what to do medically, and their people skills are at the top of the heap.”
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“I’ve told several of my friends to go see the doctors at Associated Physicians. Now they feel the same I way do - we wouldn’t want anybody else.”
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“My doctor just goes out of his way to make very sure that you’re comfortable and informed. He gives every patient the time they need. I changed my insurance so I could continue to see him at Associated Physicians.”
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“Everything you did was so supportive and kind and thorough. It was above and beyond what any other doctor has ever done for me.”
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“It really mattered to me that I could call any time and talk with a nurse. Not having to wait for a callback helped me so much!”
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“You really kept me informed and educated about what was going on with my health, and that made a real difference in how comfortable I was.”
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“How grateful I am that after over a year of trying to conceive and meeting with over three different doctors, your medical expertise is the one that ultimately worked for me.”
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“You are truly a caring, compassionate and highly skilled physician who goes above and beyond to ensure that your patients' needs are met. I have also found the staff at Associated Physicians, particularly the nursing staff to be kind and helpful.”
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