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, in addition to this notice on our website.  A paper copy of this Notice is available from any receptionist.

Protected Health Information (PHI)

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).

Your Rights

Federal law grants you certain rights with respect to your PHI. Specifically, you have the right to:

  • Receive a paper copy of this notice;
  • Request that certain uses and disclosures of your PHI be restricted or revoked, except to the extent that action has already been taken. However, we are not required to agree to such restrictions unless the disclosure is to a health plan or other payer for purposes of carrying out payment or health care operations and you have personally paid for the services in full;
  • Access, review and copy your PHI. This request may be denied in certain limited situations. All requests must be submitted to PCI Health Information Services;
  • Request that your PHI be amended; PCI has the discretion to grant or deny the request;
  • Obtain an accounting of certain disclosures by us of your PHI. 
  • Request receipt of communications in a confidential manner, which may be reasonably accommodated by alternative means or at an alternative location.

Our Responsibilities

Federal law also imposes certain obligations and duties upon us with respect to your PHI.  Specifically, we are required to:

  • Provide you with notice of our legal duties and policies regarding the use and disclosure of your PHI.
  • Maintain confidentiality of your PHI in accordance with state and federal law.
  • Notify you of an access, acquisition, use or disclosure of your PHI, not permitted by HIPAA, which compromises the security or privacy of your PHI.  This is called “breach notification”.  We will provide such notice to you without unreasonable delay, but in no case later than 60 days after discovery.
  • Abide by the terms of this notice.

How Your PHI May be Used and Disclosed 

Federal Law allows us to use or disclose your protected health information without your permission for the following purposes listed below.

It is important to understand that PHI may be redisclosed by the recipient of such information and that such redisclosure may not be protected by Federal law.

Treatment

Your PHI may be used or disclosed to provide, coordinate or manage your care. For example, we may communicate and share your PHI with other healthcare providers and their staff within and outside PCI to ensure continuity of care. 

Payment

Your PHI may be used or disclosed to create bills and collect payment from you, your insurance company or other third party payor.   For example, this may include providing information such as dates of service, symptoms, and diagnosis to your insurance company to show we provided medical services to you. 

Health Care Operations 

Your PHI may be used or disclosed for facility operations, which are necessary to ensure that our facility provides the highest quality of care. For example, this may include quality assessment and improvement activities, medical/legal reviews and auditing functions.


Uses and Disclosures Required by Law

PHI may be used or disclosed for other purposes to the extent required or mandated by law. For example, to comply with ADA, HIPAA privacy or security rule investigation or reviewing by DHS.

Public Health Activities

Public Health authorities (i.e. FDA & CDC) are legally permitted to collect and/or receive information for their approved activities, including: prevention or control of disease, injury or disability; reporting of reaction to medications or problems with products; notify people of product recalls; notify people who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.

Victims of Abuse, Neglect, or Domestic Violence

In a manner consistent with the requirements of applicable federal and state laws, we may use or disclose PHI to a protective services or social services agency if we reasonably believe you have been the victim of abuse, neglect or domestic violence. This reporting is for the health and safety of the victim.

Health Oversight Activities

Federal and state agencies may access your PHI to oversee the healthcare activities rendered by our facility or our facility’s compliance with certain laws and regulations.

Judicial and Administrative Proceedings

We may release PHI in response to a valid court or administrative order, or in response to certain types of subpoena, discovery requests or other lawful process. 

Law Enforcement

We may release PHI to law enforcement for the following purposes: in response to a court order, warrant, subpoena, summons or similar process; to identify/locate a suspect, fugitive, material witness or missing person; regarding a crime victim if, under certain limited circumstances, we are unable to obtain the person’s agreement; regarding a decedent, if we believe the individual’s death was the result of criminal conduct; regarding criminal conduct at PCI; in emergency circumstances to report a crime, the location of a crime or victims, or the identity, description or location of the person who committed a crime.

Organ, Eye, or Tissue Donations

PHI may be used or disclosed by us to entities engaged in the procurement, banking or transplantation of organs, eyes or tissues for the purpose of facilitating such donation and transplantation.

Research Purposes

All research projects are subject to a special approval process that will evaluate the precautions used to protect patient medical information. 

Serious Threat to Health Safety

PHI may be used or disclosed when necessary to prevent or lessen a serious threat to the health and/or safety of the public, yourself or another person.

Specialized Government Functions

PHI may be used or disclosed for the following variety of government functions subject to some limitations: military and veterans activities; national security and intelligence activities; protective service of the President and others; medical suitability determinations for Department of State officials; correctional institutions and law enforcement custodial situations; or provision of public benefits.

Workers’ Compensation

PHI may be used or disclosed as authorized and to the extent necessary to comply with laws relating to workers’ compensation or other programs providing benefits for work-related injuries or illness without regard to fault.

Patient Contact

At times, unless you object in advance, we may access your PHI to contact you regarding the need to set up an appointment or a reminder about future appointments.

Uses and Disclosure Requiring Your Authorization 

PCI will never share your information without your written permission in the following cases: Marketing purposes, sale of your information and most sharing of psychotherapy notes. 

We will seek authorization for PHI concerning mental health treatment, HIV/AIDS, and drug or alcohol treatment when required.

Special 

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. 

Reproductive Healthcare

We may not disclose your reproductive health information to a party requesting the information if that party’s purpose is to:

  • Conduct a criminal, civil, or administrative investigation for the mere act of seeking, obtaining, providing, or facilitating reproductive health care;
  • Impose criminal, civil, or administrative liability, for the mere act of seeking, obtaining, providing, or facilitating reproductive health care, or
  • To identify any person involved in the acts described above. 

For example, we will not disclose your reproductive health care information to law enforcement whose purpose is to investigate a patient’s lawful receipt of reproductive health care in another state. 

Should we receive a request for PHI related to reproductive healthcare, PCI will obtain a signed attestation from the requesting party that the information is not being sought for a purpose prohibited by the HIPAA Privacy Rules. 

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, PC
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.

Comments and Concerns 

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.

Effective Date 

This notice became effective July 22, 2024.

Important Contact Information 

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.