The following categories describe different ways that we may use and disclose medical information.  For each category of uses or disclosures we will explain what we mean and give some examples.  Not every use or disclosure in a category will be listed.   This notice covers treatment, payment, and what are called health care operations, as discussed below.  It also covers other uses and disclosures for which a consent or authorization are not necessary.  Where Iowa law is more protective of your medical information, we will follow state law, as explained below.

For Treatment:   We may use medical information about you to provide you with medical treatment or services without consent or authorization unless otherwise required by applicable state law.  We may disclose medical information about you to doctors, nurses, medical students, pharmacists, laboratories, or other health care providers who are involved in taking care of you whether or not they are affiliated with us.  For example, we may disclose medical information concerning you to Marion Health Center or St. Luke’s Hospital, or physicians who refer your care to us as well as to any other entity that has provided or will provide care to you.  However, we will disclose any mental health information, including psychotherapy notes, AIDS or HIV-related information, or drug treatment information, that we may have about you only with written authorization as required by Iowa law, HIPAA and other federal regulations.

During the course of your treatment, we may refer you to other health care providers such as independent laboratories with which you may not have direct patient contact.  These providers are called “indirect treatment providers.”   “Indirect treatment providers” are required to comply with the privacy requirements of state and federal law and keep your medical information confidential.  These providers will be bound by the HIPAA privacy rule.

For Payment:  We may use and disclose medical information about you without consent or authorization if permitted by Iowa law so that the treatment and services you receive from us may be billed to and payment may be collected from you, case management, an insurance company or a third party.  For example, we may need to give your insurer information about treatment received so your insurer will pay us or reimburse you for the treatment.  We may also tell your health plan or insurance company about a treatment you are going to receive to obtain prior approval or to determine whether it will cover the treatment.  We may also seek an authorization from you for payment in certain circumstance.

For Health Care Operations:  We may use and disclose medical information about you without consent or authorization for “health care operations”.  These uses and disclosures are necessary to operate our practice and make sure that all of our patients receive quality care.  For example, we may use medical information or mental health treatment information to review our treatment and services and to evaluate the performance of our staff in caring for you.  We may also disclose your protected health information to doctors, nurses, medical students and other employees or consultants for review and learning purposes.  We may also use your protected health information in preparing for litigation.

Appointment Reminders:  We may use and disclose medical information to contact you by mail or phone to remind you that you have an appointment for treatment, unless you tell us otherwise.

Treatment Alternatives:  We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you. However, we will not use or disclose medical information to market other products and services, either ours or those of third parties, without your authorization.  You have a right to opt out of any such future communications by contacting the Privacy Officer

Health-Related Benefits and Services:  We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you

Individuals Involved in Your Care or Payment for Your Care:  We may release medical information about you to a family member who is involved in your medical care without consent or authorization as permitted by Iowa law.  We may also give medical information, including prescription information or information concerning your appointments to friends who are involved in your care.   We may also give such information to someone who helps pay for your care.  In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

As Required By Law:  We will disclose medical information about you when required to do so by federal, state or local law without your consent or authorization.

To Avert a Serious Threat to Health or Safety:  We may disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.  Any disclosure, however, would only be to someone able to help prevent the threat.

To Business Associates:   Tanager Place from time to time will hire consultants called “business associates,” who render services to us.  We may disclose your medical information to such business associates without your consent or authorization.  Business associates are required to maintain and comply with the privacy requirements of state and federal law and keep your medical information confidential.   An example of  a “business associate” would be the accounting firm that we hire to perform audits of billing and payment information, as well as computer software vendors who assist us in maintaining and processing medical information.

Military and Veterans:  If you are a member of the armed forces, we may release medical information about you as required by military command authorities.  We may also release medical information about foreign military personnel to the appropriate foreign military authority.

Worker’s Compensation:  We may release medical information about you for workers’ compensation or similar programs without consent or authorization.  These programs provide benefits for work-related injuries or illnesses.  For example, if you are injured on the job, we may release information regarding that specific injury.

Public Health Risks:  We may disclose medical information about you for public health activities without your consent or authorization.  These activities generally include the following:

  • to prevent or control disease, injury or disability;
  • to report reactions to medications or problems with products;
  • to notify people of recalls of products they may be using;
  • to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
  • to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence.  We will only make this disclosure if you agree or when required or authorized by law.

Health Oversight Activities:  We may disclose medical information to a health oversight agency, such as the Department of Health and Human Services, for activities authorized by law.  These oversight activities include, for example, audits, investigations, inspections, and licensure.  These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Administrative Proceedings:  If you are involved in a lawsuit or dispute as a party, we may disclose medical information about you in response to a court or administrative order.  We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute.  Similarly we may disclose medical information about you in proceedings where you are not a party, but only if efforts have been made to tell you or your attorney about the request or to obtain an order protecting the information requested.  In addition, we may disclose medical information, including mental health treatment information, to the opposing party in any lawsuit or administrative proceeding where you have put your physical or mental condition at issue if you have signed a valid authorization.

Law Enforcement:   We may release medical information if asked to do so by a law enforcement official:

in response to a court order, subpoena, warrant, summons or similar process;

  • to identify or locate a suspect, fugitive, material witness, or missing person;
  • about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
  • about a death we believe may be the result of criminal conduct;
  • about criminal conduct at Tanager Place;
  • in emergency circumstances to report a crime; the location of the crime or victims; or the identity,  description or location of the person who committed the crime.

Coroners, Medical Examiners and Funeral Directors:  We may release medical information including mental health information to a coroner or medical examiner.  This may be necessary, for example, to identify a deceased person or determine the cause of death.

National Security and Intelligence Activities:  We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective Services for the President and Others:  We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

Inmates:  If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official.  This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.