OBGYN New Patients

Medical Record Release Policies

Federal and State law requires the patient’s signature, or that of an authorized personal representative, to release or transfer medical records. The patient records are defined as all records that relate to the health of the patient and are prepared by or under supervision of a health care provider associated with Capital Women’s Care. We maintain the patient’s rights that all medical records are kept confidential according to all federal and state laws.

Please note that in some cases, a fee will be charged for medical record copies. The medical record department will be happy to provide you information about fees, expected turnaround times and other information related to your request.

Patients that provide records from another physician, outside of CWC, are encouraged to retain their own copy as Capital Women’s Care cannot provide a copy.

Please click below to print the applicable form:

Records Release TO Capital Women’s Care

13-release-to-cwc.pdf

Records Release FROM Capital Women’s Care

13-release-from-cwc.pdf

Prescription Refills Policy

• Prescription refills will be processed only for established patients who have been seen within the past 12 months.
• Your physician will review your chart and the refill will be called in directly to your pharmacy, within 24 hours of receipt, on the next business day. If your physician feels an office visit is necessary before a refill can be given, you will be notified by phone.
• One additional month of refill birth control pills can be called in for established patients. This will allow time to schedule an annual visit.

Billing Information

Our billing company is NextGen Revenue Cycle Management and they can be reached at 800-529-3489.

Privacy Practices

Understanding Your Health and Record Information

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is created. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a basis for planning care and treatment and serves as a means of communication among the many health professionals who contribute to your care. Understanding what is in your record and how your health information is used helps you to ensure its accuracy, better understand who, what, when, where, and why others may access your health information, and make more informed decisions when authorizing disclosure to others.

Your Health Information Rights

Unless otherwise required by law, your health record is the physical property of the healthcare practitioner or facility that compiled it; the information belongs to you. You have the right to request a restriction on certain uses and disclosures of your information, and request amendments to your health record. This includes the right to obtain a paper copy of the notice of information practices upon request, inspect, and obtain a copy of your health record. You may obtain an accounting of disclosures of your health information, request communications of your health information by alternative means or at alternative locations, revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Our Responsibilities

This organization is required to maintain the privacy of your health information, and in addition, provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you. This organization must abide by the terms of this notice, notify you if we are unable to agree to a requested restriction, accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations. We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will mail a revised notice to the address you have provided. If we maintain a website that provides information about our customer services or benefits we will post our new notice on that Web site. We will not use or disclose your health information without your authorization, except as described in this notice.

Examples of Disclosures for Treatment, Payment, and Health Operations

We will use your health information for treatment. For example: Information obtained by a healthcare practitioner will be detailed in your record and used to determine the course of treatment that should work best for you. By way of example, your physician will document in your record their expectations of the members of your healthcare team. Members of your healthcare team will then record the actions they took and their observations (example varies by practitioner type). We will also provide your other practitioners with copies of various reports that should assist them in treating you. We will use your health information for payment. For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used. We will use your health information for regular health operations. For example: Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.

• Business Associates: There may be some services provided in our organization through contracts with Business Associates. Examples include physician services in the emergency department and radiology, certain laboratory tests, and a copy service we use when making copies of your health record. When these services are contracted, we may disclose some or all of your health information to our Business Associate so that they can perform the job we have asked them to do. To protect your health information, we require the Business Associate to appropriately safeguard your information.
• Directory (inpatient settings): Unless you notify us that you object, we will use your name, location in the facility, general condition, and religious affiliation for directory purposes. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name.
• Notification: We may use or disclose information to notify, or assist in notifying, a family member, personal representative, or another person responsible for your care, your location, and general condition.
• Communication with family: Health professionals, using their best judgment, may disclose to a family member, other relatives, close personal friends or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.
• Research (inpatient): We may disclose information to researchers, when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information, has approved their research.
• Funeral directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.
• Organ procurement organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged

 

Notice of Privacy Practices (First time patients only, unless requested)

Notice of Privacy Practices