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Medical Arts Building
2055 Kimball Avenue
Suite 101
Waterloo, Iowa 50702

Contact Phone Numbers for
our Research Department:
(319) 272-2536 Phone
(319) 272-1930 Fax

Email:

Samantha Beenken, BSN, RN

sbeenken@neimef.org

Karrie Cheeseman, BSN, RN
kcheeseman@neimef.org

Jessica Schwake, BSN, RN
jschwake@neimef.org

(Responses in 1-3 Days)

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Privacy Policy

Northeast Iowa Medical Education Foundation Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

The Northeast Iowa Medical Education Foundation uses health information about you for treatment, to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive. Your health information is contained in a medical record that is the physical property of Northeast Iowa Medical Education Foundation. Protecting the privacy of information about your health and medical conditions is a responsibility we take very seriously. We are committed to the practices and procedures we established to protect the confidential nature of information about your health.

How Northeast Iowa Medical Education Foundation May Use or Disclose Your Health Information

For Treatment: Northeast Iowa Medical Education Foundation may use your health information to provide you with medical treatment or services. For example, information obtained by a health care provider, such as a physician, nurse, or other person providing health services to you, will record information in your record that is related to your treatment. This information is necessary for health care providers to determine what treatment you should receive. Health care providers will also record actions taken by them in the course of your treatment and note how you respond to the actions.

For Payment: Northeast Iowa Medical Education Foundation may use and disclose your health information to others for purposes of receiving payment for treatment and services that you receive. For example, a bill may be sent to you or your insurance company. The information on the bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.

For Health Care Operations: Northeast Iowa Medical Education Foundation may use and disclose health information about you for operational purposes. Your health information may be disclosed to members of the medical staff, risk or quality improvement personnel, and others to:

  • Evaluate the performance of our staff;
  • Assess the quality of care and outcomes in your cases and similar cases;
  • Learn how to improve our facilities and services; and
  • Determine how to continually improve the quality and effectiveness of the health care we provide.

Appointments: Northeast Iowa Medical Education Foundation may use your information to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to the individual.

Fund Raising: Northeast Iowa Medical Education Foundation may use your information to contact you to raise funds for Northeast Iowa Medical Education Foundation/Waterbury Foundation.

Law Enforcement: Northeast Iowa Medical Education Foundation may use and disclose information about you as required by law. For example, Northeast Iowa Medical Education Foundation may disclose information for the following purposes:

  • For judicial and administrative proceedings pursuant to legal authority;
  • To report information related to victims of abuse, neglect or domestic violence; and
  • To assist law enforcement officials in their law enforcement duties

Public Health: Your health information may be used or disclosed for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury or disability, report child abuse or neglect, notify a person at risk for contracting or spreading a disease or condition.

Health Oversight Activities: Health oversight activities such as audits, investigations and inspections may also require your health information to be disclosed when authorized by law. These activities are necessary for the government to monitor the health care system, government programs and entities subject to civil rights laws.

Decedents: Health Information may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties.

Organ/Tissue Donation: Your health information may be used or disclosed for organ, eye or tissue donation purposes.

Research: Northeast Iowa Medical Education Foundation may use your health information for research purposes when an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved the research.

Health and Safety: Your health information may be disclosed to avert a serious threat to the health or safety of you or any other person pursuant to applicable law. Any disclosure, however, would only be to someone able to help prevent the threat.

Government Functions: Specialized government functions such as protection of public officials or reporting to various branches of the armed services that may require use or disclosure of your health information.

Workers Compensation: Your health information may be used or disclosed in order to comply with laws and regulations related to Workers Compensation.

Your Health Information Rights

You have the right to:

  • Request a restriction or a limit on certain uses and disclosures of your information. In your request, you must tell us: the information you want to limit; whether you want to limit our use, disclosure or both; and to whom you want the limits to apply (example- your spouse, etc). However, Northeast Iowa Family Practice Center is not required to agree to a requested restriction;
  • Obtain a paper copy of the notice of information practices upon request at any time;
  • Inspect and obtain a copy of your health record we maintain. Usually includes medical and billing records. The Federal Law does not include psychotherapy notes or information about your health compiled in reasonable anticipation of litigation, administrative action, or administrative proceeding. If you request a copy of this information, we may charge a standard fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request in certain limited circumstances. If you are denied access to information about your health, you may request that the denial be reviewed;
  • Amend your health record if you believe the information we have is incorrect or incomplete. You must provide a reason that supports your request. You have the right to request an amendment for as long as the information is kept by or for us. We may deny your request for an amendment if it is not in writing or does not have supporting data. Also amendment may be denied 1) if information was not created by us (unless person/entity is no longer available to make the amendment), 2) is not part of your health information kept by or for us, 3) is not part of your health information that you would permit to be inspected or copied, 4) is accurate and complete;
  • Request confidential communications of your health information by alternative means or at alternative locations if you could be endangered by our normal communication channels. We will accommodate all reasonable requests as long as you provide the reason for it. Your request must specify how or where you
    wish to be contacted;
  • Revoke your authorization to use or disclose health information except to the extent that action has already been taken. You understand we are unable to take back any disclosures we have already made with your authorization and that we may retain documents that may contain information about your health; and
  • Receive an accounting of disclosures made of your health information, if any. This right applies to disclosures for purposes other than treatment, payment, health care operations or as otherwise permitted or required by law. You have a right to receive specific information about these disclosures that occur after April 13, 2003. The right to receive this information is subject to certain exceptions, restrictions and limitations.

Complaints

You may complain to Northeast Iowa Medical Education Foundation and to the Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint.

Obligations of Northeast Iowa Medical Education Foundation
Northeast Iowa Medical Education Foundation is required to:

  • Maintain the privacy of your protected health information;
  • Provide you with this notice of our legal duties and privacy practices with respect to your health information;
  • Abide by the terms of this notice;
  • Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed;
  • Obtain your written authorization to use or disclose your health information for reasons other than those listed above and permitted under law.

Changes to This Notice

Northeast Iowa Medical Education Foundation reserves the right to change its information practices and to make the new provisions effective for all protected health information it maintains. Revised notices will be made available to you by Northeast Iowa Medical Education Foundation's business mail.

Contact Information

If you have any questions or complaints, please contact:

Privacy Officer
Northeast Iowa Family Practice Center
2055 Kimball Avenue Suite 101
Waterloo, Iowa 50702
(319) 272-2525