Privacy Practices

Confidentiality

Southern Tier Women’s Health Services, LLC staff members are pledged to provide the greatest confidentiality possible. Consequently, we do not confirm appointments over the phone without proper identification. A signed statement is required for the release of records. We do require a phone number if we need to cancel an appointment for any reason or for medical follow-up. Staff will often text you if that is acceptable. A contact number or special instructions for calling are accepted.

Your Information. Your Rights. Your Responsibilities.

In accordance with the Federal Health Information Portability and Accountability Act (HIPAA), it is the policy of Southern Tier Women's Health Services, LLC to ensure each patient reviews, acknowledges, and is provided a copy of, if requested, our Privacy Policy, the Patient's Rights, Responsibilities, and copies of Advanced Directives. To download this information click here.

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.

HIPAA Privacy Policy

Protecting the privacy of our patient’s health information is important to all the staff and physicians at the Southern Tier Women’s Health Services, LLC. The facility therefore adheres to the Health Information Portability and Accountability Act (HIPAA) enacted in April, 2001 and in effect April 14, 2003.

Protected health information (PHI) is information that may identify the patient and that is related to the patient’s past, present or future physical or mental health or condition and related health care services.

Our Policies

  1. Disclosure of a patient’s PHI is forbidden without the written consent of the patient or guardian and is limited to defined situations that include: treatment, health care operations, communications with individuals involved in the patients care, payment of care, business associates such as third party payors, health related communications, workers compensation, Public Health, law enforcement, judicial and administrative procedures, health oversight activities, coroners, medical examiners, funeral directors, organ or tissue procurement organizations in conjunction with the law, notification of family or personal representative, and disclosure to a government agency if there is reason to suspect the patient is a victim of abuse, neglect or domestic violence.

  2. Disclosure of PHI is limited to the minimum necessary for the purpose of the disclosure. This provision does not apply to the transfer of medical records for treatment.

  3. The patient may request, in writing, to receive a copy of their medical record or patient profile.

  4. The patient may make a written request to the administrator (HIPAA Officer) to have their PHI amended or changed if it is incomplete or contains errors. A reason for the request must be included and the request may be denied by the administrator.

  5. A Privacy Notice shall be posted in the waiting room and information made available to the patient, patient’s family and visitors.

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.

  • 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. For more information see: https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html

Patient Rights and Responsibilities

Patient Rights

As a patient of Southern Tier Women’s Health Services, LLC, you have the right to:

  1. Understand and use these rights. If for any reason you do not understand or you need help, we will provide assistance;

  2. Receive services without regard to age, race, color, sexual orientation, gender identity, religion, marital status, sex, national origin or sponsor;

  3. Be treated with consideration, respect and dignity including privacy in treatment;

  4. Be informed of the services available at the Center;

  5. Be informed of the provisions of off-hour emergency coverage;

  6. Be informed of, and receive an estimate of the charges for services, view a list of the health plans and the hospitals that the Center participates with; eligibility for third-party reimbursements and, when applicable, the availability of free or reduced cost care;

  7. Receive an itemized copy of your account statement, upon request;

  8. Obtain from your health care practitioner, or delegate, complete and current information concerning your diagnosis, treatment and prognosis in terms you can understand;

  9. Receive from your physician information necessary to give informed consent prior to the start of any non-emergency procedure or treatment. An informed consent shall include, as a minimum, information about the specific procedure or treatment or both, the reasonably foreseeable risks involved, and alternatives for care or treatment, if any, as a reasonable medical practitioner under similar circumstances would disclose in a manner permitting the patient to make a knowledgeable decision;

  10. Refuse treatment to the extent permitted by law and to be fully informed of the medical consequences of your action;

  11. Voice grievances and recommend changes in policies and services to the Center's staff, the operator and the New York State Department of Health without fear of reprisal;

  12. Express complaints about the care and services provided and to have the Center investigate such complaints. The Center is responsible for providing you or your designee with a written response within 30 days, if requested by the patient, indicating the findings of the investigation. The Center is also responsible for notifying the patient or their designee that if the patient is not satisfied by the Center response, you may complain to the New York State Department of Health;

  13. Privacy and confidentiality of all information and records pertaining to the patient's treatment;

  14. Approve or refuse the release or disclosure of the contents of their medical record to any health-care practitioner and/or health-care facility except as required by law or third-party payment contract;

  15. Access to your medical record pursuant to the provisions of section 18 of the Public Health Law, and Subpart 50-3. For more information http;//www.health.ny.gov/publications/1449/section_1.htm#access;

  16. Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors;

  17. When applicable, make known your wishes in regard to anatomical gifts. Persons sixteen years of age or older may document their consent to donate their organs, eyes and/or tissues, upon their death, by enrolling in the NYS Donate Life Registry or by documenting their authorization for organ and/or tissue donation in writing in a number of ways (such as health care proxy, will, donor card, or other signed paper). The health care proxy is available from the Center.

  18. View a list of the health plans and the hospitals that the center participates with; and

  19. Receive an estimate of the amount you will be billed after services are rendered.

Patient Responsibilities

Patients of Southern Tier Women’s Services, LLC seeking treatment at the center have the responsibility to:

  1. Behave in a responsible manner and observe all center rules and regulations.

  2. Treat staff and other patients with courtesy and respect.

  3. Be considerate of other patients’ rights to confidential care. Please, do not take photographs of yourself or others in or around the building. Facetime and other electronic communication that could compromise another’s privacy are also prohibited.

  4. Provide to the best of your knowledge, accurate and complete information about present complaints, past illnesses, medications and other relevant facts relating to your health status. A patient is responsible for making it known whether you clearly comprehend a suggested course of action and what is expected of you.

  5. Follow the treatment plan prescribed by your provider and participate in your care.

  6. Participate in the decision-making involved in your care.

  7. Discuss with the medical staff any problems or obstacles that may affect your ability to carry out your treatment or obtain prescriptions for any reason.

  8. Be responsible for your actions if you refuse treatment or do not follow instructions.

  9. Pay for care on a timely basis after receiving a bill for payment from Southern Tier Women’s Health Services.

  10. Make suggestions about improving Center operations. Ask questions about any aspect of your care and treatment plan.

  11. Participate in the surveys to assist in maintaining high-quality care at the Center

  12. Provide a responsible adult to transport you home from the Center and remain with them for 24 hours if required by your physician.

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 website.

Other Instructions for Notice

  • Effective Date of this Notice: 06/14/2019

  • HIPAA Privacy Officer contact: Call 607-785-4171 or 1-800-676-9011 and ask for a manager or administrator to discuss a privacy issue.

  • Southern Tier Women's Health Services LLC will never market or sell personal information.

 
 

Or you may call/text 607-785-4171 (or call toll-free 800-676-9011) to schedule an appointment. Please provide your last period date and insurance info. Typically, we can offer an appointment within the week. Some early evening and Saturday appointments may be available for medication abortions.