NOTICE OF PRIVACY PRACTICES
This Notice Describes How The Confidential and Medical Information About You May Be Used and Disclosed and How You Can Get Access to This Information. Please Review It Carefully.
Uses and Disclosures
Diversity Fertility Services, LLC believes in maintaining the privacy of your individually identifiable health information to the best of its ability. Diversity Fertility Services, LLC is not a medical clinic nor does it provide medical care or treatment. Diversity Fertility Services, LLC is a fertility planning, egg donation and surrogacy agency that takes a holistic approach in facilitating the process of assisting you in identifying your fertility options and educating you about treatment options. All treatment and medical recommendations are made by licensed healthcare professionals. Diversity Fertility Services, LLC is not liable or responsible for the results of any medical recommendations or treatment provided by any professional, medical professional, healthcare professional or legal professional it recommends to a client.
Duties of the Company
HIPAA Privacy Regulations were created because of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and provides a national standard for the protection of health information. The Privacy Rule applies to health plans, health care clearinghouses and health care providers. Diversity Fertility Services, LLC, is an Egg Donation and Surrogacy Agency and is not a medical clinic, not a health plan, and is not a health care clearinghouse nor a health care provider. Our organization is a private company. However, Diversity Fertility Services, LLC believes in maintaining the privacy of your individually identifiable health information to the best of its ability. Below please find a list of your rights with regards to the self- imposed limitations with regards to the use of the information we obtain on you.
Intended Parents, Egg Donors and Gestational Surrogates. Your confidential and health information may be disclosed to health care professionals for evaluating your health, diagnosing medical conditions, and providing treatment. For example, the results of laboratory tests, procedures, psychological evaluation or genetic evaluation will be made available to health professionals such as your Medical Clinic, Physician, Psychologist or Genetic Counselor who may provide treatment or who may be consulted by staff members on your behalf.
Facilitation and Appointment reminders. Your identifying and health information may be used by our staff to send you appointment reminders and to facilitate or assist in the coordination of the services that you have requested such as fertility planning, egg donation or surrogacy related services. Your confidential and health information may be used to send you information that you may find interesting on the treatment and management of your medical condition.
Additional Uses of Your Information. We may also send you information describing other health-related products and services that we believe may interest you.
Operations. Your confidential and health information may be used as necessary to support the day-today activities and management of our Company. For example, information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.
Consultants and Independent Contractors. Your confidential information is used for the purpose of verifying your qualifications and for the processing of any payment due to you for services rendered. All Consultants that are paid directly by Diversity Fertility Services, LLC will be issued a 10-99 and must provide an E.I.N or S.S.N for such purposes. Your information may be used as necessary to support the day-today activities and management of our Company. For example, information on the services you provide to our agency or on behalf of our clients may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.
Levy enforcement. Your health information may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government mandated reporting.
Public health reporting. Your health information may be disclosed to public health agencies as required by law.
Other uses and disclosures require your written authorization. Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information you may submit a written revocation of the authorization, However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision to revoke your authorization,
You may request the following in writing:
Restrictions on the use and disclosure of your protected health information
Confidential communications concerning your medical information
Submit corrections to your protected health information
Right to Revise Privacy Practices
As permitted by law, Diversity Fertility Services, LLC reserves the right to amend or modify our privacy policies and practices. Changes in our policies and practices may be required by changes in federal and state laws and regulations, upon written request, we will provide you with the most recently revised notice. The revised policies and practices will be applied to all protected health information we maintain.
Requests to Inspect Protected Health Information
Diversity Fertility Services, LLC works with clients who wish to maintain total anonymity while participating in the process of fertility planning, egg donation or surrogacy. To protect the identity of our clients, Diversity Fertility Services, LLC may not maintain copies of our clients’ health records on a long-term basis and advise all clients to request copies of their medical records directly from the medical clinics from which they have received medical treatment. A client may request in writing that Diversity Fertility Services, LLC destroy all his/her records on file. Clients understand that electronic records and electronic communication may leave a digital footprint and may not be permanently destroyed despite best efforts by Diversity Fertility Services, LLC to destroy all records.
Complaints. If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:
Diversity Fertility Services, LLC Medical Compliance,
51 John F Kennedy Parkway,
First Floor West, Short Hills, NJ 07078
Request of Medical Records
You have the right to request your medical records directly from the medical clinics as Diversity Fertility, LLC is not a medical clinic, insurance company or healthcare clearing house and does not store medical records.
You may request a restriction or limitation on the medical information we use or disclose about you regarding the services provided to you or on your behalf in the areas of fertility planning, egg donation and surrogacy. We are not required to agree to your request but will do our best to comply. We may not be able to comply with your request, if the information is excepted from the consent requirement or we are otherwise required to disclose the information by law. To request restrictions, you must make your request in writing and your request must indicate:
What information you want to limit
Whether you want to limit our use, disclosure or both
To whom you want the limits to apply, (e.g., disclosures to clinics, etc.)
If you wish your file to be deactivated and your information to be removed
Right to Request Confidential Communications
You have the right to request that we communicate with you about confidential and medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail, that we not leave voice mail or e-mail, or such. To request confidential communications, you must make your request in writing. We will accommodate all reasonable requests. Your request must specify how or where you wish us to contact you.
This Notice is effective on or after January 1, 2018.