Notice of Privacy Practices

The notice describes how medical/protected health information about you may be used and disclosed and how you can get access to this information.  Please review carefully.

Uses and disclosures of protected health information

Your protected health information may be used and disclosed by your physician, our staff and others outside of our facility that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the physician’s practice, and any other use required by law.

Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services.

Payment: Your protected health information will be used, as needed, to obtain payment for your health care services.

Healthcare Operations: We may use or disclose, as-needed, your protected health information in order to support the business activities of your physician’s practice.

Other Permitted and Required Uses and Disclosures will be made only with your consent, authorization or opportunity to object unless required by law.

You may revoke the authorization, at any time, in writing, except to the extent that your physician or the facility has taken an action in reliance on the use or disclosure indicated in the authorization.

By law, we are required to provide you with our Notice of Privacy Practices (NPP).  This Notice describes how your medical information may be used and disclosed by us.  It also tells you how you can obtain access to this information.

Rights Regarding Electronic Health Information Technology

Wichita Urology Surgery Center participates in electronic health information technology or HIT.  This technology allows a provider or a health plan to make a single request through a health information organization or HIO to obtain electronic records for a specific patient from other HIT participants for purposes of treatment, payment, or health care operations. HIOs are required to use appropriate safeguards to prevent unauthorized uses and disclosures.

You have two options with respect to HIT.  First, you may permit authorized individuals to access your electronic health information through an HIO.  If you choose this option, you do not have to do anything.

Second, you may restrict access to all of your information through an HIO (except as required by law).  If you wish to restrict access, you must submit the required information either online at http://www.KanHIT.org or by completing and mailing a form.  This form is available at http://www.KanHIT.org.  You cannot restrict access to certain information only; your choice is to permit or restrict access to all of your information.

If you have questions regarding HIT or HIOs, please visit http://www.KanHIT.org for additional information.

If you receive health care services in a state other than Kansas, different rules may apply regarding restrictions on access to your electronic health information. Please communicate directly with your out-of-state health care provider regarding those rules.

 Certain Marketing Activities

We may use your mailing address, email or phone number to communicate with you about products, services and educational programs offered by Wichita Urology Surgery Center, to communicate with you about case management and care coordination and to communicate with you about treatment alternatives.  We do not sell your health information to any third party for their marketing activities unless you sign an authorization allowing us to do this.

As a patient, you have the following rights:

  1. The right to inspect and copy your information (fees may apply)
  2. The right to request a restriction of your protected health information
  3. The right to request confidential communications
  4. The right to request an amendment to your protected health information
  5. The right to receive an accounting of certain disclosures
  6. The right to receive notice of a breach
  7. The right to a paper copy of this notice

We want to assure you that your medical/protected health information is secure with us.  The Notice contains information about how we will ensure that your information remains private.

If you have any questions about the Notice, the name and phone number of our contact person is:
Contact Person:  Susan Butcher, Administrator                                                                         Phone Number:  316-358-0813

Effective Date Of This Notice:  November 1, 2021