Notice of Privacy Practices
Maternal Wellness Center of Nebraska (MWC-NE)
Effective Date of This Notice: 9/1/2025
THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I. Our Commitment to Your Privacy
Maternal Wellness Center of Nebraska (MWC-NE) understands that your health information is personal. We are committed to protecting your privacy and safeguarding your Protected Health Information (“PHI”).
We create and maintain records of the care and services you receive. These records are necessary for high-quality care and to comply with professional, ethical, and legal obligations.
This notice applies to all records of your care generated by MWC-NE. It explains:
How we may use and disclose your PHI
Your rights regarding your PHI
Our responsibilities as your provider
MWC-NE is required by law to:
Ensure your PHI is kept private
Provide you with this Notice describing our legal duties and privacy practices
Follow the terms of this Notice
We may update this Notice at any time. Any changes will apply to all PHI we maintain. Updated versions will be available upon request, in our office, and on our website.
II. How We May Use and Disclose Health Information About You
For Treatment, Payment, and Health Care Operations
Federal privacy rules allow us to use or disclose your PHI without written authorization for:
Treatment: coordinating, managing, or consulting with other providers about your care
Payment: verifying insurance benefits, submitting claims, billing, and collections
Health Care Operations: quality review, clinical supervision, audits, training, or administrative functions
Example:
Your clinician may consult with another licensed professional about your case to ensure high-quality care. These uses are not subject to the “minimum necessary” standard because full access to your information may be required.
Lawsuits and Legal Proceedings
If you are involved in a legal matter, we may disclose PHI:
As required by a court order
In response to a subpoena or legal request once reasonable efforts have been made to notify you or obtain a protective order
III. Certain Uses and Disclosures Require Your Authorization
Psychotherapy Notes
“Psychotherapy notes” (as defined by HIPAA) receive special protection. MWC-NE will not disclose psychotherapy notes without your written authorization except in limited situations, such as:
For our own treatment use
For clinical supervision or training
To defend ourselves in a legal proceeding initiated by you
When required by law
To prevent or lessen a serious and imminent safety threat
Marketing & Sale of PHI
MWC-NE does not use your PHI for marketing purposes and will never sell your PHI.
IV. Certain Uses and Disclosures Do Not Require Your Authorization
We may use or disclose your PHI without your written consent when required or permitted by law, including:
When required by federal or state law
To report suspected abuse, neglect, or threats to safety
For public health reporting or oversight activities (e.g., audits, investigations)
For judicial or administrative proceedings
To report a crime on our premises
To medical examiners or coroners
For research approved under HIPAA safeguards
For specialized government functions (e.g., military, national security, correctional safety)
For workers’ compensation claims
To send appointment reminders or inform you of treatment alternatives or services
Incapacitation or Death of the Provider (Professional Will)
In the event of clinician death, disability, or inability to continue practicing, a pre-designated licensed mental health professional (professional executor) will have limited access to client contact information and treatment records solely for:
Client notification
Transfer of records
Coordination of ongoing care
This person is legally and ethically required to uphold HIPAA confidentiality protections.
V. Uses and Disclosures That Allow You the Opportunity to Object
If you do not object, we may disclose relevant PHI to a family member, friend, or individual involved in your care or responsible for payment.
If you are unable to consent due to incapacity or emergency, we may share information when it is in your best interest. We will document the circumstances appropriately.
VI. Your Rights Regarding Your Protected Health Information
1. Request Restrictions
You may request limitations on how your PHI is used or disclosed.
MWC-NE is not required to agree unless you pay for services in full, out-of-pocket, and request that information not be shared with your insurer.
2. Confidential Communications
You may request to be contacted in a specific way (e.g., only by email, only at work).
We will honor all reasonable requests.
3. Access to Records
You have the right to request and receive a copy of your treatment record (excluding psychotherapy notes) in paper or electronic format within 30 days.
Reasonable copying or administrative fees may apply.
4. Accounting of Disclosures
You may request a list of disclosures of your PHI made in the past six years, excluding disclosures for treatment, payment, or operations.
One request per year is free; additional requests may involve a fee.
5. Request Amendments
If you believe information in your record is incorrect or incomplete, you may request an amendment.
If we deny your request, you will receive a written explanation within 60 days.
6. Paper or Electronic Copy of This Notice
You may request a paper or emailed copy of this Notice at any time, even if you have received it electronically.
Acknowledgment of Receipt of Privacy Notice
Under HIPAA, you have specific rights related to your protected health information.
By signing below, you acknowledge that you have received and reviewed this Notice of Privacy Practices.