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Patient's Rights &
Financial Policy

 

Financial Policy
FemGYN participates in select insurance plans. If FemGYN does not participate in your insurance plan or you do not have health insurance, you must pay in full for the visit at the time of service. If you have a health insurance plan that FemGYN does not participate in, after you have paid us, you may send the bill to your insurance company. Your insurance may then reimburse you.

If you have a health insurance plan that FemGYN does participate in, you may have a co-pay. You must pay your co-pay at the time of service. All testing done at FemGYN will be sent to a laboratory that accepts your insurance (if applicable). This is not a guarantee that lab work done at FemGYN will be covered by your insurance. The patient must pay the laboratory any amount not paid by insurance.

Patient's Privacy Rights
RIGHT TO INSPECT AND COPY MEDICAL RECORDS: In most cases, you have the right to look at or get copies of your records. You must make the request in writing.

RIGHT TO REQUEST RESTRICTIONS: You have the right to ask us to limit how your information is used or disclosed. You must make the request in writing and tell us what information you want to limit and to whomyou want the limits to apply. We are not required to agree to the limit. You can request in writing that the limit be terminated.

RIGHT TO AMEND: You may ask us to change or add missing information to your records if you think there is a mistake. You must make the request in writing or upon request to staff, and provide a reason for your request.

RIGHT TO OBTAIN A PAPER COPY: You have the right to ask for a paper copy of this notice at any time.

RIGHT TO FILE A COMPLAINT: You have the right to file a complaint with us at the address listed with out practice and with the Secretary of the United States Department of Health and Human Services if you do not agree about how we have used or disclosed information about you.


RIGHT TO REVOKE PERMISSION: If you are asked to sign an authorization to use or disclose information, you can cancel that authorization at any time. You must make the request in writing. This will not affect information that has already been shared.

RIGHT TO CHOOSE HOW WE COMMUNICATE WITH YOU: You have the right to ask that we share information with you in a certain way or in a certain place. For example, you can ask us to send information to your work address instead of your home address. You must make this request in writing. You do not have to explain the reason for your request.

Got questions about your information?

Don't hesitate to reach out to us for more details, such as requesting a copy of the patient registration form, insurance coverage, and more.

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