KOLBECK, NABITY, BOSSERT & SIMMONS OB-GYN, L.L.C.

NOTICE OF PRIVACY PRACTICES

[EFFECTIVE April 13, 2003]

PURSUANT TO FEDERAL LAW, the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and the Privacy Rules promulgated thereunder, Kolbeck, Nabity, Bossert & SIMMONS Ob-Gyn, L.L.C. is providing this Notice of Privacy Practices ("Notice") to you to describe how Kolbeck, Nabity, Bossert & sIMMONS Ob-Gyn, L.L.C. (the "PRACTICE") may use and disclose protected health information (as more fully described below) about you and how you can get access to this information.  The PRACTICE asks that you review this notice carefully and should you have any questions regarding the content thereof please contact any of the staff at the PRACTICE and they will forward your questions or concerns to the PRACTICE's HIPAA Privacy Officer as appropriate.

Much of the information you provide to the PRACTICE in the course of the PRACTICE's provision of health care services to you may fall under the category of “protected health information” ("PHI") as those terms are defined under HIPAA.  HIPAA generally defines PHI as information about your past, present or future health or condition (mental or physical) and health care services you have received in relation thereto.  PHI also includes your demographic information.

This Notice sets forth pursuant to HIPAA:

I.                   The use and disclosure by PRACTICE of your protected health information to carry out treatment, payment or health care operations.

II.                The uses and disclosures by the PRACTICE of your PHI for other purposes that are permitted or required by law.

III.             Your rights to access and control your PHI.

IV.             Our Responsibilities with regard to your PHI.

I.                   USE & DISCLOSURE FOR TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS

The PRACTICE will share your PHI for treatment, payment and health care operations, which includes use and disclosure of your PHI among the PRACTICE's physicians and staff and others outside of the PRACTICE's office that are  involved in providing health care services to you.  This includes then the use and disclosure of your PHI by the PRACTICE in relation to payment of your health care bills and to support the healthcare operations of the PRACTICE.  Below are examples of some of the uses and disclosures of your PHI that the PRACTICE is permitted under HIPAA to make.  (Please note that these examples are not all the situations in which the PRACTICE may use or disclose your PHI, rather these examples are only a few of the types of permitted  uses and disclosures by the PRACTICE)