NOTICE OF PRIVACY PRACTICES
Effective Date: January 1, 2025
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE
REVIEW IT CAREFULLY.
Who We Are
Heart to Heart Midwifery is a licensed midwifery practice in the State of Minnesota, providing
prenatal care, home birth services, and postpartum care. We are committed to protecting the
privacy of your health information and complying with the Health Insurance Portability and
Accountability Act (HIPAA) and the Minnesota Health Records Act (MHRA).
Information We Collect
To provide you with quality care, we collect personal and health information including:
• Your name, address, date of birth, and contact information
• Medical history, pregnancy history, and health records
• Insurance and billing information
• Lab results, ultrasound referrals, and clinical notes
• Newborn health information
How We Use Your Information
We use your health information for the following purposes:
Treatment
We use your information to provide midwifery care, coordinate with other healthcare providers,
order lab work, make referrals, and ensure the health and safety of you and your baby.
Payment
We may use your information to bill your insurance company or health sharing ministry, process
payments, or work with our billing service (STM Billing, LLC) to manage your account.
Healthcare Operations
We may use your information for internal quality review, training, and to improve our practice.
We do not sell your information to third parties or use it for marketing without your written
consent.
Minnesota Law and Your Extra Protections
Minnesota law provides stronger privacy protections than federal HIPAA rules. Under the
Minnesota Health Records Act, we will not share your health records without your written
consent except in the specific situations described in this Notice or as required by Minnesota
law. This means we obtain your written consent even for disclosures that HIPAA alone would
permit.
When We May Share Your Information Without Your Permission
In limited situations, we may share your information without your written consent:
• When required by law (such as mandatory reporting of certain communicable diseases)
• To prevent a serious threat to your health or safety, or the health or safety of others
• For public health activities required by law
• In response to a court order or legal process
• To a coroner, medical examiner, or funeral director as required by law
Business Associates
Certain third parties assist us in providing care and may have access to your information. These
include our billing company (STM Billing, LLC) and our patient portal provider. We require all
business associates to sign a Business Associate Agreement and protect your information in
compliance with HIPAA and Minnesota law.
Your Rights
You have the following rights regarding your health information:
Right to Access Your Records
You may request a copy of your health records at any time. We will respond within 30 days. A
reasonable fee may apply for copies.
Right to Request Corrections
If you believe your records contain an error, you may request a correction. We will review your
request and respond in writing.
Right to Know Who Has Seen Your Records
You may request an accounting of disclosures we have made of your health information for
purposes other than treatment, payment, or operations.
Right to Request Restrictions
You may ask us to restrict certain uses or disclosures of your information. We will honor
reasonable requests unless we are required by law to make the disclosure.
Right to a Paper Copy of This Notice
You may request a printed copy of this Notice at any time, even if you previously received it
electronically.
How to Contact Us With Questions or Complaints
If you have questions about this Notice or believe your privacy rights have been violated, please
contact us:
Heart to Heart Midwifery
1833 West US Hwy 2, Suite A, Grand Rapids, MN 55744
Phone: 218-999-7354
Email: hearttoheartmidwifery@gmail.com
You also have the right to file a complaint with the U.S. Department of Health and Human
Services:
Office for Civil Rights, HHS | 200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-877-696-6775 | Website: www.hhs.gov/hipaa
We will not retaliate against you in any way for filing a complaint.
This Notice is subject to change. Any updated version will be posted in our office and on our
website. The effective date will be updated accordingly.
Effective Date: January 1, 2025
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE
REVIEW IT CAREFULLY.
Who We Are
Heart to Heart Midwifery is a licensed midwifery practice in the State of Minnesota, providing
prenatal care, home birth services, and postpartum care. We are committed to protecting the
privacy of your health information and complying with the Health Insurance Portability and
Accountability Act (HIPAA) and the Minnesota Health Records Act (MHRA).
Information We Collect
To provide you with quality care, we collect personal and health information including:
• Your name, address, date of birth, and contact information
• Medical history, pregnancy history, and health records
• Insurance and billing information
• Lab results, ultrasound referrals, and clinical notes
• Newborn health information
How We Use Your Information
We use your health information for the following purposes:
Treatment
We use your information to provide midwifery care, coordinate with other healthcare providers,
order lab work, make referrals, and ensure the health and safety of you and your baby.
Payment
We may use your information to bill your insurance company or health sharing ministry, process
payments, or work with our billing service (STM Billing, LLC) to manage your account.
Healthcare Operations
We may use your information for internal quality review, training, and to improve our practice.
We do not sell your information to third parties or use it for marketing without your written
consent.
Minnesota Law and Your Extra Protections
Minnesota law provides stronger privacy protections than federal HIPAA rules. Under the
Minnesota Health Records Act, we will not share your health records without your written
consent except in the specific situations described in this Notice or as required by Minnesota
law. This means we obtain your written consent even for disclosures that HIPAA alone would
permit.
When We May Share Your Information Without Your Permission
In limited situations, we may share your information without your written consent:
• When required by law (such as mandatory reporting of certain communicable diseases)
• To prevent a serious threat to your health or safety, or the health or safety of others
• For public health activities required by law
• In response to a court order or legal process
• To a coroner, medical examiner, or funeral director as required by law
Business Associates
Certain third parties assist us in providing care and may have access to your information. These
include our billing company (STM Billing, LLC) and our patient portal provider. We require all
business associates to sign a Business Associate Agreement and protect your information in
compliance with HIPAA and Minnesota law.
Your Rights
You have the following rights regarding your health information:
Right to Access Your Records
You may request a copy of your health records at any time. We will respond within 30 days. A
reasonable fee may apply for copies.
Right to Request Corrections
If you believe your records contain an error, you may request a correction. We will review your
request and respond in writing.
Right to Know Who Has Seen Your Records
You may request an accounting of disclosures we have made of your health information for
purposes other than treatment, payment, or operations.
Right to Request Restrictions
You may ask us to restrict certain uses or disclosures of your information. We will honor
reasonable requests unless we are required by law to make the disclosure.
Right to a Paper Copy of This Notice
You may request a printed copy of this Notice at any time, even if you previously received it
electronically.
How to Contact Us With Questions or Complaints
If you have questions about this Notice or believe your privacy rights have been violated, please
contact us:
Heart to Heart Midwifery
1833 West US Hwy 2, Suite A, Grand Rapids, MN 55744
Phone: 218-999-7354
Email: hearttoheartmidwifery@gmail.com
You also have the right to file a complaint with the U.S. Department of Health and Human
Services:
Office for Civil Rights, HHS | 200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-877-696-6775 | Website: www.hhs.gov/hipaa
We will not retaliate against you in any way for filing a complaint.
This Notice is subject to change. Any updated version will be posted in our office and on our
website. The effective date will be updated accordingly.
