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NOTICE
OF HEALTH INFORMATION PRIVACY PRACTICES
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.
Colorado Springs Health Partners,
P.C. (CSHP) is committed to the protection of patients’ privacy and
confidentiality of medical information. CSHP recognizes that
patients depend upon us to safeguard their personal information and
to uphold the privacy rights of patients. This notice, which is
based upon state and federal law, as well as the CSHP code of
ethics, confirms our commitment to preserving patient
confidentiality and privacy and also confirms that CSHP will not use
or disclose patient personal or health information except as
described in this Notice. This Notice applies to all of the personal
information gathered by and medical records generated by CSHP, as
well as records received from other providers.
USES AND DISCLOSURES FOR
TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS: Without your
authorization, CSHP may use and disclose your personal and/or health
information for the following purposes:
TREATMENT: CSHP may use your
personal and/or health information in the provision and
coordination of your healthcare. CSHP may disclose all or any
portion of your personal and/or medical information to your
attending physician, consulting physician(s), nurses, technicians,
medical students, and other health care providers who have a
legitimate need for such information in your care and treatment.
Different departments may share information about you in order to
coordinate specific services, such as prescriptions, lab work and
x-rays. Other ways we may use or disclose your information for
purposes related to treatment are:
- Treatment Alternatives:
To tell you about or recommend possible treatment options or
alternatives that may be of interest to you.
- Appointment Reminders: To
contact you as a reminder that you have an appointment for
treatment or medical care at CSHP.
PAYMENT: CSHP may release
personal and/or health information about you for the purposes of
determining insurance coverage, billing, claims management,
medical data processing, and reimbursement. The information may be
released to an insurance company, or other entity (or their
authorized representatives) involved in the payment of your
medical bill and may include copies or excerpts of your medical
record which are necessary for payment of your account. For
example, a bill may include information that identifies you, your
diagnosis, and the procedures and supplies used. CSHP may also
provide information to other care providers who have been involved
in your care, such as a home health care agency or an ambulance
company.
HEALTHCARE OPERATIONS:
CSHP
may use and disclose your personal and/or health information
during healthcare operations including quality assurance,
utilization review, medical review, internal auditing,
accreditation, certification, licensing activities of CSHP,
medical research, and educational purposes. CSHP may engage
outside companies to carry out certain aspects of healthcare
operations. These entities are called "Business Associates". CSHP
may need to disclose your information to Business Associates to
allow them to perform their duties. The Business Associates will,
in turn, use and disclose your information as they conduct
business on behalf of CSHP. Examples of Business Associates
include, but are not limited to, a copy service used by CSHP to
copy medical records, consultants, accountants, lawyers, medical transcriptionists and billing companies. CSHP requires their
Business Associates to protect the confidentiality of your
personal and health information.
OTHER USES AND DISCLOSURES THAT
ARE REQUIRED OR PERMITTED WITHOUT AUTHORIZATION: Special
situations and certain state and federal laws may require CSHP to
use or release your information. For example, CSHP may be obligated
to release your information for the following reasons:
RESEARCH: Under certain
circumstances, CSHP may use and disclose your health information
for approved clinical research. For example, a research project
may involve comparing the health and recovery of patients who
received one medication for their medical condition to those who
received a different medication for that same condition.
REGULATORY AGENCIES: CSHP may
disclose your personal and/or health information to government and
certain private health oversight agencies, such as the Department
of Public Health and Environment, the Federal Department of Health
and Human Services, or the Board of Medical Examiners, for
activities authorized by law including, but not limited to,
licensure, certification, audits, investigations and inspections.
These activities are necessary to monitor compliance with the
requirements of government programs.
LAW ENFORCEMENT/LITIGATION: CSHP
may disclose your personal and/or health information for law
enforcement purposes as required by law or in response to a court
order.
PUBLIC HEALTH: As required by
law, CSHP may disclose your personal and/or health information to
public health or legal authorities charged with preventing or
controlling disease, injury or disability. For example, CSHP is
required to report the existence of several communicable diseases
including, but not limited to, acquired immune deficiency syndrome
("AIDS"), to the Department of Public Health and Environment to
protect the health and well-being of the general public.
WORKERS’ COMPENSATION: CSHP
may release personal and/or health information about you to
workers' compensation or similar programs. These programs provide
benefits for work related injuries or illnesses.
MILITARY/VETERANS:
CSHP may
disclose your personal and/or health information as required by
military command authorities, if you are a member of the armed
forces.
AS OTHERWISE REQUIRED BY LAW: CSHP
will disclose your personal and/or health information in any
situation where such disclosures are required by law (such as
child abuse, domestic abuse).
USES AND DISCLOSURES REQUIRING
YOUR AUTHORIZATION: Without your authorization, CSHP may not
disclose your personal or health information to persons outside of CSHP for purposes other than treatment, payment, healthcare
operations or special circumstances as listed above. In addition, CSHP may not use or disclose specially sensitive information, such
as AIDS/HIV, alcohol and drug abuse prevention and/or treatment, or
mental health information without your specific authorization unless
legally required to do so.
FAMILY/FRIENDS: With your
authorization, CSHP may disclose your personal and/or health
information to a friend or family member who is involved in your
medical care. CSHP may also provide information to someone who
helps pay for your care. CSHP may also tell your family or friends
of your condition and that you are in the hospital. In addition, CSHP may disclose information about you to an entity assisting in
a disaster relief effort so that your family can be notified about
your condition, status and location. CSHP also may disclose your
information to other people outside CSHP who may be involved in
your medical care after you leave CSHP, such as clergy and others
used to provide services that are part of your care.
YOUR RIGHTS RELATED TO YOUR
PERSONAL AND HEALTH INFORMATION: Although all records
concerning your treatment obtained at CSHP are the property of CSHP,
you have the following rights concerning your personal and health
information:
CONFIDENTIAL COMMUNICATIONS:
You have the right to request confidential communications of your
information by alternative means or at alternative locations. For
example, you may request that CSHP only contact you at work or by
mail.
YOUR RIGHTS RELATED TO YOUR
PERSONAL AND HEALTH INFORMATION, CONT:
REQUEST TO REVIEW AND COPY:
You have the right to request a review and/or a copy your health
information, except as restricted by your physician or by law.
This right does not obligate CSHP to grant you access to certain
types of information.
AMEND: You have the right to
request an amendment or correction to your health information. If CSHP agrees that an amendment or correction is appropriate, we
will ensure that the amendment or correction is attached to your
medical record.
AN ACCOUNTING: You have the
right to obtain a statement of the disclosures that have been made
of your personal and health information other than by your
authorization, other than disclosures made to you, and other than
for the purpose of treatment, payment or operational purposes.
REQUEST RESTRICTIONS: You have
the right to request restrictions on certain uses and disclosures
of your information. If CSHP is able to agree to your request, we
will abide by the restrictions.
RECEIVE A COPY OF THIS NOTICE:
If this Notice has been provided to you electronically, upon
request you have the right to receive a paper copy of this Notice.
REVOKE AUTHORIZATION: You have
the right to revoke your authorization to use or disclose your
information, except to the extent that action has already been
taken in reliance on your authorization.
FOR MORE INFORMATION REGARDING
HOW TO EXERCISE THESE RIGHTS: If you have questions or would
like more information regarding any of the rights listed above,
written correspondence should be mailed to the attention of the CSHP HIPAA Compliance Officer at any of the CSHP facilities. Information
concerning your rights under this Notice may also be obtained by
calling 475-7700 and speaking with the Patient Services Coordinator.
IF YOU BELIEVE THAT YOUR RIGHTS
HAVE BEEN VIOLATED: You may file a complaint with CSHP or
with the Secretary of the Department of Health and Human Services.
To gain information on to how file a complaint with CSHP, contact the Patient Services
Coordinator at 475-7700. All complaints must be submitted in writing
to the attention of the CSHP HIPAA Compliance
Officer, addressed to any of the CSHP facilities. You may be assured
there will be no retaliation for filing a complaint.
CHANGES TO THIS NOTICE: CSHP will abide by the terms of the Notice currently in effect. CSHP
reserves the right to change the terms of this Notice at any time.
Any new notice provisions will be effective for all protected health
information that it maintains. Any new revision to this Notice will
be posted at each CSHP facility.
NOTICE EFFECTIVE DATE:
The effective date of the Notice is April 14, 2003 |
