Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
Uses and Disclosures
Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.
Your health information may be used as necessary to support the day-to-day activities and management of High Altitude Mobile Physicians. For example, information on the services you received may be used to support activities to evaluate and promote quality care.
Your health information may be disclosed to law enforcement agencies, without your permission, to support government audits and inspections, to facilitate law enforcement investigations, and to comply with government mandated reporting.
Public Health Reporting
Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.
Other use and disclosures require your authorization
Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision.
Additional Uses of Information
Medical management updates. Your health information will be used by our staff to periodically contact you evaluate your medical condition and confirm improvement. We may also contact you to coordinate pick up or drop off of medical equipment. Lab results, x-ray, test results, and other pertinent information, including medical instruction and advice are left on voice mail, through text message, or with a responsible adult at the number you have indicated to us.
You have certain rights under the federal privacy standards. These include:
• the right to request restrictions on the use and disclosure of your protected health information
• the right to receive confidential communications concerning your medical condition and treatment
• the right to inspect and copy your protected health information
• the right to amend or submit corrections to your protected health information
• the right to receive an accounting of how and to whom your protected health information has been disclosed
• the right to receive a printed copy of this notice
We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices. We are also required to abide by the privacy policies and practices that are outlined in this notice.
Right to Revise Privacy Practices
As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Whatever reason for these revisions, we will provide you with a revised notice on your next office visit. The revised policies and practices will be applied to all protected health information that we maintain.
Requests to Inspect Protected Health Information.
As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting our office.
If you would like to submit a comment or complaint about our privacy practices, you may do so be sending a letter outlining your concerns to:
High Altitude Mobile Medical Office of Civil Rights
PO Box 3488 OR 1961 Stout Street, Room 1185
Breckenridge, CO, 80424 Denver, CO 80294-3538
If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concerns to the same address. You will not be penalized or otherwise retaliated against for filing a complaint.
The name and address of the person you can contact for further information concerning our privacy practices is:
High Altitude Mobile Medical
Attn: Office Manager
PO Box 3488
Breckenridge, CO, 80424
PHONE (970) 389-7999
This notice is effective on 10/2018.