Notice of Privacy Practices (Effective Date: April 14, 2003, Updated July 25, 2013)
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
This notice describes the privacy practices of Rocky Mountain Infectious Diseases and applies to all of your medical records that identify you and the care you receive at Rocky Mountain Infectious Diseases. Described is information on how we may use and disclose your protected health information and describes your rights as a patient.
Our Legal Responsibility
Rocky Mountain Infectious Diseases is required to protect the privacy of your health information. This information is called “protected health information” (PHI). PHI includes information that can be used to identify you that we have created or received about your past, present, or future health or condition, the provision of health care to you, or the payment of this health care. We have an obligation to provide you with this notice about our privacy practices that explains how, when, and why we use and disclose your PHI. We are legally required to follow the privacy practices that are described in this notice. We do reserve the right to revise this document at any time. If you have any question about this Notice please contact our Privacy Officer at 307-234-8700.
Used and Disclosures of PHI
Rocky Mountain Infectious Diseases uses and discloses PHI in the ways listed below:
- Treatment. Payment and Healthcare Operations We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. Your protected health information will be used and disclosed, as needed, to obtain payment for your health care services provided by us or by another provider. We may use or disclose, as needed, your protected health information in order to support the business activities of Rocky Mountain Infectious Diseases
- Notification and communication with family or patient representative. We may disclose your health information to notify or assist in notifying a family member, your personal representative, or another person responsible for your care about your location, your general condition or in the event of your death. If possible, we will give you the opportunity to agree or object prior to making this notification.
- As Required by Law. We may use or disclose your protected health information to the extent that the use or disclosure is required by law. This includes releasing information to law enforcement for purposes such as identifying or locating a suspect, fugitive, or witness, or complying with a court order or subpoena.
- Public Health. We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information.
- Health Oversight Activities. We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure, and other proceedings.
- Judicial, Law, and Administrative Proceedings. We may disclose your health information in the course of any administrative, law, or judicial proceedings.
- Deceased Person Information. We may disclose your health information to coroners, medical examiners, funeral directors, or others previously involved in your care unless you previously request a restriction.
- Research. We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
- Organ Donation. We may disclose your health information to organizations involved in procuring, banking, or transplanting organs and tissues.
- Public Safety. We may disclose your health information if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
- Military & National Security. If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also disclose your PHI for reasons of national security.
- Worker’s Compensation. We may use or disclose your protected health information as authorized to comply with workers’ compensation laws and other similar legally-established programs.
- Appointment Reminders and Health Benefits or Services. We may use PHI to provide appointment reminders or give you information about treatment alternatives, or other health care services or benefits we offer.
- Inmates. We may use or disclose your protected health information if you are an inmate of a correctional facility and your physician created or received your protected health information in the course of providing care to you.
- School Immunizations. We may release immunization records to schools without written permission.
- State Electronic Health Information Exchange. Rocky Mountain Infectious Diseases participates in the state electronic health information exchange. We may make your protected health information available electronically to other health care providers, health plans, and public health authorities who request your information for the purpose of treatment, payment, operations, or public health activities. You may opt out of this exchange by contracting the privacy officer in writing.
Uses and Disclosures of Protected Health Information Based upon Your Written Authorization
Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as otherwise described in this notice. If you choose to sign an authorization to disclose your PHI, you can later revoke that authorization in writing to stop any future uses and disclosures.
Your Rights Regarding Medical Information
You have the right to inspect and copy your protected health information. This means you may inspect and obtain a copy of protected health information about you for so long as we maintain the protected health information. You may obtain your medical record that contains medical and billing records and any other records that your physician and the practice uses for making decisions about you. As permitted by federal or state law, we may charge you a reasonable copy fee for a copy of your records. You have the right to request psychotherapy notes; however, HIPAA does not provide you a right to those and the release of such is made on a case-by-case basis.
To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to: Release of Information, Rocky Mountain Infectious Diseases, 1450 E. A. St. Casper, WY 82601.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by the hospital will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
Right to Privacy Breach Notification. You have a right to receive notifications whenever a breach of unsecured protected health information occurs.
Right to Amend. If you believe that the medical information we have about you is incorrect or incomplete, you may request an amendment to your medical record. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. To request an amendment to submit a request in writing to: Privacy Officer, Rocky Mountain Infectious Diseases 1450 E. A. St. Casper WY 82601.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. To request confidential communications, you must make your request in writing to the Privacy Officer.
Right to Request Restrictions. You have the right to request us not to use or disclose any part of your protected health information for the purposes of treatment, payment or health care operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
Your physician is not required to agree to a restriction that you may request. If your physician does agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. Rocky Mountain Infectious Diseases will always agree to a request to restrict a release of information to an insurance provider if you pay the bill at the time of service. You may request a restriction by contract the Privacy Officer at Rocky Mountain Infectious Diseases.
Sale and Marketing of Protected Health Information. Rocky Mountain Infectious Diseases will not use or disclose any protected health information for marketing purposes or sale your protected health information without your prior authorization.
Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you. This applies to disclosures for purposes other than treatment, payment, or healthcare operations. This also excludes disclosures we may have made to you if you authorized us to make the disclosure to family members or third parties.
Right to a Paper Copy of this Notice. You have the right to obtain a paper copy of this notice from us, even you agreed to receive this notice electronically.
How to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint in writing with the clinic or with the Office of Civil Rights. To file a complaint with the clinic, write to:
The Privacy Officer
Rocky Mountain Infectious Diseases
1450 E. A. St.
Casper, WY 82601
Office for Civil Rights, DHHS
1961 Stout Street – Room 1426
Denver, CO 80294
(303) 844-2024; (303) 844-3439 (TDD)
(303) 844-2025 FAX
You Will Not Be Penalized for Filing a Complaint
Rocky Mountain Infectious Diseases values your privacy and makes the protection of your health information a high priority. You will not be penalized for filing a complaint. If you feel that you have received undue treatment for filing a complaint, please use the above contract information to report the incident.