THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.
We are required by law to maintain the privacy of protected health information (PHI) and to provide individuals with this notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of the notice currently in effect. We reserve the right to make changes to this notice at any time. We reserve the right to make the revised notice effective for PHI we have about you as well as any PHI we receive in the future. In the event there is a material change to this Notice, the revised Notice will be posted. In addition, you may request a copy of the revised Notice at any time.
How we may use and disclose your protected health information:
We may use and disclose protected and identifiable health information about you for treatment. For example, we will use your medical history, to assess your health and perform requested services. For payment. For example, we may need to give a health plan information about your current medical condition so that it will pay us for the services that we have furnished you. For health care operations. For example, we sometimes arrange for accreditation organizations, auditors or other consultants to review our practice, evaluate our operations, and tell us how to improve our services. We may disclose PHI about you when we are required to do so by federal, state, or local law. We may disclose PHI about you in connection with certain public health reporting activities, for instance, we may disclose such information to a public health authority authorized to collect or receive PHI such as state health departments, and federal health agencies. We are also permitted to disclose PHI to a public health authority or other government authority authorized by law to receive reports of child abuse or neglect. We may disclose your PHI in situations of domestic abuse. We may disclose PHI in connection with certain health oversight activities of licensing and other agencies, such as audit, investigation, inspection, licensure or disciplinary actions, and civil, criminal, or administrative proceedings. We may disclose PHI in response to a warrant, subpoena, or other order of a court or administrative hearing body, and in connection with certain government investigations and law enforcement activities. We may release PHI to a coroner or medical examiner to identify a deceased person or determine the cause of death. We may release your PHI to workers’ compensation or similar programs. Information about you also will be disclosed when necessary to prevent a serious threat to your health and safety or the health and safety of others. If you are a member of the Armed Forces, we may release PHI about you as required by military command authorities. We also may release PHI about foreign military personnel to the appropriate foreign military authority. We may disclose your PHI to our business associates so that they can perform the tasks that we hire them to do. Our business associates must guarantee to us that they will respect the confidentiality of your PHI. We may contact you to remind you of an upcoming appointment or to ask for additional information related to your appointment. We are required to obtain written authorization from you for any other uses and disclosures of PHI other than those described above. If you provide us with such permission, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose protected information about you for the reasons covered by your written authorization. We will be unable to take back any disclosures already made based upon your original permission.
You have the right to ask for restrictions on the ways in which we use and disclose your medical information beyond those imposed by law. We will consider your request, but we are not required, to accept it. You have the right to request that you receive communications containing your PHI from us by alternative means or at alternative locations. For example, you may ask that we only contact you at home or by mail. We will accommodate reasonable requests. Except under certain circumstances, you have the right to inspect and copy medical and billing records about you. If you ask for copies of this information, we may charge you a cost-based fee for copying and mailing. We will base this fee on current Colorado Law. It is our policy to only accept written requests for access to medical and billing records. If you believe that information in your records is incorrect or incomplete, you have the right to ask us to correct the existing information or correct the missing information. Under certain circumstances, we may deny your request. It is our policy to require requests for correction or amendment to be submitted in writing. You have a right to ask for a list of instances when we have used or disclosed your PHI for reasons other than your treatment, payment for services furnished to you, our health care operations, or disclosures you give us authorization to make. If you ask for this information from us more than once every twelve months, we may charge you a fee. You have the right to a copy of this Notice in paper form. You may ask us for a copy at any time.
To exercise any of your rights, please contact us in writing at:
Colorado Imaging Associates
1819 Denver W Dr #101
Golden, CO 80401
If you believe your privacy rights have been violated, you may contact the Secretary of the Department of Health and Human Services. You will not be retaliated against for filing a complaint.