Notice of Privacy Practices
Western Slope Endocrinology, LLC is required by law to maintain the privacy of your health information (HI) and to provide you with notice of its legal duties and privacy practices with respect to your health information. If you have questions about any part of this notice or if you want more information about the privacy practices at Western Slope Endocrinology please let us know.
Effective Date of This Notice: September 8, 2009
I. How Western Slope Endocrinology, LLC (WSE) may Use or Disclose your HI.
WSE collects HI from you and stores it in a chart and on a computer. This is your medical record. The medical record is the property of WSE but the information in the medical record belongs to you. WSE protects the privacy of your health information. The law permits WSE to use or disclose your health information for the following purposes:
1) Treatment. HI will be disclosed to appropriate staff and fellow medical providers in order to offer comprehensive medical care and provide for your continuity of care. For example, we may share medical information with other physicians who are treating you, or with a pharmacist who is filling a prescription on your behalf.
2) Payment. We will disclose HI to health plans or other parties who provide you with health insurance and services coverage to secure payment. We may also disclose information to other health care providers who have treated you to assist in obtaining payment.
3) Regular Health Care Operations. We may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications of our professional staff. Or we may use and disclose this information as necessary for medical reviews, legal services and audits, including fraud and abuse detection and compliance programs and business planning and management. We may share information with a local regional health information organization for purposes of continuity of care and reviewing quality of care. We may also share your medical information with our “business associates” that perform administrative services for us. We have written contract with each of these business associates that contains terms requiring them to protect the confidentiality of your medical information.
4) Appointment Reminders. We may use of disclose medical information to contact and remind you about appointments. If you are not home, we may leave this information on your answering machine or in a message left with the person answering the phone.
5) Sign in Sheet. We may use or disclose medical information about you by having you sign in when you arrive at our office. The sign in sheet will contain only minimal information. We may also call out your name when we are ready to see you.
6) Notification and Communication with Family. We may disclose your HI 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, assistance in your health care, or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
7) Required by Law. As required by law, we may use or disclose your HI, but we will limit our use or disclosure to the relevant requirements of the law. When the law requires us to report abuse, neglect or domestic violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we will further comply with the requirement set forth below concerning those activities.
8) Public Health. As required by law, we may disclose your HI to public health authorities for purposes related to: preventing or controlling disease, injury or disability: reporting child abuse or neglect: reporting domestic violence: reporting to the Food and Drug Administration problems with products and reactions to medications: and reporting disease or infection exposure.
9) Health Oversight Activities. We may disclose your HI to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.
10) Judicial and Administrative Proceedings. We may disclose your HI in the course of any administrative or judicial proceeding. We may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order.
11) Law enforcement. We may disclose your HI to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.
12) Deceased Person Information. We may disclose your HI to coroners, medical examiners and funeral directors, or valid personal representatives or those with legal authority.
13) Research. We may disclose your HI to researchers conducting research that has been approved by an Institutional Review Board or valid privacy board.
14) Public Safety. We may disclose your HI to appropriate persons in order to prevent or lessen a serious or imminent threat to the health or safety of a particular person or the general public.
15) Specialized Government Functions. We may disclose you HI for military, national security, prisoner and government benefits purposes.
16) Worker’s Compensation. We may disclose your HI as necessary to comply with worker’s compensation laws.
17) Health Plan. We may disclose your HI to the sponsor of your health plan or your health plan as required by our participating agreement.
18) Marketing. When we see you, we may give you information about other treatments or health-related benefits and services that may be of interest to you or we may provide small promotional gifts. If we receive any remuneration from any party we will disclose this. We will not otherwise use or disclose your HI for marketing purposes without your written authorization which may be revoked at any time.
II. When WSE May Not Use or Disclose Your HI.
Except as described in this notice WSE will not use or disclose your HI without your written authorization. If you do authorize WSE to use or disclose your HI for another purpose, you may revoke your authorization in writing at any time.
III. Your HI Rights
1. You have the right to request restrictions on certain uses and disclosures of your HI. WSE in not required to agree to the restrictions that you request.
2. You have the right to request that you receive your HI in a specific way or at a specific location. We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.
3. You have the right to inspect and copy your HI with limited exceptions. WSE may charge you a reasonable cost based fee for copies.
4. You have a right to request that WSE amend your HI that is incorrect or incomplete. WSE is not required to change your HI and will provide you with the information about any denial and how you can disagree with the denial.
5. You have a right to receive an accounting of the of the disclosures of your HI made by WSE except WSE does not have to account for the disclosures made in parts 1(treatment), 2(payment), 3(health care operations), 4(information provided to you) or where you have in writing authorized a disclosure, and 16(certain government functions) of section I of this Notice of Privacy Practices, or the disclosures to a health oversight agency or law enforcement official to the extent that this practice has received notice from that agency or official that providing this accounting would be reasonably likely to impede their activities.
6. You have a right to a paper copy of this Notice of Privacy Practices; even if you have previously received this notice electronically.
IV. Changes to This Notice of Privacy Practices
WSE reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment. Until such amendment is made, WSE is required by law to comply with this Notice. All revisions will be posted in the office locations.
V. Complaints
Complaints about this Notice of Privacy Practices or how WSE handles your HI should be directed to Dr Greenlee at 970-241-8630. You will not be penalized or retaliated against for making a complaint.
If you are not satisfied with the manner in which this complaint is handled, you may submit a formal complaint to: Department of Health and Human Services
Office of Civil Rights
Hubert H. Humphrey Bldg
200 Independence Avenue, SW
Room 509F HHH Building
Washington, DC 20201
You may also address your complaint to one of the regional Offices of Civil rights. A list of these offices can be found online at http://www.hs.gov/ocr/regmail.html.
www.WesternSlopeEndocrinology.com
Effective Date of This Notice: September 8, 2009
I. How Western Slope Endocrinology, LLC (WSE) may Use or Disclose your HI.
WSE collects HI from you and stores it in a chart and on a computer. This is your medical record. The medical record is the property of WSE but the information in the medical record belongs to you. WSE protects the privacy of your health information. The law permits WSE to use or disclose your health information for the following purposes:
1) Treatment. HI will be disclosed to appropriate staff and fellow medical providers in order to offer comprehensive medical care and provide for your continuity of care. For example, we may share medical information with other physicians who are treating you, or with a pharmacist who is filling a prescription on your behalf.
2) Payment. We will disclose HI to health plans or other parties who provide you with health insurance and services coverage to secure payment. We may also disclose information to other health care providers who have treated you to assist in obtaining payment.
3) Regular Health Care Operations. We may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications of our professional staff. Or we may use and disclose this information as necessary for medical reviews, legal services and audits, including fraud and abuse detection and compliance programs and business planning and management. We may share information with a local regional health information organization for purposes of continuity of care and reviewing quality of care. We may also share your medical information with our “business associates” that perform administrative services for us. We have written contract with each of these business associates that contains terms requiring them to protect the confidentiality of your medical information.
4) Appointment Reminders. We may use of disclose medical information to contact and remind you about appointments. If you are not home, we may leave this information on your answering machine or in a message left with the person answering the phone.
5) Sign in Sheet. We may use or disclose medical information about you by having you sign in when you arrive at our office. The sign in sheet will contain only minimal information. We may also call out your name when we are ready to see you.
6) Notification and Communication with Family. We may disclose your HI 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, assistance in your health care, or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
7) Required by Law. As required by law, we may use or disclose your HI, but we will limit our use or disclosure to the relevant requirements of the law. When the law requires us to report abuse, neglect or domestic violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we will further comply with the requirement set forth below concerning those activities.
8) Public Health. As required by law, we may disclose your HI to public health authorities for purposes related to: preventing or controlling disease, injury or disability: reporting child abuse or neglect: reporting domestic violence: reporting to the Food and Drug Administration problems with products and reactions to medications: and reporting disease or infection exposure.
9) Health Oversight Activities. We may disclose your HI to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.
10) Judicial and Administrative Proceedings. We may disclose your HI in the course of any administrative or judicial proceeding. We may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order.
11) Law enforcement. We may disclose your HI to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.
12) Deceased Person Information. We may disclose your HI to coroners, medical examiners and funeral directors, or valid personal representatives or those with legal authority.
13) Research. We may disclose your HI to researchers conducting research that has been approved by an Institutional Review Board or valid privacy board.
14) Public Safety. We may disclose your HI to appropriate persons in order to prevent or lessen a serious or imminent threat to the health or safety of a particular person or the general public.
15) Specialized Government Functions. We may disclose you HI for military, national security, prisoner and government benefits purposes.
16) Worker’s Compensation. We may disclose your HI as necessary to comply with worker’s compensation laws.
17) Health Plan. We may disclose your HI to the sponsor of your health plan or your health plan as required by our participating agreement.
18) Marketing. When we see you, we may give you information about other treatments or health-related benefits and services that may be of interest to you or we may provide small promotional gifts. If we receive any remuneration from any party we will disclose this. We will not otherwise use or disclose your HI for marketing purposes without your written authorization which may be revoked at any time.
II. When WSE May Not Use or Disclose Your HI.
Except as described in this notice WSE will not use or disclose your HI without your written authorization. If you do authorize WSE to use or disclose your HI for another purpose, you may revoke your authorization in writing at any time.
III. Your HI Rights
1. You have the right to request restrictions on certain uses and disclosures of your HI. WSE in not required to agree to the restrictions that you request.
2. You have the right to request that you receive your HI in a specific way or at a specific location. We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.
3. You have the right to inspect and copy your HI with limited exceptions. WSE may charge you a reasonable cost based fee for copies.
4. You have a right to request that WSE amend your HI that is incorrect or incomplete. WSE is not required to change your HI and will provide you with the information about any denial and how you can disagree with the denial.
5. You have a right to receive an accounting of the of the disclosures of your HI made by WSE except WSE does not have to account for the disclosures made in parts 1(treatment), 2(payment), 3(health care operations), 4(information provided to you) or where you have in writing authorized a disclosure, and 16(certain government functions) of section I of this Notice of Privacy Practices, or the disclosures to a health oversight agency or law enforcement official to the extent that this practice has received notice from that agency or official that providing this accounting would be reasonably likely to impede their activities.
6. You have a right to a paper copy of this Notice of Privacy Practices; even if you have previously received this notice electronically.
IV. Changes to This Notice of Privacy Practices
WSE reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment. Until such amendment is made, WSE is required by law to comply with this Notice. All revisions will be posted in the office locations.
V. Complaints
Complaints about this Notice of Privacy Practices or how WSE handles your HI should be directed to Dr Greenlee at 970-241-8630. You will not be penalized or retaliated against for making a complaint.
If you are not satisfied with the manner in which this complaint is handled, you may submit a formal complaint to: Department of Health and Human Services
Office of Civil Rights
Hubert H. Humphrey Bldg
200 Independence Avenue, SW
Room 509F HHH Building
Washington, DC 20201
You may also address your complaint to one of the regional Offices of Civil rights. A list of these offices can be found online at http://www.hs.gov/ocr/regmail.html.
www.WesternSlopeEndocrinology.com