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Notice of Privacy Practices for the Protected Health Information
Effective: September 23, 2013
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Colorado Comprehensive Spine Institute, LLC (CCSI) understands how important your personal medical information is to you. We know that you are concerned with how that information might be used, the way in which it is disclosed and how you can access the information. That is why we have put this document in your hands. It is why the “Privacy Practices” outlined here is so important and why we want to pledge our commitment, at the onset, to respect your personal medical information.
CCSI is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment and health care operations. Protected health information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination, test results, diagnoses, treatment, and applying for future care or treatment. It also includes billing documents for these services.
In summary, the law requires us to:
The US Department of Health and Human Services sponsored the Health Insurance Portability and Accountability Act (HIPAA). HIPAA dictates the medical information privacy practices that health care organizations and their partners are obligated to follow. CCSI provides health care to our patients in partnership with many physicians, other medical professionals and organizations.
This notice outlines CCSI practices and that of:
CCSI is responsible for ensure that these individuals and organizations understand the importance of medical information and are trained following HIPAA guidelines to ensure that your information is used only as it is intended.
How your personal medical information can be used and disclosed
The following is a list of ways in which your personal medical information can be used and disclosed as allowed by HIPAA provisions. Be assured that we will use your information in the most discreet manner.
Subject to certain requirements, we may give out your personal medical information to other organizations without prior authorization:
We are also required to disclose medical information when required by law in response to:
We are required to obtain authorization from you before using or disclosing your medical information for the purpose of the following activities:
Communication with family, friends and others will only be provided through written authorization from our patients. Upon initial treatment and annually thereafter, we will request your permission to speak with your family, friends and others. If you have provided permission to our office to communicate this information and wish to rescind this information; you will need to complete an updated acknowledgement with our office. This authorization will allow us to speak with individuals who are involved with your care, someone who helps pay for services or advocates on your behalf.
In any other situation not covered by this notice, we will ask for your written authorization before disclosing your medical information. If you choose to authorize use or disclosure, you can later revoke that authorization by notifying us in writing.
You have a right to receive a paper copy of this notice. You may view or print a copy of the notice at our website www.coloradospineinstitute.com. Our staff can also provide an email version to you as well for convenience.
We may change our policies at any time. Changes will apply to medical information we already hold, as well as new information after the change occurs. When we make a significant change to our policies, we will change this notice and post the current notice in our facility on our website. This notice will contain the effective date. In addition, you will be offered a copy of the current notice each time you register for a new visit.
If you are concerned that your privacy rights may have been violated or disagree with a decision we made about access to your records, you may contact our company privacy officer at 303-762-0808.
Colorado State Agency:
Colorado Department of Public Health and Environment; 4300 Cherry Creek Drive South; Denver, CO 80222; ph.: 303-692-2800
Office of Medicare Beneficiary Ombudsman, Medicare Website or call 1-800-MEDICARE (1-800-633-4227)