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HIPAA Statement
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HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
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NOTICE OF PRIVACY PRACTICES
Effective Date April 14, 2003
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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. If you have any questions about this notice, please
contact Alpine Women's Healthcare, P.C. at 303-744-3477. This notice
describes the privacy practices at our office. |
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We are required by law to:
- Maintain the privacy of protected health information
- Give you this notice of our legal duties and privacy practices
regarding your health information
- Follow the terms of the notice currently in effect.
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How we may use and disclose your health information.
Described as follows are the ways we may use and disclose your health
information. Except for the following purposes we will use and disclose
your health information only with your written permission. You may
revoke such permission at any time by writing to Alpine Women's
Healthcare, P.C. |
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Treatment. We may use and disclose your health information for
your treatment and to provide you with treatment-related health care
services. For example, we may disclose your health information to
doctors, nurses, technicians, or other personnel, including people
outside our office, who are involved in your medical care and need the
information to provide you with medical care. |
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Payment. We may use and disclose your health information so that
others or we may bill and receive payment from you, an insurance
company, or a third party for the treatment and services you received.
For example, we may give information to your health plan so that they
will pay for your treatment. |
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Health Care Operations. We may use and disclose your health
information to evaluate and improve our medical care and to operate and
manage our office. For example, we may use and disclose information to a
peer review organization or a health plan that is evaluating our care.
We may also share information with others that have a relationship with
you for their health care operation activities. |
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Appointment Reminders, Treatment Alternatives, and Health-Related
Benefits and Services. We may use and disclose your health
information to contact you and remind you of your appointment, to tell
you about treatment alternatives or health-related benefits and services
you could use. Individuals Involved in Your Care or Payment for Your
Care. When appropriate, we may share your health information with a
person involved in, or paying for, your care (such as your family or a
close friend). We may notify your family about your location or
condition or disclose such information to an entity assisting in
disaster relief. |
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Research. We may use and disclose your health information for
research. For example, a research project may involve comparing the
health of patients who received one treatment to those who received
another for the same condition. Before we do so, the project needs to go
through a special approval process. Even without special approval, we
may permit researchers to look at records to help identify patients who
may be included in their research, as long as they do not remove or copy
any of your health information. |
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As Required by Law. We will disclose your health information when
required to do so by international, federal, state or local law. |
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To Avert a Serious Threat to Health or Safety. We may use and
disclose your health information when necessary to prevent a serious
threat to the health and safety of you, another person, or the public.
Disclosures will be made only to someone who can prevent the threat. |
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Business Associates. We may disclose your health information to
our business associates that perform functions on our behalf or provide
us with services if necessary. For example, we may use another company
to perform billing services on our behalf. All of our business
associates are obligated to protect the privacy of your information and
are not allowed to use or disclose the information for any other purpose
than appears in their contract with us. |
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Military and Veterans. If you are a member of the armed forces,
we may release your health information as required by military command
authorities. If you are a member of a foreign military we may release
your health information to the foreign military command authority.
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Worker’s Compensation. We may release your health information for
worker’s compensation or similar programs that provide benefits for
work-related injuries or illness. |
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Public Health Risks. We may disclose your health information for
public health activities to prevent or control disease, injury or
disability. We may use your health information in reporting births or
deaths, suspected child abuse or neglect, medication reactions or
product malfunctions or injuries, and product recall notifications. We
may use your health information to notify someone who may have been
exposed to a disease or may be at risk for contracting or spreading a
disease or condition. If we are concerned that a patient may have been a
victim of abuse, neglect, or domestic violence we may ask your
permission to make a disclosure to an appropriate government authority.
We will make that disclosure only when you agree or when required or
authorized to do so by law. |
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Health Oversight Activities. We may disclose your health
information to a health oversight agency for activities authorized by
law. These may include audits, investigations, inspections, and
licensure. These activities are necessary to for the government to
monitor the health care system, government programs, and compliance with
civil rights laws. |
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Lawsuits and Disputes. If you are involved in a lawsuit or
dispute, we may disclose your health information in response to a court
or administrative order. We may disclose your health information in
response to a subpoena, discovery request, or other lawful process by
someone else involved in the dispute, but only if efforts have been made
to tell you about the request or to obtain an order protecting the
information requested. |
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Law Enforcement. We may release your health information request
by law enforcement official if 1) there is a court order, subpoena,
warrant, summons or similar process; 2) if the request is limited to
information needed to identify or locate a suspect, fugitive, material
witness, or missing person; 3) the information is about the victim of a
crime even if, under certain very limited circumstances, we are unable
to obtain your agreement; 4) the information is about a death that may
be the result of criminal conduct; 5) the information is relevant to
criminal conduct on our premises; and 6) it is needed in an emergency to
report a crime, the location of a crime or victims, or the identity,
description, or location of the person who may have committed the crime. |
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Coroners, Medical Examiners, and Funeral Directors. We may
release your health information to a coroner, medical examiner, or
funeral director to identify a deceased person or cause of death, or
other similar circumstance. |
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National Security and Intelligence Activities. We may disclose
your health information to authorized federal officials for intelligence
and other national security activities authorized by law. |
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Inmates or Individuals in Custody. If you are an inmate of a
correctional institution or in custody we may disclose your information
1) for the institution to provide you with health care, 2) to protect
your health and safety or that of others, and 3) for the safety and
security of the institution. |
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YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION |
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Right to Inspect and Copy. You have the right to inspect and copy
your medical and billing records by written request to Alpine Women's
Healthcare, P.C. |
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Right to Amend. You have the right to request an amendment to
your records by written request to Alpine Women's Healthcare, P.C. |
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Right to an Accounting Of Disclosures. You have a right to an
accounting of certain disclosures by written request to Alpine Women's
Healthcare, P.C. |
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Right to Request Restrictions. You have the right to request
restriction or limitation on your health information used for treatment,
payment or health care operations. You may request us to limit
disclosure to someone involved in your care or in payment for your care
(such as a spouse) by written request to Alpine Women's Healthcare, P.C.
We are not required to agree with your request, but we will try to
comply. |
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Right to Request Confidential Communication. You have the right
to request that we communicate with you about medical matters in a
certain way or at a certain location. You can ask, for example, that we
contact you only by mail or at work. Your written request must specify
how or where you wish to be contacted and be addressed to Alpine Women's
Healthcare, P.C. We will accommodate reasonable requests. |
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CHANGES TO THIS NOTICE |
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We may change this notice and make it effective for medical information
we already have about you as well as new information. The current notice
will be posted and available at all times. You have a right to request a
paper copy of the current notice at any visit or by written request to
Alpine Women's Healthcare, P.C. |
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Alpine Women's Healthcare, P.C.
499 East Hampden
Suite 350
Englewood, Colorado 80113
(303) 744-3477 |
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