Boulder Endocrinology Associates

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for PDF version of policy. NOTICE OF PRIVACY POLICIES AND PRACTICES FOR BOULDER ENDOCRINOLOGY, PLLC DEAR PATIENT: THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. INTRODUCTION At Boulder Endocrinology, PLLC we are committed to treating and using protected health information about you responsibly. This Notice describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information. This Notice is effective January 5, 2009 and applies to all protected health information as defined by federal regulations. UNDERSTANDING YOUR MEDICAL RECORD / HEALTH INFORMATION Each time you visit Boulder Endocrinology, PLLC a record of your visit is made. Typically, this record contains information about your visit including your examination, diagnosis, test results, treatment as well as other pertinent healthcare data. This information, often referred to as your health or medical record, serves as a:  Basis for planning your care and treatment Means of communication with other health professionals involved in your care  Legal document outlining and describing the care you received  A tool that you, or another payer (your insurance company) will use to verify that services billed were actually provided  An education tool for medical health providers  A source for medical research  Basis for public health officials who might use this information to assess and/or improve state as well as national healthcare standards  A source of data for planning and / or marketing  A tool that we can reference to ensure the highest quality of care and patient satisfaction Understanding what is in your record and how your health information is used helps you to ensure its accuracy, determine what entities have access to you health information, and make an informed decision when authorizing the disclosure of this information to other individuals. YOUR RIGHTS You have certain rights under the federal privacy standards. These include:  The right to request restrictions on the use and disclosure of your protected health information  The right to receive confidential communications concerning your medical condition and treatment  The right to inspect and copy your protected health information  The right to amend or submit corrections to your protected health information  The right to receive an accounting of how and to whom your protected health information has been disclosed  The right to receive a printed copy of this notice OUR RESPONSIBILITIES Boulder Endocrinology, PLLC is required to:  Maintain the privacy of your health information  Provide you with this Notice as to our legal duties and privacy practices with respect to information we collect and maintain about you  Abide by the terms of this notice  Notify you if we are unable to agree to a requested restriction  Accommodate reasonable requests you may have regarding communication of health information via alternative means and/ locations As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Whatever the reason for these revisions, we will provide you with a revised notice on your next office visit. The revised policies and practices will be applied to all protected health information that we maintain. We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue to use or disclose your health information after we have received a written revocation of the authorization according procedures included in the authorization. HOW WE MAY USE AND/OR DISCLOSE YOUR HEALTH INFORMATION We will use your health information for treatment. Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example: results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members. We will use your information for payment. Your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated in order to pay for the service rendered to you. We will use your information for regular health operations. Your health information may be used as necessary to support the day-to-day activities and management of Boulder Endocrinology, PLLC. For example: information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality. Business Associates. In some instances, we have contracted separate entities to provide services for us. These

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