Notice of Privacy Practices
This notice describes how health information about your child (as a patient of this practice) or you (as a patient of this practice) may be used and disclosed and how you have access to this information. Please review this notice carefully.
Our Commitment to Privacy
Advanced Pediatric Associates is dedicated to maintaining the privacy of its patients' protected health information (PHI). We are required by law to maintain the confidentiality of this health information. We are also required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning PHI. We reserve the right to amend, change or eliminate provisions in our privacy practices and to enact new provisions regarding the PHI we maintain. If our privacy practices change, we will amend our Notice. By federal and state law we must follow the terms of the Notice of Privacy Practices that we have in effect at the time. Our privacy practices also meet the requirements of Colorado state law regarding the release of information for specifically protected health information such as HIV, psychotherapy and substance abuse.
This Notice of Privacy Practice informs you of the following important information:
- How we may use and disclose PHI
- Your privacy rights about PHI
- Our obligations concerning use and disclosure of PHI
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Use and Disclosure of PHI
Our practice may use and disclose PHI for the purposes of treatment, payment and business operations. The following information describes the different ways in which we may use and disclose PHI for these purposes.
Our practice will use PHI for treatment purposes. For example, one of our clinical staff may record health information about your child or you in your medical record. We may request that laboratory tests be done (such as blood or urine tests) and we may use the results to help us reach a diagnosis and treatment plan. We might use PHI in order to write a prescription, disclose PHI when calling a pharmacy to order a prescription, or when calling a home health agency to order medical equipment. Many of the people who work in our practice - including, but not limited to, our health care providers - may use or disclose PHI in order to treat your child or to assist others in the treatment of your child. Additionally, we may disclose PHI to others who may assist in your child's care. Finally, we may also disclose PHI to other health care providers outside of our office for purposes related to medical care and treatment.
Our practice may use and disclose PHI in order to bill and collect payment for the services you receive from us. For example, we may contact your health insurer to certify that you or your child are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding the medical care we have provided to determine if your insurer will cover, or pay for the care received. We also may use and disclose PHI to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use PHI to bill you directly for services and items. We may also disclose PHI to other health care providers and entities to assist in their billing and collection or business associates who assist us in collection efforts.
Health Care Operations
Our practice may use and disclose PHI to operate our business. For example, we may share PHI with an insurance company for quality review or credentialing purposes. We may use a sign-in sheet at our reception desk where you will be asked to sign your name and time of arrival. We may also call you by name in the reception area when your health care professional is ready to see you. We may use PHI when contacting you to remind you of an appointment or to send you a practice newsletter. Also, we share PHI in the form of immunization data with the state immunization registry and with schools.
Release or Sharing of Information
Our practice may release PHI to others that may be involved in the care of your child. For example, a parent or guardian may ask that a grandparent take their child to our office for treatment of a cold. In this example, the grandparent may have access to the child's medical information.
We will share PHI only with the following people unless we specifically have written authorization from you that allows us to share PHI with others. People with whom we will share PHI include: Parents, Legal Guardians, Step-Parents, Grandparents, and Day Care Providers. We will not share PHI with neighbors, other relatives, or employers unless specifically authorized by you or in the event of an emergency. We will attempt to verify the identity of all persons calling our practice requesting PHI of a patient.
The Rights of Minors and Personal Representatives
The State of Colorado identifies a minor as anyone under the age of 18, except in certain circumstances such as an emancipated minor or a minor who is married. For patients under the age of 18, a parent or legal guardian is normally recognized as the minor's personal representative with the right to use and control the minor's PHI. In some instances, however, the minor is the personal representative of PHI and we may not share that PHI with parents or guardians unless authorized by the minor. Colorado state law gives minors the right to give consent for treatment for drug or alcohol abuse without the parent's consent and requires that the minor consent to any notification to the parent. In these instances the minor has control over the use and disclosure of the PHI. We may also choose not to recognize a parent as the personal representative of the child if a court determines or authorizes someone other than the parent to make treatment decisions for a minor. Patients 18 years of age or older will be considered personal representatives with the right to use and control their PHI.
Release of Information to Business Associates
Our practice may use and disclose PHI with third party business associates that provide various services for us. Examples of these services include an answering or after-hours service or a medical records storage firm. Whenever an arrangement between our office and a business associate involves the use or disclosure of PHI, we will have a written contract that contains terms that will protect the privacy of PHI.
Release of Information Required by Law
Our practice may use and disclose PHI when we are required to do so by federal, state or local law. For example, we may disclose PHI to public health authorities that are authorized by law to collect information for the purpose of reporting child abuse or neglect, preventing or controlling disease or injury, or reporting re-actions to drugs or immunizations. We may disclose PHI if required to do so in response to a court or administrative order, or discovery request, subpoena, or other lawful process. We may release PHI if asked to do so by law enforcement officials.
Our practice may use and disclose PHI for research purposes when the research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of PHI.
Our practice will obtain an authorization prior to any use of PHI for marketing purposes.
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Your Health Information Rights
You have the following rights regarding the PHI that we maintain about your child or you.
You have the right to request that our practice communicate with you about your child's health and related issues in a particular manner or at a certain location. For example, you may request that we contact you at home, rather than at work. In order to request a type of confidential communication, you must make a written request. We will supply you with a form for this request or you may make the request in writing. The request will be forwarded to the APA Administrator for a determination. Our practice will accommodate reasonable requests.
Requesting Restrictions on PHI
You have the right to request a restriction in our use or disclosure of PHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of PHI to only certain individuals involved in your child's medical care or for payment of medical care, such as family members or friends. In order to request any restrictions on the use or disclosure of PHI, you must make a written request. We will supply you with a form for this request or you may make the request in writing. The request will be forwarded to the APA Administrator for a determination. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to provide medical care and treatment.
Inspection and Copies of PHI
You have the right to inspect and obtain a copy of PHI that may be used to make decisions about you or your child's medical care, including medical records and billing records, but not including psychotherapy notes. In order to inspect and obtain a copy of PHI you must complete a written request. We will supply you with a form for this request. There is no charge to inspect PHI; however, the practice requires that we be given 48 hours notice and that a staff member of the practice must supervise any such inspection. In the event that you wish to obtain copies of PHI, the practice will charge its standard rate for the copying of medical records. The charges for copying medical records are listed on the request form.
Amendment of PHI
You may ask us to amend health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our practice. In order to request an amendment of PHI, you must make a written request. The request will be forwarded to the APA Administrator and will be reviewed by a health care provider. You must provide a reason that supports your request for an amendment.
We may deny your request if you ask us to amend information that is in our opinion (1) accurate and complete, (2) not part of PHI kept by or for the practice, (3) not part of PHI which you would be permitted to inspect or copy, or (4) not created by our practice. If your request is denied, you will be informed of the reason for the denial and will have an opportunity to submit a statement of disagreement to be maintained with your records.
Accounting of Disclosures
You may request an "accounting of disclosures." An accounting of disclosures is a list of certain non-routine disclosures our practice has made of PHI for non-treatment, non-payment, or non-operations purposes. In order to request an accounting of disclosures you must make a written request. We will supply you with a form for the request or you may make the request in writing. All requests for an accounting of disclosures must state a time period, which may not be any longer than six years from the date of disclosure and may not include dates prior to April 14, 2003. The first list you request within a 12-month period is provided at nor charge, but we may chare you for additional lists within the same 12-month period. Our practice will notify you of the costs involved with additional requests and you may withdraw your request before you incur any costs.
Right to a Paper Copy of This Notice
You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time.
Right to File a Complaint
You are entitled to file a complaint if you believe your privacy rights have been violated. To file a complaint with our practice, please submit the complaint in writing to the APA Administrator. You may also file a complaint by mailing it to the Secretary of Health and Human Services/Office for Civil Rights, US Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201.
Right to Provide an Authorization for Other Uses and Disclosures
Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use or disclosure of PHI may be revoked at any time in writing. After you revoke the authorization, we will no longer use or disclose PHI for the reasons described in the authorization.
If you have any questions regarding this notice or our health information privacy policies, please contact Denise Hall, Administrator/Advanced Pediatric Associates, 5657 South Himalaya, #100, Centennial, CO 80015, phone 720-886-9410.
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