Gunnison Valley Health is committed to keeping your health information
secure. The HIPAA Privacy Rule provides federal protections for individually
identifiable health information held by covered entities and their business
associates and gives patients an array of rights with respect to that
information. At the same time, the Privacy Rule is balanced so that it
permits the disclosure of health information needed for patient care and
other important purposes. The Security Rule specifies a series of administrative,
physical, and technical safeguards for covered entities and their business
associates to use to assure the confidentiality, integrity, and availability
of electronic protected health information.
NOTICE OF PRIVACY PRACTICES
Patients and visitors will find this notice posted at the entrances to
Gunnison Valley Hospital and Gunnison Valley Health Family Medicine Clinic.
This notice describes how medical information about you may be used and
disclosed and how you can gain access to this information.
Patients will receive a full disclosure of privacy practices and a listing
of your rights as a patient during the registration process.
The Gunnison Valley Health Notice of Privacy Practices is displayed in
its entirety below.
HEALTH INFORMATION MANAGEMENT DEPARTMENT
Health Information Management is open Monday – Friday from 7:00 a.m.
– 5:00 p.m. Release of Information staff will process requests for
medical records in a manner that ensures your health information is protected.
PRIVACY OFFICER
Please contact the Privacy Officer should you have questions, concerns,
or a complaint about Gunnison Valley Health’s privacy practices.
Privacy Officer Phone: 970-641-7265
Fax: 970-641-7273
Grievance and compliance hotline number: 855-763-4531 or 970-642-4772
Notice of Privacy Practices
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.
We are legally required to Safeguard Your Protected Health Information (PHI). PHI is any clinical or demographic health information that can be linked
to a patient.
The law requires us to:
Maintain the privacy of your health information
Provide you with this Notice, and to
Comply with this Notice
How Gunnison Valley Health Will Use and Disclose Your PHI:
Treatment
Physicians, nurses, and other health care personnel for the provision,
coordination, and management of your healthcare.
Consultations between providers and referrals by one provider to another.
Your name, location in our facility and general condition will be included in the
patient directory. Your religious affiliation may be released to clergy.
Contact you as a reminder that you have an appointment for treatment at
our facility.
Inform a family member or friend if the provider’s professional judgment
deems it is in your best interest or there is an imminent threat to you
or another person.
Tell you about treatment options or alternatives, or health-related benefits
or services.
Payment
We may use your personal health information as it relates to payment for
your healthcare treatment, such as sharing your information with our business
office, our clearinghouse, any contracted workforce member, and the insurance
carrier responsible for payment of your bill.
At times it may be necessary to send copies of your medical records to
your insurance carrier. You may opt to restrict disclosure of your PHI
to health plans if you pay out of pocket for services.
Operations
Quality assessment and improvement activities, including case management
and care coordination.
Competency assurance activities, including provider or health plan performance
evaluation, credentialing, and accreditation.
Business planning, development, management, and administration.
Reports About Victims of Abuse, Neglect or Domestic Violence: Reported if we are required or authorized by law.
Coroners, Medical Examiners and Funeral Directors: Released to assist these individuals
Drug and alcohol abuse patient treatment information, HIV test results,
mental health information, and genetic testing results release may be stricter. A
minor patient’s PHI may be released to a parent/guardian, but parent’s access may be
denied in some situations.
Organ Procurement Organizations: Released for organ donation and transplantation.
Public Health Activities: Report the occurrence of certain diseases, or adverse reactions to a drug
or medical device.
Health Oversight Agencies: Released as requested to government agencies that have authority to audit
or investigate our operations.
Avert a Serious Threat to Health or Safety. Released to help prevent a serious threat to health and safety, individual
or public, or disaster relief notification activities.
Lawsuits, Disputes, Law Enforcement: Released if asked to do so by a law enforcement official:
In response to a court order, subpoena, warrant, summons or similar process;
To identify or find a suspect, fugitive, material witness, missing person;
or crime victim
About a death believed to be due to criminal conduct;
About criminal conduct at our hospital; and
In an emergency to report a crime
For Specialized Government Functions. Released to authorized federal officials for intelligence, national security
activities, and providing services to protected individuals.
Workers’ Compensation or Similar Programs. Released to programs to obtain benefits for work-related injuries or illness.
Medical Research. To researchers with previously authorized permission.
Immunization Records. To schools with written or oral consent.
Marketing. We must obtain your permission to communicate any marketing material that
encourages use of a product or service for which we receive payment from
a third party.
Sale of PHI. Sale of PHI is prohibited without the patient’s permission.
You have the following rights:
The right to request a restriction on certain uses and releases.
You may opt to restrict disclosure of your PHI to health plans if you pay
out of pocket for services.
You may direct how you wish to be contacted, such as through a particular
phone number or address, and whether messages may be left.
You may opt out of fundraising communications.
The right to receive confidential communications of your PHI.
We will send your PHI to a specific address and in a specific manner as
you direct.
The right to request that your information be shared with friends and family.
The right to inspect and copy all PHI in our possession, including materials
from other providers.
If you ask us to copy your PHI, we may charge you $14 for 10 pages or less,
$.50 for each page between 11 and 40, and $.33 for each page thereafter.
The right to request an electronic copy of your medical record.
We may provide you with a summary or explanation of your PHI if you agree.
The right to amend your PHI
If you believe the PHI we have about you is incomplete or incorrect, you
may ask us to amend it.
You will be notified about the results of the request.
The right to receive an accounting of uses/disclosures of your PHI.
The list will not include releases made for treatment, payment and operations purposes.
The first list requested within a 12-month period will be free. There is
a charge for providing any additional lists within the 12-month period.
The right to obtain a paper of the Notice upon request.
The Notice is also available in our Out-Patient Registration Department
and our Emergency Department.
All uses and disclosures other than those required by law are released
only on your authorization.
You may revoke, in writing, any authorization for use and disclosure of
your PHI at any time.
If you revoke your authorization, your PHI will not be released after adoption
of your request.
**Requests will be processed within 30-60 days.** **You must make any request in writing, addressed to our Privacy Officer. **
We reserve the right to change our privacy practices in the future. Notices
are available upon registration for Gunnison Valley Health services, the
Outpatient Registration Department, the Emergency Department, or you may
contact the Privacy Officer.
Complaints:
if you believe your privacy rights have been violated, you may file a
complaint with us or with the Secretary of the Federal Department of Health
and Human Services.
We will not retaliate against you for filing a complaint.
You may also contact our
Privacy Officer if you have questions or comments about our privacy practices.
Privacy Officer Phone: 970-641-7265
Fax: 970-641-7273
Grievance and compliance hotline number: 855-763-4531 or 970-642-4772
To file a complaint or ask questions in writing:
Privacy Officer Gunnison Valley Health 711 N Taylor St Gunnison, CO 81230
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