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The
Longmont Surgery Center (LSC) is committed to protecting
personal healthcare information in accordance with The Health
Insurance Portability and Accountability Act of 1996 (HIPAA).
This
privacy statement is an outline of LSC privacy practices pertaining to
healthcare information and shall remain publicly posted as required by law.
If you have any questions regarding this information please contact the
LSC Business Office Manager at 303-682-0375.
Understanding
Your Health Information
Each
time you have a procedure at the Longmont Surgery Center,
a medical record
of your care is made. Typically
this record contains your personal information, insurance information,
diagnosis and treatment.This
information serves as a:
-
Legal document describing the care you received at LSC,
- Means
by which you or a third-party payer can verify that services billed were
actually provided,
- A
tool with which we can assess and continually work to improve the care we
render and the outcomes we achieve,
- A
source for public health officials charged with improving the health of this
state and nation.
Understanding
what is in your record and how your health information is used helps you to:
ensure its accuracy, better understand who, what, where, and why others may
access your health information, and make more informed decisions when
authorizing disclosure to others.
How
LSC may use and disclose Healthcare Information.
1.
Treatment
LSC
may use and disclose your health information in order to provide quality
treatment and services to you. We
may disclose health information about you to doctors, nurses, technicians,
and/or other personnel directly involved in your care.
We may also provide your physician or subsequent healthcare provider
with copies of your medical records in order for your continued treatment once
you are discharged from the
Longmont
Surgery
Center
.
2.
Financial Information
LSC
may use and disclose health information pertaining to your care in order to
bill and collect payment from you, your insurance provider and/or a third party
payer. Such information may
include your identity, diagnosis, procedures performed and/or supplies used for
your care.
3.
Health Care Operations
Members
of the LSC medical staff, LSC Quality Improvement Committee, accreditation
committees and state licensure agencies may use health information in your LSC
medical record to assess the care and outcomes related to your care.
This information may be used to continually improve the quality of care
for all patients we serve. LSC
doctors, nurses, and other healthcare providers may use the information for
educational purposes. All personal
information that identifies you may be removed in order to protect your
privacy.
4.
Business Associates
LSC
may also use and disclose health information to business associates we have
contracted with to perform services related to your care, such as, laboratory
personnel, radiology personnel, medical equipment and supply companies and/or
medical billing and collection services.
To protect your healthcare information all business associates affiliated with
LSC are required to sign a ?Business Associate Agreement?.
5.
Individuals involved in your treatment or care
LSC
may use or disclose health information about you to a friend, family member,
caregiver, or language translator who may be directly involved in your medical
care or have financial responsibility for your care.
6.
Affiliated Healthcare Entities
Protected
healthcare information will be made available to hospital personnel as
necessary to carry out treatment, payment and other services related to your
care. For information on hospital
privacy policies, you will need to contact a hospital privacy officer.
7.
Other Entities
As
required by law, LSC may also use and disclose health information without your
written authorization for the following types of entities, including but not
limited to:
- Food and Drug Administration
- Public
Health or Legal Authorities charged with preventing or controlling disease,
injury or disability
- Correctional
Institutions
- Workers
Compensation Agencies
- Organ
and Tissue Donation Organizations
-
Military
Command Authorities
-
Military
Command Authorities
- Health
Oversight Agencies
- Funeral
Directors, Coroners and Medical Directors
- National
Security And Intelligence Agencies
-
Protective
Services
Law
Enforcement / Legal Proceedings:
We may disclose health information for law enforcement purposes as required by
law or in response to a valid subpoena.
8.
Research
LSC
may disclose your health information to an approved research organization if
you are a participant in a medical research program and have signed the
necessary informed consents with your doctor and the research organization.
9.
Other uses of Health Information
Other
uses and disclosures of health information not covered by this statement or the
laws that pertain to protected healthcare information shall be made only with
your written permission. If you
provide permission for LSC to use or disclose your health information, you may
revoke that permission in writing at any time.
If you revoke your permission, we will no longer use or disclose your
health information for the reasons covered by your original written
authorization. You understand that
we are unable to take back any disclosures already made with your permission,
and that we are required to retain our records of the care provided to you at
the Longmont Surgery Center.
10.
LSC Waiting Areas
LSC
waiting areas are shared with other patients and family members.
Your name will be called when it is time for your appointment or when
you will be able to visit your family member or friend.
If you object to having your name announced in the waiting area, please
notify the receptionist.
In
order to protect the privacy of all patients we try to limit one visitor at a
time for each patient. Exceptions
are made for children or patients with special needs.
Your
Health Information Rights
Although
your healthcare record is the physical property of the
Longmont
Surgery
Center
, you have the right
to:
1.
Inspect and Copy
You
have the right to inspect and obtain a copy of your personal health information
and medical records related to your care at LSC.
Your request to inspect and copy your medical records may be denied in
certain limited circumstances. If
you are denied access to your health information, you may request the denial be
reviewed by the LSC Facility Administrator or Medical Director.
2.
Amend your Medical Record
If
you feel that your health information is incorrect or incomplete, you may ask
to have the information amended. The
facility administrator or your healthcare provider may deny requests for
medical record amendments. The reason for denial will be discussed with you by
the LSC Facility Administrator or LSC Medical Director.
3.
An
Accounting of Disclosures
You
have the right to request an accounting of disclosures.
This is a list of the disclosures made by LSC of your health information
for purposes other than treatment, payment or health care operations where
authorization was not required.
4.
Request Restrictions
You
have the right to request restrictions or limitations on the health information
the LSC uses or discloses related to your care, payment or health care
operations. You also have the
right to restrict or limit health care information that we may disclose to
someone who is directly involved in your care or the payment for your care.
LSC will comply with any such agreement providing the agreement does not
adversely interfere with your medical care.
5.
Confidential Communications
LSC
personnel may leave general information regarding your care or appointment on a
telephone answering machine, at the number provided to LSC by you or your
doctor?s office, or with family members directly involved in your care.
You have the right to request that LSC personnel not leave such messages
on a machine or with a family member.
If a confidentiality request is made, it will be necessary to provide LSC
personnel with an alternative means of communication in order for LSC to
provide your care or obtain payment for your care.
LSC
has a shared waiting area for patients and family members.
You have the right to request that your name or the name of your family
members not be announced in the waiting area.
Such requests can be made with the LSC receptionist and will be
communicated to other LSC personnel.
6.
Copies of the LSC Privacy Statement
You
have the right to request a paper copy of this privacy statement from the LSC
business office.
*To
exercise any of your rights, please obtain the required forms from the LSC
Business Office Manager.
Changes
to the LSC Privacy Statement
LSC
reserves the right to revise or modify this privacy statement from time to
time. Any revisions or
modifications will be effective immediately upon posting.
The revisions or modifications will be effective for healthcare
information we currently have about you and also any information we receive in
the future. The current LSC
privacy statement will be posted in the LSC waiting area and include the
effective date. In addition, each
time you are admitted for care at LSC you will be offered a copy of the current
LSC privacy statement.
Complaints
or Grievances
If
you believe your privacy rights have been violated, you may file a complaint
with the LSC Business Office Manager or Facility Administrator.
Written complaints may also be submitted to the Colorado Department of
Health and Human Services. All
complaints must be submitted in writing.
Submitting a complaint or concern will not affect your care at LSC in any way.
Our
Pledge To You
The
Longmont
Surgery
Center
is committed to
protecting your privacy and your personal healthcare information because we
understand that your medical care and all information related to your care are
very personal.
Sincerely,
LSC
Management
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