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II. It is Pueblo Pioneer Psychology duty to safeguard your protected health information (PHI).

By law Pueblo Pioneer Psychology (from now on referred as PPP) is required to insure that your PHI is kept private. The PHI constitutes information created or noted by us that can be used to identify you. It contains data about your past, present, or future health or condition, the provision of health care services to you, or the payment for such health care. PPP is required to provide you with this Notice about our privacy procedures. This Notice must explain when, why, and how PPP would use and/or disclose your PHI. Use of PHI means when PPP shares, applies, utilizes, examines, or analyzes information within its practice; PHI is disclosed when PPP releases, transfers, gives, or otherwise reveals it to a third party outside our practice. With some exceptions, PPP may not use or disclose more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made; however, PPP is always legally required to follow the privacy practices described in this Notice. Please note that PPP reserves the right to change the terms of this Notice and our privacy policies at any time as permitted by law. Any changes will apply to PHI already on file with us. Before PPP makes any important changes to our policies, PPP will immediately change this Notice and post a new copy of it in our office and on our website. You may also request a copy of this Notice from me, or you can view a copy of it in our office or on our website, which is located at



PPP will use and disclose your PHI for many different reasons. Some of the uses or disclosures will require your prior written authorization; others, however, will not. Below you will find the different categories of our uses and disclosures, with some examples.


A. Uses and Disclosures Related to Treatment, Payment, or Health Care Operations

Do Not Require Your Prior Written Consent. PPP may use and disclose your PHI without your consent for the following reasons: 1. For treatment. PPP can use your PHI within its practice to provide you with mental health treatment, including discussing or sharing your PHI with our trainees and interns. We may disclose your PHI to physicians, psychiatrists, psychologists, and other licensed health care providers who provide you with health care services or are otherwise involved in your care. Example: If a psychiatrist is treating you, PPP may disclose your PHI to her/him in order to coordinate your care. 2. For health care operations. PPP may disclose your PHI to facilitate the efficient and correct operation of our practice. Examples: Quality control - PPP might use your PHI in the evaluation of the quality of health care services that you have received or to evaluate the performance of the health care professionals who provided you with these services. PPP may also provide your PHI to our attorneys, accountants, consultants, and others to make sure that PPP is in compliance with applicable laws. 3. To obtain payment for treatment. PPP may use and disclose your PHI to bill and collect payment for the treatment and services PPP provided you. Example: PPP might send your PHI to your insurance company or health plan in order to get payment for the health care services that PPP have provided to you. PPP could also provide your PHI to business associates, such as billing companies, claims processing companies, and others that process health care claims for our office. 4. Other disclosures. Examples: Your consent isn't required if you need emergency treatment provided that PPP attempts to get your consent after treatment is rendered. In the event that PPP tries to get your consent but you are unable to communicate with us (for example, if you are unconscious or in severe pain) but PPP thinks that you would consent to such treatment if you could, PPP may disclose your PHI.


B. Certain Other Uses and Disclosures Do Not Require Your Consent. PPP may use and/or disclose your PHI without your consent or authorization for the following reasons: When disclosure is required by federal, state, or local law; judicial, board, or administrative proceedings; or, law enforcement. Example: PPP may make a disclosure to the appropriate officials when a law requires us to report information to government agencies, law enforcement personnel and/or in an administrative proceeding.

  1. If disclosure is compelled by a party to a proceeding before a court of an administrative agency pursuant to its lawful authority.

  2. If disclosure is required by a search warrant lawfully issued to a governmental law enforcement agency.

  3. To avoid harm. PPP may provide PHI to law enforcement personnel or persons able to prevent or mitigate a serious threat to the health or safety of a person or the public.

  4. If disclosure is compelled or permitted by the fact that you are in such mental or emotional condition as to be dangerous to yourself or the person or property of others, and if PPP determines that disclosure is necessary to prevent the threatened danger.

  5. If disclosure is compelled or permitted by the fact that you tell us of a serious/imminent threat of physical violence by you against a reasonably identifiable victim or victims.

  6. For public health activities.

  7. For health oversight activities.

  8. For specific government functions..

  9. For research purposes.

  10. For Workers' Compensation purposes.

  11. Appointment reminders and health related benefits or services.

  12. If an arbitrator or arbitration panel compels disclosure, when arbitration is lawfully requested by either party, pursuant to subpoena duces tectum.

  13. If disclosure is required or permitted to a health oversight agency for oversight activities authorized by law.

  14. If disclosure is otherwise specifically required by law.


C. Certain Uses and Disclosures Require You to Have the Opportunity to Object.

Disclosures to family, friends, or others. PPP may provide your PHI to a family member, friend, or other individual who you indicate is involved in your care or responsible for the payment for your health care, unless you object in whole or in part. Retroactive consent may be obtained in emergency situations.


D. Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in Sections IIIA, IIIB, and IIIC above, PPP will request your written authorization before using or disclosing any of your PHI. Even if you have signed an authorization to disclose your PHI, you may later revoke that authorization, in writing, to stop any future uses and disclosures (assuming that PPP haven't taken any action subsequent to the original authorization) of your PHI by us.



These are your rights with respect to your PHI:

A. The Right to See and Get Copies of Your PHI. In general, you have the right to see your PHI that is in our possession, or to get copies of it; however, you must request it in writing. If PPP does not have your PHI, but PPP know who does, PPP will advise you how you can get it. You will receive a response from us within 30 days of our receiving your written request. Under certain circumstances, PPP may feel PPP must deny your request, but if PPP does, We will give you, in writing, the reasons for the denial. PPP will also explain your right to have our denial reviewed. If you ask for copies of your PHI, PPP will charge you not more than $.25 per page. PPP may see fit to provide you with a summary or explanation of the PHI, but only if you agree to it, as well as to the cost, in advance.


B. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask that PPP limit how PPP use and disclose your PHI. While PPP will consider your request, PPP is not legally bound to agree. If PPP does agree to your request, PPP will put those limits in writing and abide by them except in emergency situations. You do not have the right to limit the uses and disclosures that PPP is legally required or permitted to make.


C. The Right to Choose How PPP Send Your PHI to You. It is your right to ask that your PHI be sent to you at an alternate address (for example, sending information to your work address rather than your home address) or by an alternate method (for example, via e-mail instead of by regular mail). PPP is obliged to agree to your request providing that PPP can give you the PHI, in the format you requested, without undue inconvenience. PPP may not require an explanation from you as to the basis of your request as a condition of providing communications on a confidential basis.


D. The Right to Get a List of the Disclosures PPP Have Made. You are entitled to a list of disclosures of your PHI that PPP has made. The list will not include uses or disclosures to which you have already consented, i.e., those for treatment, payment, or health care operations, sent directly to you, or to your family; neither will the list include disclosures made for national security purposes, to corrections or law enforcement personnel, or disclosures made before April 15, 2003. After April 15, 2003, disclosure records will be held for six years. We will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list PPP gives you will include disclosures made in the previous six years unless you indicate a shorter period. The list will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. PPP will provide the list to you at no cost, unless you make more than one request in the same year, in which case PPP will charge you a reasonable sum based on a set fee for each additional request.


E. The Right to Amend Your PHI. If you believe that there is some error in your PHI or that important information has been omitted, it is your right to request that PPP corrects the existing information or add the missing information. Your request and the reason for the request must be made in writing. You will receive a response within 60 days of our receipt of your request. PPP may deny your request, in writing, if PPP finds that: the PHI is (a) correct and complete, (b) forbidden to be disclosed, (c) not part of our records, or (d) written by someone other than us. our denial must be in writing and must state the reasons for the denial. It must also explain your right to file a written statement objecting to the denial. If you do not file a written objection, you still have the right to ask that your request and our denial be attached to any future disclosures of your PHI. If PPP approves your request, PPP will make the change(s) to your PHI. Additionally, PPP will tell you that the changes have been made, and PPP will advise all others who need to know about the change(s) to your PHI.


F. The Right to Get This Notice by E-mail. You have the right to get this notice by email. You have the right to request a paper copy of it, as well.



If, in your opinion, PPP may have violated your privacy rights, or if you object to a decision PPP made about access to your PHI, you are entitled to file a complaint with the person listed in Section VI below. You may also send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Avenue S.W. Washington, D.C. 20201. If you file a complaint about our privacy practices, PPP will take no retaliatory action against you.




If you have any questions about this notice or any complaints about our privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact us at: PPP, 720 N Main, Suite 300, Pueblo, CO, 81008. tel: 719-870-0514, e-mail:



In the case of a breach, PPP requires to notify each affected individual whose unsecured PHI has been compromised. Even if such a breach was caused by a business associate, PPP is ultimately responsible for providing the notification directly or via the business associate. If the breach involves more than 500 persons, The Office of Civil Rights (OCR) must be notified in accordance with instructions posted on its website. PPP bears the ultimate burden of proof to demonstrate that all notifications were given or that the impermissible use or disclosure of PHI did not constitute a breach and must maintain supporting documentation, including documentation pertaining to the risk assessment.



Generally, PHI excludes any health information of a person who has been deceased for more than 50 years after the date of death. PPP may disclose deceased individuals' PHI to non-family members, as well as family members, who were involved in the care or payment for healthcare of the decedent prior to death; however, the disclosure must be limited to PHI relevant to such care or payment and cannot be inconsistent with any prior expressed preference of the deceased individual.



To implement the 2013 HITECH Act, the Privacy Rule is amended. PPP is required to restrict the disclosure of PHI about you, the patient, to a health plan, upon request, if the disclosure is for the purpose of carrying out payment or healthcare operations and is not otherwise required by law. The PHI must pertain solely to a healthcare item or service for which you have paid the covered entity in full. (OCR clarifies that the adopted provisions do not require that covered healthcare providers create separate medical records or otherwise segregate PHI subject to a restrict healthcare item or service; rather, providers need to employ a method to flag or note restrictions of PHI to ensure that such PHI is not inadvertently sent or made accessible to a health plan.) The 2013 Amendments also adopt the proposal in the interim rule requiring PPP, to provide you, the patient, a copy of PHI if you, the patient, requests it in electronic form. The electronic format must be provided to you if it is readily producible. OCR clarifies that PPP must provide you only with an electronic copy of their PHI, not direct access to their electronic health record systems. The 2013 Amendments also give you the right to direct PPP to transmit an electronic copy of PHI to an entity or person designated by you. Furthermore, the amendments restrict the fees that PPP may charge you for handling and reproduction of PHI, which must be reasonable, cost-based and identify separately the labor for copying PHI (if any). Finally, the 2013 Amendments modify the timeliness requirement for right of access, from up to 90 days currently permitted to 30 days, with a one-time extension of 30 additional days.

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