Privacy Policy
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To our patients:
This notice describes how information about you (as a patient of this
practice) may be used and disclosed and how you can get access to this
information. [This is required by the Privacy Regulations created as a
result of the Health Insurance Portability and Accountability Act of 1996
(HIPPA). ] Please review it carefully.
Web Site
The privacy of our customers has always been of utmost importance to
Cottonwood Medical Center, Ltd. Cottonwood Medical Center, Ltd. has a
long history of protecting your privacy and our concern for your privacy is
no different in the electronic age.
Our Internet privacy policy is:
You do not have to give us personal information to visit our site. We will
collect personally identifiable information (name, email address, Social
Security number, or other unique identifier) only if specifically and
knowingly provided by you. Personally identifying information you provide
will be used only in connection with Cottonwood Medical Center, Ltd.
programs and services or for such other purposes as are described at the
point of collection. Information is collected for statistical purposes and
Cottonwood Medical Center sometimes performs analyses of user behavior
in order to measure customer interest in the various areas of our site. We do
not give, sell or transfer any personal information to a third party. We may
enable "cookies." A "cookie" is a file placed on your personal computer's
hard drive by a Web site that allows it to monitor your use of the site.
Health Insurance Portability and Accountability Act of 1996 Statement
Introduction
At Cottonwood Medical Center, Ltd. we are committed to treating and
using your protected health information responsibly. This Notice of Health
Information Practices 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 April 2003, and applies to all protected health information as
defined by federal regulations. Understanding Your Health
Record/Information. Each time you are seen by Cottonwood Medical
Center, Ltd., a record of your visit is made. Typically, this record contains
your symptoms, examination and test results, diagnosis, treatment, and a
plan for future care and treatment. This information, often referred to as
your health or medical record, serves as a: Basis for planning your care and
treatment, Means of communication among the many health professionals
who contribute to your care, Legal documents describing the care you
received, Means by which you or a third-party payer can verify that services
billed were actually provided. A tool in educating health professionals, A
source of data for medical research, A source of information for public
health officials charged with improving the health of this state of this
nation, A source of data for our planning and marketing, A tool with which
we can assess and continually work to improve the care we render and the
outcomes we achieve. Understanding what is in your record and how your
health information is used helps you to: ensure its accuracy, better
understand who , what, when, where, and why others may access your
health information, and make more informed decisions when authorizing
disclosure to other.
Your Health Information Rights
Although your health record is the physical property of Cottonwood Medical
Center, Ltd. the information belongs to you. You have the right to:
Communications. You can request that our practice communicate with
you about your health and related issues in a particular manner or at a
certain location. For instance, you may ask that we contact you at home
rather than work. We will accommodate reasonable requests. You can
request a restriction in our use or disclosure of your health information for
treatment, payment, or health care operations. Additionally, you have the
right to request that we restrict our disclosure of your health information to
only certain individuals involved in your care or the payment for your care,
such as a family member or friend. 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 treat you. You have the right to inspect and obtain a copy of
the health information that may be used to make decisions about you,
including patient medical records and billing records, but not including
psychotherapy notes. You must submit your request in writing to (Attn:
Privacy Officer, Brandy Reagan. Cottonwood Medical Center, Ltd. , 560
N Camino Mercado, Ste 7, Casa Grande, AZ 85122). You may ask us to
amend your health information if you believe it is incorrect or incomplete,
and as long as the information is kept by or for our practice. To request an
amendment, your request must be made in writing and submitted to (Attn:
Privacy Officer, Brandy Reagan at Cottonwood Medical Center Ltd. , 560
N Camino Mercado, Ste 7, Casa Grande, AZ 85122). You must provide us
with a reason that supports your request for amendment. Right to a copy
of this notice. You are entitled to receive a copy of this Notice of Privacy
Practices. You may ask us to give you a copy of this notice. Contact our
front desk receptionist. Right to file a complaint. If you believe your
privacy rights have been violated, you may file a complaint with our
practice or with the Secretary of Department of Health and Human
Services. To file a complaint with our practice, contact our Privacy
Officer, Brandy Reagan at Cottonwood Medical Center Ltd. , 560 N
Camino Mercado, Ste 7, Casa Grande, AZ 85122). All complaints must be
submitted in writing. You will not be penalized for filing a complaint.
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.
OUR RESPONSIBILITIES
Cottonwood Medical Center, Ltd. is required to Maintain the privacy of
your health information, Provide you with this notice as to our legal duties
andprivacy 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 requestedrestriction, and Accommodate reasonable requests
you may have to communicate health information by alternative means or
at alternative locations. We reserve the right to change our practices and
to make the new provisions effective for all protected health information we
maintain. Should our information practices change, we will mail a revised
notice to the address you've supplied us. 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
to the procedures included in the authorization. For More Information or to
Report a ProblemIf you have questions or would like additional information,
you may contact the Practice's Privacy Officer, Brandy Reagan at
520-836-5538. If you believe your privacy rights have been violated, you
can file a complaint with the practice's Privacy Officer, or with the Office
for Civil Rights, U. S. Department of Health and Human Services. There
will be no retaliation for filing a complaint with either the Privacy Officer or
the Office for Civil Rights. The address for the OCR is listed below:
Office for Civil Rights
U. S. Department of Health and Human Services
200 Independence Avenue, S. W. Room 509F, HHH Building
Washington, D. C. 20201
Examples of Disclosures for Treatment, Payment and Health OperationsWe
will use your information for treatment. For example: Information obtained
by a nurse, physician, or other member of your health care team will be
recorded in your record and used to determine the course of treatment that
should work best for you. Your physician will document in your record his
or her expectations of the members of your health care team. Members of
your health care team will then record the actions they took and their
observations. In that way, the physician will know how you are responding
to treatment. We will provide a subsequent health care provider with copies
of various reports that should assist him or her in treating you. We will use
your health information for payment. For example: A bill may be sent to
you or a third-party payer. The information on or accompanying the bill
may include information that identifies you, as well as your diagnosis,
procedures, and supplies used. We will use your health information for
regular health operations. For example: Members of the medical staff, the
risk or quality improvement manager, or members of the quality
improvement team may use information in your health record to assess the
care and outcomes in your case and others like it. This information will
then be used in an effort to continually improve the quality and
effectiveness of the health care and service we provide. Business
associates: There are some services provided in our organization through
contacts with business associates. Examples include physician services in
the emergency department and radiology, certain laboratory tests, and a
copy service we use when making copies of your health record. When
these services are contracted, we may disclose your health information to
our business associate so that they can perform the job we've asked them to
do and bill you or your third-party payer for services rendered. To protect
your health information, however, we require the business associate to
appropriately safeguard your information. Notification: We may use or
disclose information to notify or assist in notifying a family member,
personal representative, or another person responsible for your care, your
location, and general condition. Communication with family: Health
professionals, using their best judgment, may disclose to a family member,
other relative, close personal friend or any other person you identify, health
information relevant to that person's involvement in your care or payment
related to your care. Research: We may disclose information to researchers
when their research has been approved by an institutional review board that
has reviewed the research proposal and established protocols to ensure the
privacy of your health information. Funeral Directors: We may disclose
health information to funeral directors consistent with applicable law to
carry out their duties. Organ Procurement Organizations: Consistent with
applicable law, we may disclose health information to organ procurement
organizations or other entities engaged in the procurement, banking, or
transplantation of organs for the purpose of tissue donation and transplant.
Marketing: We may contact you to provide appointment reminders or
information about treatment alternatives or other health-related benefits
and services that may be of interest to you. Food and Drug Administration
(FDA): We may disclose to the FDA health information relative to adverse
events with respect to food, supplements, product and product defects, or
post marketing surveillance information to enable product recalls, repairs,
or replacement. Workers Compensation: We may disclose your health
information to public health or legal authorities charged with preventing or
controlling disease, injury, or disability. Law Enforcement: We may
disclose health information for law enforcement purposes as required by law
or in response to a valid subpoena. Federal law makes provisions for your
health information to be released to an appropriate health oversight
agency, public health authority or attorney, provided that a work force
member or business associate believes in good faith that we have engaged
in unlawful conduct or have otherwise violated professional or clinical
standards and are potentially endangering one or more patients, workers or
the public.
Copyright 2003-2012
Cottonwood Medical Center, Ltd.
www.cottonwoodmedical.com/privacy.html
This notice describes how information about you (as a patient of this
practice) may be used and disclosed and how you can get access to this
information. [This is required by the Privacy Regulations created as a
result of the Health Insurance Portability and Accountability Act of 1996
(HIPPA). ] Please review it carefully.
Web Site
The privacy of our customers has always been of utmost importance to
Cottonwood Medical Center, Ltd. Cottonwood Medical Center, Ltd. has a
long history of protecting your privacy and our concern for your privacy is
no different in the electronic age.
Our Internet privacy policy is:
You do not have to give us personal information to visit our site. We will
collect personally identifiable information (name, email address, Social
Security number, or other unique identifier) only if specifically and
knowingly provided by you. Personally identifying information you provide
will be used only in connection with Cottonwood Medical Center, Ltd.
programs and services or for such other purposes as are described at the
point of collection. Information is collected for statistical purposes and
Cottonwood Medical Center sometimes performs analyses of user behavior
in order to measure customer interest in the various areas of our site. We do
not give, sell or transfer any personal information to a third party. We may
enable "cookies." A "cookie" is a file placed on your personal computer's
hard drive by a Web site that allows it to monitor your use of the site.
Health Insurance Portability and Accountability Act of 1996 Statement
Introduction
At Cottonwood Medical Center, Ltd. we are committed to treating and
using your protected health information responsibly. This Notice of Health
Information Practices 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 April 2003, and applies to all protected health information as
defined by federal regulations. Understanding Your Health
Record/Information. Each time you are seen by Cottonwood Medical
Center, Ltd., a record of your visit is made. Typically, this record contains
your symptoms, examination and test results, diagnosis, treatment, and a
plan for future care and treatment. This information, often referred to as
your health or medical record, serves as a: Basis for planning your care and
treatment, Means of communication among the many health professionals
who contribute to your care, Legal documents describing the care you
received, Means by which you or a third-party payer can verify that services
billed were actually provided. A tool in educating health professionals, A
source of data for medical research, A source of information for public
health officials charged with improving the health of this state of this
nation, A source of data for our planning and marketing, A tool with which
we can assess and continually work to improve the care we render and the
outcomes we achieve. Understanding what is in your record and how your
health information is used helps you to: ensure its accuracy, better
understand who , what, when, where, and why others may access your
health information, and make more informed decisions when authorizing
disclosure to other.
Your Health Information Rights
Although your health record is the physical property of Cottonwood Medical
Center, Ltd. the information belongs to you. You have the right to:
Communications. You can request that our practice communicate with
you about your health and related issues in a particular manner or at a
certain location. For instance, you may ask that we contact you at home
rather than work. We will accommodate reasonable requests. You can
request a restriction in our use or disclosure of your health information for
treatment, payment, or health care operations. Additionally, you have the
right to request that we restrict our disclosure of your health information to
only certain individuals involved in your care or the payment for your care,
such as a family member or friend. 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 treat you. You have the right to inspect and obtain a copy of
the health information that may be used to make decisions about you,
including patient medical records and billing records, but not including
psychotherapy notes. You must submit your request in writing to (Attn:
Privacy Officer, Brandy Reagan. Cottonwood Medical Center, Ltd. , 560
N Camino Mercado, Ste 7, Casa Grande, AZ 85122). You may ask us to
amend your health information if you believe it is incorrect or incomplete,
and as long as the information is kept by or for our practice. To request an
amendment, your request must be made in writing and submitted to (Attn:
Privacy Officer, Brandy Reagan at Cottonwood Medical Center Ltd. , 560
N Camino Mercado, Ste 7, Casa Grande, AZ 85122). You must provide us
with a reason that supports your request for amendment. Right to a copy
of this notice. You are entitled to receive a copy of this Notice of Privacy
Practices. You may ask us to give you a copy of this notice. Contact our
front desk receptionist. Right to file a complaint. If you believe your
privacy rights have been violated, you may file a complaint with our
practice or with the Secretary of Department of Health and Human
Services. To file a complaint with our practice, contact our Privacy
Officer, Brandy Reagan at Cottonwood Medical Center Ltd. , 560 N
Camino Mercado, Ste 7, Casa Grande, AZ 85122). All complaints must be
submitted in writing. You will not be penalized for filing a complaint.
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.
OUR RESPONSIBILITIES
Cottonwood Medical Center, Ltd. is required to Maintain the privacy of
your health information, Provide you with this notice as to our legal duties
andprivacy 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 requestedrestriction, and Accommodate reasonable requests
you may have to communicate health information by alternative means or
at alternative locations. We reserve the right to change our practices and
to make the new provisions effective for all protected health information we
maintain. Should our information practices change, we will mail a revised
notice to the address you've supplied us. 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
to the procedures included in the authorization. For More Information or to
Report a ProblemIf you have questions or would like additional information,
you may contact the Practice's Privacy Officer, Brandy Reagan at
520-836-5538. If you believe your privacy rights have been violated, you
can file a complaint with the practice's Privacy Officer, or with the Office
for Civil Rights, U. S. Department of Health and Human Services. There
will be no retaliation for filing a complaint with either the Privacy Officer or
the Office for Civil Rights. The address for the OCR is listed below:
Office for Civil Rights
U. S. Department of Health and Human Services
200 Independence Avenue, S. W. Room 509F, HHH Building
Washington, D. C. 20201
Examples of Disclosures for Treatment, Payment and Health OperationsWe
will use your information for treatment. For example: Information obtained
by a nurse, physician, or other member of your health care team will be
recorded in your record and used to determine the course of treatment that
should work best for you. Your physician will document in your record his
or her expectations of the members of your health care team. Members of
your health care team will then record the actions they took and their
observations. In that way, the physician will know how you are responding
to treatment. We will provide a subsequent health care provider with copies
of various reports that should assist him or her in treating you. We will use
your health information for payment. For example: A bill may be sent to
you or a third-party payer. The information on or accompanying the bill
may include information that identifies you, as well as your diagnosis,
procedures, and supplies used. We will use your health information for
regular health operations. For example: Members of the medical staff, the
risk or quality improvement manager, or members of the quality
improvement team may use information in your health record to assess the
care and outcomes in your case and others like it. This information will
then be used in an effort to continually improve the quality and
effectiveness of the health care and service we provide. Business
associates: There are some services provided in our organization through
contacts with business associates. Examples include physician services in
the emergency department and radiology, certain laboratory tests, and a
copy service we use when making copies of your health record. When
these services are contracted, we may disclose your health information to
our business associate so that they can perform the job we've asked them to
do and bill you or your third-party payer for services rendered. To protect
your health information, however, we require the business associate to
appropriately safeguard your information. Notification: We may use or
disclose information to notify or assist in notifying a family member,
personal representative, or another person responsible for your care, your
location, and general condition. Communication with family: Health
professionals, using their best judgment, may disclose to a family member,
other relative, close personal friend or any other person you identify, health
information relevant to that person's involvement in your care or payment
related to your care. Research: We may disclose information to researchers
when their research has been approved by an institutional review board that
has reviewed the research proposal and established protocols to ensure the
privacy of your health information. Funeral Directors: We may disclose
health information to funeral directors consistent with applicable law to
carry out their duties. Organ Procurement Organizations: Consistent with
applicable law, we may disclose health information to organ procurement
organizations or other entities engaged in the procurement, banking, or
transplantation of organs for the purpose of tissue donation and transplant.
Marketing: We may contact you to provide appointment reminders or
information about treatment alternatives or other health-related benefits
and services that may be of interest to you. Food and Drug Administration
(FDA): We may disclose to the FDA health information relative to adverse
events with respect to food, supplements, product and product defects, or
post marketing surveillance information to enable product recalls, repairs,
or replacement. Workers Compensation: We may disclose your health
information to public health or legal authorities charged with preventing or
controlling disease, injury, or disability. Law Enforcement: We may
disclose health information for law enforcement purposes as required by law
or in response to a valid subpoena. Federal law makes provisions for your
health information to be released to an appropriate health oversight
agency, public health authority or attorney, provided that a work force
member or business associate believes in good faith that we have engaged
in unlawful conduct or have otherwise violated professional or clinical
standards and are potentially endangering one or more patients, workers or
the public.
Copyright 2003-2012
Cottonwood Medical Center, Ltd.
www.cottonwoodmedical.com/privacy.html
| Cottonwood Medical Center, LTD. 560 N Camino Mercado, Suite 7 Casa Grande, Arizona 85122 Tel: (520) 836-5538 Fax: (520) 876-0878 Toll Free: (800) 895-5538 www.cottonwoodmedical.com |