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.
1. About This Notice
Elevated Medicine provides medical services in Durango, Colorado, including platelet- rich plasma (PRP), orthobiologic treatments, ketamine infusions, and mental health care.
This notice explains how we handle your protected health information, which includes information that identifies you and relates to your health, healthcare, or payment for healthcare. It applies to information we maintain in electronic, paper, oral, and other forms and to the members of our practice’s workforce who handle that information.
This notice addresses your medical information and is separate from our website Privacy Policy.
2. Our Responsibilities
We are required by law to protect the privacy of your protected health information, give you notice of our legal duties and privacy practices, and follow the notice currently in effect.We maintain administrative, physical, and technical safeguards appropriate to the information we handle. We limit access to health information according to personnel responsibilities and apply the minimum-necessary requirements when required by law.
If a breach of your unsecured protected health information occurs that requires notification, we will notify you without unreasonable delay and within applicable legal deadlines.
3. How We Use and Share Your Health Information
The following sections describe circumstances in which we may use or disclose your health information. These descriptions do not mean that we routinely make every disclosure listed. Additional protections for certain records, described in Section 5, apply throughout this notice. Treatment We use your health information to evaluate your health, recommend treatment, provide care, and monitor your response. For example, our clinician and nursing staff may review your medical history medications, and previous treatment responses when planning or monitoring a ketamine infusion or PRP treatment.When legally permitted, we may share relevant information with other professionals involved in your care, such as your primary care clinician, mental health provider, pharmacy, or an emergency department. Payment We use health information to prepare bills, document services, process payments, and address payment questions.
For example, we may use your treatment dates and procedure information to prepare an itemized statement. When applicable, we may provide information to a health plan or another responsible payer to obtain payment, subject to any required authorization or restriction.
Healthcare Operations We use health information to operate our practice, maintain records, assess quality, train personnel, and meet professional and legal obligations.
For example, we may review treatment records to evaluate patient safety and improve our clinical procedures. We may also contact you about appointments, follow-up care, or treatment alternatives. Service Providers and CharmHealth We use CharmHealth, operated by MedicalMine, Inc., to store and manage patient medical records. We may also use service providers for functions such as information technology support, accounting, or legal services.
When a service provider handles protected health information as our business associate, we require an appropriate agreement addressing permitted uses, disclosures, and safeguards. These arrangements do not authorize the provider to use your identifiable health information for unrelated purposes.
De-Identified Information Where permitted by law and applicable agreements, information may be de-identified using legally recognized methods and used for purposes such as analysis or quality improvement. Properly de-identified information is no longer protected healthinformation under HIPAA, although other laws and contractual restrictions may still apply.
4. Other Permitted or Required Disclosures
People Involved in Your Care
We may share information directly relevant to the involvement of a family member, friend, caregiver, or another person you identify in your care or payment for care when you agree, do not object after an opportunity to do so, or circumstances reasonably indicate your agreement.
For example, with your agreement, we may explain appropriate aftercare instructions to the person assisting you after an infusion or procedure. If you cannot express your preferences, we may share relevant information when professional judgment indicates that doing so is in your best interest and the law permits it. We may also provide limited information for disaster-relief notification. Stricter confidentiality requirements still apply.
Public Health and Safety
We may disclose information when legally permitted or required to report communicable diseases, medication reactions, product safety concerns, suspected abuse or neglect, or certain injuries. We may also disclose information to help prevent or lessen a serious and imminent threat to a person’s health or safety, consistent with applicable law.
Oversight, Legal Requirements, and Legal Proceedings
We may disclose information for legally authorized audits, inspections, licensing activities, or investigations, including to the U.S. Department of Health and Human Services when required to assess compliance. We may respond to qualifying court orders, subpoenas, or law-enforcement requests only after the applicable legal requirements are satisfied. A request for information does not, by itself, authorize release of your records.
Other Specific Legal Purposes
When applicable and legally permitted, information may be disclosed for workers’ compensation, certain military or national-security functions, correctional healthcare or safety, organ and tissue donation, or the lawful duties of coroners, medical examiners, and funeral directors.
Research
Health information may be used or disclosed for research with your written authorization
or under a legally permitted exception that satisfies required privacy protections and review procedures. Additional restrictions on mental health and substance use disorder records remain applicable.
5. Additional Protections for Sensitive Information
Mental Health Information and Psychotherapy Notes
Your mental health treatment information is protected health information. Some records receive additional protection.
Psychotherapy notes have a specific legal meaning: a mental health professional’s separately maintained notes documenting or analyzing conversations during counseling sessions. They are different from routine medical records, including diagnoses, medication information, treatment plans, and ordinary clinical progress notes.
If we maintain psychotherapy notes, most uses or disclosures require your written authorization, including most disclosures to another treating provider. Limited legal exceptions apply. A record does not become a psychotherapy note simply because it concerns ketamine treatment or a mental health condition.
Colorado Confidentiality Protections
Certain mental health records protected by Colorado law may be released only with appropriate permission or under a specific legal exception, such as an authorized treatment referral or a qualifying court order. Particular disclosures to family members may also be subject to additional restrictions and procedures. When those protections apply to records we create or receive, we follow them rather than relying solely on HIPAA’s general disclosure permissions. We obtain any additional consent or authorization required by applicable law.
Substance Use Disorder Records
Some substance use disorder records are protected by an additional federal confidentiality law, 42 CFR Part 2.
If we receive or maintain records protected by Part 2, we handle them in accordance with those additional requirements. Uses and disclosures generally require appropriate consent unless a specific legal exception applies. When we receive Part 2 records under a valid consent covering treatment, payment, and healthcare operations, we may use and further disclose those records as permitted by HIPAA and Part 2, subject to other applicable restrictions. You may revoke that consent in writing, subject to actions already taken in reliance on it.
Part 2 records, and testimony describing their contents, may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without the required written consent or a qualifying court order. The court-order process must provide the legally required notice and opportunity to be heard to you or the record holder. An authorizing court order must be accompanied by a subpoena or other legal requirement compelling disclosure before the requested records are used or disclosed.
Minors’ Information
Parents and legal guardians generally act as personal representatives for minor children, but exceptions apply. We follow applicable law regarding a minor’s ability to consent to care, the confidentiality of that care, and parental access to records. We do not assume that a parent is entitled to every record in every circumstance. HHS.gov
6. Uses Requiring Your Written Authorization
Elevated Medicine does not sell, rent, or trade your personal information. We do not give your identifiable health information to other businesses for their advertising, marketing, or solicitation.
Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing that require authorization under HIPAA, and disclosures constituting a sale of protected health information require written authorization. Our practice does not sell protected health information. For example, we would obtain the appropriate written authorization before using identifiable patient photographs or treatment information in our promotional materials. Other uses and disclosures not described in this notice will be made only with your written authorization. You may revoke an authorization by submitting a written request to our Privacy Officer. Revocation will not undo actions already taken in reliance on your authorization.
Acknowledging receipt of this notice is not an authorization for marketing or other disclosures requiring separate permission.
7. Your Rights
To exercise these rights, contact our Privacy Officer using the information in Section 10. We will explain the process, provide any appropriate forms, and verify identity or legal authority when necessary. Access Your Medical Records
You may request to inspect or obtain an electronic or paper copy of the health information used to make decisions about you, including medical and billing records.
We generally provide access within 30 calendar days, or sooner when required by applicable law. If a legally permitted extension is necessary, we will give you written notice explaining the reason and the expected completion date.
We will provide records in your requested format when readily producible. Otherwise, we will work with you on an appropriate alternative. Any fee will be limited to what applicable law permits.
Limited exceptions apply, including to separately maintained psychotherapy notes. If access is denied, we will explain the reason in writing and describe any available review rights. An unpaid treatment bill does not, by itself, justify denying access to your records.
Request a Correction or Amendment
You may submit a written request to amend information you believe is inaccurate or incomplete, explaining the requested change.
We generally respond within 60 days. If a legally permitted extension is needed, we will notify you in writing. We may deny an amendment request for reasons permitted by law, but we will explain the decision and your right to submit a statement of disagreement.
Request Confidential Communications
You may ask us to contact you in a particular way or at a different location—for example, at a specific telephone number or mailing address. We will accommodate reasonable requests. You do not have to explain why you are requesting confidential communications.
Request Limits on Uses or Disclosures
You may ask us to limit certain uses or disclosures for treatment, payment, or healthcare operations, or disclosures to people involved in your care. We are generally not required to agree to a requested restriction. If we agree, we will follow it, subject to legally permitted exceptions, including certain emergency-treatment situations.
Special protection for services paid in full: If you, or someone other than a health plan acting on your behalf, pays us in full for a healthcare item or service, you may ask us not to disclose information relating solely to that item or service to your health plan for payment or healthcare operations. We must honor that request unless disclosure is required by law.
Obtain an Accounting of Certain Disclosures
You may request a list of certain disclosures of your health information made during the six years before your request. The accounting generally excludes disclosures for treatment, payment, and healthcare operations; disclosures made with your authorization; and certain other legally excluded disclosures. The first accounting within a 12-month period is free. For additional requests within that period, we may charge a reasonable, cost-based fee after informing you of the charge and giving you an opportunity to withdraw or modify your request.
Receive a Copy of This Notice You may obtain a paper copy of this notice at any time, even if you previously agreed to receive it electronically. You may also request an electronic copy. Have an Authorized Representative Act for You A person with appropriate legal authority, such as an authorized healthcare agent or guardian, may exercise privacy rights on your behalf within the scope of that authority. We will verify the person’s authority. Exceptions may apply when recognizing a representative could expose you to abuse, neglect, or endangerment.
8. Questions and Complaints
You may contact our Privacy Officer with questions or concerns about your information or to file a privacy complaint. You may submit a complaint by telephone, mail, or email using the contact information below. You may also file a complaint directly with the U.S. Department of Health and Human Services, Office for Civil Rights, through its online complaint process or by writing to:
Centralized Case Management Operations U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, DC 20201
For assistance, call 1-800-368-1019. TDD assistance is available at 1-800-537-7697. You do not need to complain to our practice before contacting the Office for Civil Rights.
We will not retaliate against you for filing a complaint or exercising your privacy rights.
9. Changes to This Notice
We reserve the right to change this notice and, as permitted by law, apply the revised terms to information we already maintain as well as information we receive in the future. The current notice will be available on our website, in our office, and upon request. Each revised notice will display its effective date. Changes will not override consent or authorization requirements imposed by applicable law.
For questions about this notice, privacy requests, or complaints, contact:
Elevated Medicine
Attention: Privacy Officer
3750 Main Ave, Suite 2 Durango, CO 81301
Phone: 970-749-4443 Email: info@elevatedmedicine.org Elevated Medicine
Please avoid including detailed medical information in an initial email. Contact our office to arrange an appropriate way to provide sensitive information.
