Privacy Notice
Summary of
Harmony Surgery Center's
Notice of Privacy Practices
This summary describes how we use and share information about you, and how you may see and receive copies of this information.
WE MIGHT USE OR SHARE INFORMATION ABOUT YOU FOR...
| Treatment: |
Such as when our physicians and nurses discuss your care, or other healthcare providers request protected health information on a patient. For example, a pharmacist, home nurse, physical therapist, or physician's office. |
| Payment: |
Such as when we bill your insurance company for services provided to you. |
| Operations: |
Such as when we submit reports for compliance audits, accreditation and licensing reviews, or our quality assurance program. |
| Other ways: |
Such as when we send disease reports to county and state health offices; law requires this. When we provide information to funeral directors, organ donation groups, and researchers. When we share information to protect the health and safety of others or you. Alternatively, when we respond to court requests. We also may send you appointment reminders, greeting cards, and newsletters. |
HOW YOU MAY SEE AND RECEIVE COPIES OF THIS INFORMATION...
You have the right to:
Ask for restrictions on the ways we use and give out your information. However, we are not required to do what you ask.
Receive and inspect a copy of your health record.
Add information to your health record.
Ask that your health information be sent to a different address or that we call you at a different phone number.
Change your mind if you told us we could use or share your information for reasons other than those listed above.
Receive a list of the times we gave out your information. This list will include only what is required by law to have documented in our records.
OUR COMMITMENT TO RESPECT PRIVACY...
Harmony Surgery Center is required to:
Keep your information private.
Let you know if we cannot do what you have asked us to do with your information.
Try to reach you at another location or phone number, if you ask us to do so.
Use and/or give out your information as listed above and as the law permits, unless we have your permission to do more.
As we serve our patients, we at Harmony Surgery Center, LLC may change what we do with your information. If we make a change, we will give you a new notice the next time you visit us. You may call us or write to us to check if we have made any changes.
COMPLAINTS
If you think your privacy rights have been violated, you may complain to the Harmony Surgery Center Privacy Officer, Poudre Valley Health Systems, or the Department of Health and Human Resources. You will not be mistreated for filing a complaint.
PRIVACY NOTICE
You have the right to request and obtain a paper copy of the complete Privacy Notice. Please contact the HSC Privacy Officer at (970) 297-6448.
CONTACT INFORMATION
Harmony Surgery Center, LLC ▪ Privacy Officer
2127 East Harmony Road, Suite 200
Fort Collins, Colorado 80528
Phone: (970) 297-6448
