Same-day appointments often available · Silverthorne, CO · 970.364.2228
Same-day appointments · Call us
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.
Peak HRT & IV Drip Lounge ("Peak HRT," "we," "us," or "our") is required by the Health Insurance Portability and Accountability Act (HIPAA) to maintain the privacy of your protected health information (PHI), provide you with this notice of our legal duties and privacy practices, notify you following a breach of unsecured PHI, and follow the terms of the notice currently in effect. This notice explains how we may use and share your health information and your rights regarding that information.
Protected health information (PHI) is individually identifiable health information that we create, receive, maintain, or transmit as part of providing your care. It includes information that identifies you (such as your name, date of birth, address, or contact information) along with details about your health, treatment, or payment for healthcare. Examples include:
The following categories describe the ways we are permitted to use and disclose your PHI without your specific written authorization. Not every use is listed, but every use will fall within one of these categories.
We may use your PHI to provide, coordinate, or manage your healthcare. For example, your medical records may be reviewed by our providers, nurses, and clinical staff who are involved in your care. We may share your PHI with other healthcare providers (such as your primary care doctor, specialists, lab partners, or pharmacies) when necessary for your treatment.
We may use and disclose your PHI to bill and collect payment for the services we provide. This may include verifying coverage with HSA or FSA plans (when you request reimbursement), processing payments, and providing itemized receipts at your request. Peak HRT does not bill insurance directly; we are a cash-pay practice.
We may use your PHI for activities necessary to operate our practice, such as quality improvement reviews, staff training, scheduling, contacting you about appointments, internal audits, accreditation, licensing, and certain administrative functions. Examples include using your information to evaluate the performance of our staff, improve our services, or coordinate care across our team.
We may contact you by phone, text, or email to remind you of appointments, share lab results, follow up on treatment, or provide information about our services. You can ask us to use a specific method or to limit communications at any time.
We may tell you about treatment options, services, or health-related products that may be of interest to you.
With your permission (or if you are unable to give permission and we determine it is in your best interest), we may share PHI with a family member, friend, or other person you have identified as involved in your care or payment for your care.
We may use or disclose PHI when required by federal, state, or local law. This includes:
Other uses and disclosures of your PHI not described in this notice will be made only with your written authorization. This always includes:
If you give us authorization to use or disclose your PHI for any other reason, you may revoke that authorization in writing at any time. Once revoked, we will no longer use or disclose your PHI for the purposes described in the authorization, except to the extent we have already taken action in reliance on it.
You have the following rights regarding the protected health information we maintain about you. To exercise any of these rights, please submit your request in writing to our Privacy Officer (contact information at the bottom of this page).
You may request to inspect or receive a copy of your medical and billing records. We will provide access within the timeframe required by law and may charge a reasonable fee for copies.
If you believe information in your record is incorrect or incomplete, you may request that we amend it. We may deny your request in certain circumstances; if we do, we will explain why in writing.
You may request a list of certain disclosures we have made of your PHI for purposes other than treatment, payment, or healthcare operations.
You may request that we restrict how we use or disclose your PHI. We are not required to agree, except for disclosures to a health plan for services you paid for in full out of pocket.
You may request that we communicate with you in a specific way (for example, by phone instead of email) or at a specific location. We will accommodate reasonable requests.
Even if you have agreed to receive this notice electronically, you have the right to request a paper copy at any time.
You have the right to be notified following a breach of your unsecured PHI, in accordance with federal and state law.
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
Peak HRT is required by law to:
We reserve the right to change this notice at any time, and to make the revised notice effective for all PHI we maintain — including information created or received before the change. The current notice will always be posted at our clinic and on our website at peakhrt.com/hipaa-notice. Upon request, we will provide you with a copy of the most current notice.
If you believe your privacy rights have been violated, you may file a complaint with us by contacting our Privacy Officer using the information below. You may also file a complaint directly with the U.S. Department of Health and Human Services Office for Civil Rights:
We will not retaliate against you for filing a complaint.
If you have questions about this notice, want to exercise any of your rights, or wish to file a complaint with us directly, please contact our Privacy Officer:
You will be asked to sign an acknowledgment that you have received this notice when you become a patient at Peak HRT. If you have any questions before signing, our team is happy to walk you through it.
