Treasure  State  Orthotic and  Prosthetic Clinic, Inc . 

Notice  of  Privacy  Practices

This notice describes how health information about you may be use and disclosed, and how

you can obtain access to this information. Please review carefully.

​

We are required by law to maintain the privacy of our patients' personal health information

and to provide patients with notice of our legal duties and privacy practices with respect to

your personal health information. We are required to abide by the terms of this Notice so long

as it remains in effect. We reserve the right to change the terms of this Notice as necessary.

You may receive a copy of any revised notices at our office or by mail.

​

Use and disclosures of your personal health information:

​

Your Authorization. Except as outlined below, we will not use or disclose your personal

health information for any purpose unless you have signed a form authorizing the use or

disclosure. You have the right to revoke that authorization in writing unless we have taken

any action in reliance on the authorization.

​

Use and Disclosure for Treatment, Payment, and Health Care Operations. We will make

uses and disclosures of your personal health information as necessary for treatment to other

individuals or entities involved in your care. We will make uses and disclosures of your

personal health information as necessary for the payment purposes of those health

professionals and facilities that have treated you or provided services to you. We will use and

disclose person health information as necessary, and as permitted by law, for our health care

operations which included clinical improvement, professional peer review, business

management, accreditation and licensing, etc.

​

Business Associates. Certain aspects and components of our services are performed through

contracts with outside persons or organizations, such as auditing, accreditation, billing, e t c .

At times it may b e necessary for us to provide certain aspects of your personal health

information to one or more of these outside persons or organizations that assist us with our

health care operations.

​

Appointment and Services. - We may contact you to provide appointment reminders. You

have the right to request and we will accommodate reasonable requests by you to receive

communications regarding your personal health information from us by alternative means.

For instance, if you wish appointment reminders to not be left on voice mail, etc. All requests

must be made in writing.

​

Health Products and services. We may from time to time use your personal health

information to communicate with you about health products and services necessary  for your

treatment, to advise you of new products and services we offer, and to provide general health

and wellness information.

​

Research. In limited circumstances, we may use and disclose your personal health

information for research purposes.

​

Other Uses and Disclosures. We are permitted by law to make certain other uses and

disclosures of your personal health information without your consent or authorization.

​

• Any purpose required by law;

• Public health activities, such as required reporting of disease, injury and for

       required public health investigations;

• If we suspect child abuse or neglect or if we believe you to be a victim of

       abuse, neglect or domestic violence.

• To the Food and Drug Administration if necessary to report adverse events,

       product defects, or to participate in product recalls;

• To your employer when we have provided health care to you at the request of

       your employer;

• If required by law to a government oversight agency conducting audits,

       investigations, or civil or criminal proceedings;

• If you are a member of the military as required by armed forces; we may also

       release your personal health information if necessary for national security or

       intelligent activities; and

• To workers' compensation agencies if necessary for your workers'

       compensation benefit determination.

 

Rights that you have:

​

Access to Your Personal Health Information. You have the right to copy and/or inspect

much of the personal health information that we retain on your behalf. All requests for access

must be made in writing and signed by you or your personal representative. We may charge a fee if you request this information. You may retain a record release form from our office.

​

Amendments t o Your Personal Health Information. You have the right to receive an

accounting of certain disclosures made by us for your personal health information after July,

2005. Requests must be made in writing. The first account in any 12 month period is free;

you will be charged a fee of $10.00 for each subsequent accounting you request within the

same 12-month period.

​

Restrictions on Use and Disclosure of Your Personal Health Information. You have the

right to request restriction on certain uses and disclosures of your personal health information

for treatment, payment, or health care operations. We are not required to agree to your

restriction request, but will attempt to accommodate reasonable requests when appropriate and we retain the right to terminate an agreed-to restriction if we believe such termination is

appropriate. In event of termination by us, we will notify you of such termination.

​

Complaints. If you believe your privacy rights have been violated, you can file a complaint

with our clinic or with the Secretary of the Department of Health and Human Services. You

must submit your complaint in writing to Treasure State Orthotic and Prosthetic Clinic, Inc.

1648 Ellis St., Suite 102, Bozeman, Mt. 59715. You will not be penalized for filing a

complaint.

​

If you have any questions regarding this notice or our health information privacy policies,

please contact our office at 585.1440.