Roosevelt General Hospital Notice of Privacy Practices
This notice describes how medical information about you may be used and
disclosed and how you can get access to this information. Please review
The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
is a federal program that requires that all medical records and other
individually identifiable health information used or disclosed by us in
any form, whether electronically, on paper, or orally, are kept properly
confidential. This act gives you, the patient, significant new rights
to understand and control how your health information is used. HIPAA provides
penalties for covered entities that misuse personal health information.
We may use and disclose your medical records only for each of the following
purposes: Treatment, Payment, and Health Care Operations.
- Treatment means providing, coordinating, or managing health care and related
services by one or more health care providers. An example of this would
include x-rays, lab work, emergency services, etc.
- Payment means such activities as obtaining reimbursement for services,
confirming coverage, billing or collection activities, and Utilization
Review. An Example of this would be sending a bill for your visit to your
insurance company for payment.
- Health care operations include the business aspects of running the hospital,
such as conducting quality assessment and improvement activities, auditing
functions, cost-management analysis, and customer service. An example
would be an internal quality assessment review.
We may also create and distribute de-identified health information by removing
all references to individually identifiable information.
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.
Any other uses and disclosures will be made only with your written authorization.
You may revoke such authorization in writing and we are required to honor
and abide by that written request, except to the extent that we have already
taken action relying on your authorization.
You have the following rights with respect to your protected health information,
which you can exercise by presenting a written request to the Privacy Officer.
- The right to request restrictions on certain uses and disclosures of protected
health information, including those related to disclosures to family members,
other relatives, close personal friends, or any other person identified
by you. We are, however, not required to agree to a requested restriction.
If we do agree to a restriction, we must abide by it unless you agree
in writing to remove.
- The right to reasonable requests to receive confidential communications
of protected health information from us by alternative means or at alternative
- The right to inspect and copy your protected health information.
- The right to amend your protected health information.
- The right to receive an accounting of disclosures of protected health information.
- The right to obtain a paper copy of this notice from us upon request.
We are required by law to maintain the privacy of your protected health
information and to provide you with notice of our legal duties and privacy
practices with respect to protected health information.
This notice is effective as of April 14, 2003, and we are required to abide
by the terms of the Notice of Privacy Practices currently in effect. We
reserve the right to change the terms of our Notice of Privacy Practices
and to make the new notice provisions effective for all protected health
information that we maintain. We will post this and you may request a
written copy of a revised Notice of Privacy Practices from this office.
You have recourse if you feel your privacy protections have been violated.
You have the right to file a formal written complaint with our office
or with the Department of Health and Human Services, Office of Civil Rights,
about violations of the provisions of this notice or the policies and
procedures of our office. We will not retaliate against you for filing
Complimentary guest Wi-Fi is provided throughout our facility. When logging
on, you will be prompted to enter an email address. This email address
may be used by our facility to send you emails with information about
our facility and services we offer or with surveys seeking input about
your experience at our facility. If you do not consent to the use of the
email address, please refrain from logging onto the guest Wi-Fi during
your visit to the facility.
Please contact us for more information by asking to speak to our Privacy Officer,
Cricket Keyes at 575.359.1800, ext. 3413, or send written inquiries to:
Roosevelt General Hospital
Attn: HIPAA Privacy Officer
42121 US Highway 70
Portales, NM 88130
For more information about HIPAA or to file a complaint:
U.S. Department of Health & Human Services
Office of Civil Rights
200 Independence Avenue SW
Washington, DC 20201