DISCLOSURES WITH YOUR AUTHORIZATION
We must obtain your authorization to use or disclose health information in those situations not otherwise described in this Notice. If you do authorize us to use or disclose your medical information, you have the right to revoke that authorization at anytime.
YOUR RIGHTS IN CONNECTION WITH YOUR MEDICAL INFORMATION
You have the following rights in connection with the medical information we maintain about you:
Right to Inspect and Copy: You have the right to inspect and copy your medical information that is in our possession. You may not, however, have access to information that is put together for use in a civil, criminal or administrative proceeding.
To inspect or copy your medical information, you must submit your request in writing to our corporate office. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request.
We may deny your request to inspect or copy your health information in certain very limited circumstances. If you are denied access to your medical information, you may be able to request that the denial be reviewed.
Right to Request Amendment: If you feel that your medical information is incorrect or incomplete, you may ask us to amend that information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, your request must be made in writing and submitted to our corporate office. You must explain why you believe that the medical information is incorrect or incomplete. If we deny your request, you have a right to give us a short statement to be placed with you medical information or to have us include your request for amendment with your medical information.
Right to an Accounting of Disclosures: You have the right to request, and we must provide you with a list of certain disclosures of your medical information. We are not required to include on that, disclosures to carry out your treatment, payment for your care, and other health care operations and certain other disclosures. To request this list or accounting of disclosures, you must submit your request in writing to our corporate office.
Your request must state a time period covered by your request. That time period may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example on paper or electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Additional Privacy Protections: You have the right to request additional restrictions from those detailed in this notice. Your request must be submitted in writing to our corporate office. We are not required, however, to agree to your request.
Right to Request Confidential Communication: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. Your request must specify how or where you wish to be contacted. To request confidential communications, you must make your request in writing to our corporate office. We will not ask you the reason for your request and we will accommodate all reasonable requests.
Right to a Paper Copy of this Notice: You may ask us to give you a copy of this notice at any time by asking for it in person or in writing. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
COMPLAINTS
If you believe your privacy rights have been violated; you may file a complaint with us or with the Secretary of the United States Department of Health and Human Services. To file a complaint with us, contact our corporate office in writing. You will not be penalized for filing a complaint.
Complaint Officer
1180 Mall Drive Suite C
Las Cruces, NM 88011
If you have any questions about this notice, please contact our Privacy Officer at the address listed above.
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