HIPAA Notice of Privacy Practices

Boulder Biologics ("we," "us," or "our") is required by law to maintain the privacy of your protected health information (PHI), to provide you with this Notice of our legal duties and privacy practices regarding your PHI, and to notify you following a breach of unsecured PHI. We are required to abide by the terms of the Notice currently in effect.

How we may use and disclose your health information

For Treatment: We may use your PHI to provide, coordinate, and manage your medical care and related services. This includes sharing PHI among the providers and staff involved in your care, and with other providers to whom we refer you.

For Payment: We may use and disclose your PHI to obtain payment for the services we provide, such as billing you or a third party and confirming coverage and benefits.

For Health Care Operations: We may use and disclose your PHI for operational purposes such as quality assessment, staff training and review, licensing, and general administration of our practice.

Appointment Reminders and Related Communications: We may use your PHI to contact you with appointment reminders and information about treatment alternatives or other health-related services that may be of interest to you.

Other uses and disclosures permitted or required without your authorization

We may use or disclose your PHI without your authorization in certain circumstances permitted or required by law, including:

• when required by federal, state, or local law;
• for public health activities such as reporting disease or vital statistics;
• to report suspected abuse, neglect, or domestic violence;
• for health oversight activities such as audits and investigations;
• in response to a court order, subpoena, or other lawful process;
• for specified law enforcement purposes;
• to coroners, medical examiners, and funeral directors;
• for organ and tissue donation;
• for approved research under applicable safeguards;
• to avert a serious threat to health or safety;
• for specialized government functions such as military and national security activities; and
• for workers' compensation as authorized by law.

Uses and disclosures that require your written authorization

Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and any sale of your PHI require your written authorization. Other uses and disclosures not described in this Notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.

Your rights regarding your health information

• Right to Inspect and Copy: You have the right to inspect and obtain a copy of your PHI that we maintain in a designated record set, in the form and format you request if readily producible. We may charge a reasonable, cost-based fee.
• Right to Request an Amendment: You have the right to request that we amend PHI you believe is incorrect or incomplete. We may deny your request under certain circumstances and will explain the reason in writing.
• Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures we have made of your PHI.
• Right to Request Restrictions: You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or health care operations. We are not required to agree, except that we must agree to a request to restrict disclosure to a health plan for payment or operations when you have paid in full out of pocket for the item or service.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about your PHI by alternative means or at an alternative location.
• Right to a Paper Copy: You have the right to obtain a paper copy of this Notice upon request, even if you have agreed to receive it electronically.
• Right to Be Notified of a Breach: You have the right to be notified following a breach of your unsecured PHI.

Our duties

We are required by law to maintain the privacy and security of your PHI, to provide you with this Notice, to abide by the terms of the Notice currently in effect, and to notify you following a breach of unsecured PHI.

Changes to this Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have as well as any information we receive in the future. The current Notice will be posted in our facility and on our website, and will include its effective date.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

Contact information

Boulder Biologics
4745 Arapahoe Ave, Suite 300, Boulder, CO 80303
Phone: 720-550-6175
Email: info@boulderbiologics.com