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.
1. Who Follows This Notice
This Notice applies to Bridge Medical and all of its providers, employees, contractors, and staff who may access your protected health information ("PHI"), whether you are seen in person, by telehealth, or contact us by phone, text, or email.
2. Our Pledge Regarding Your Health Information
We understand that medical information about you and your health is personal. We are committed to protecting your PHI and complying with the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), the HITECH Act, and other applicable federal and state privacy laws (including 42 CFR Part 2 protections for substance use disorder records, where applicable).
3. How We May Use and Disclose Your PHI
We may use and disclose your PHI without your specific authorization for the following purposes:
- Treatment: To provide, coordinate, or manage your healthcare with your providers, pharmacies, labs, and other care team members (including telehealth platforms such as Twilio Video used under a Business Associate Agreement).
- Payment: To bill and collect payment from you, your insurance company, Medicaid, or other payers, including verifying coverage and obtaining prior authorizations.
- Healthcare Operations: For quality assessment, training, credentialing, audits, legal services, and general business management.
- Appointment Reminders, Follow-Ups & Treatment Alternatives: To remind you of appointments, send check-in links, share lab/UA results, or tell you about treatment options or health-related services we offer.
- Required by Law: When required by federal, state, or local law (e.g., reporting suspected abuse, certain communicable diseases, or in response to a court order).
- Public Health & Safety: To prevent serious threats to health or safety, including reporting to the Colorado Prescription Drug Monitoring Program (PDMP).
- Family, Friends, or Others Involved in Your Care: Only when you agree, when you do not object, or in an emergency where we determine disclosure is in your best interest.
4. Uses & Disclosures That Require Your Written Authorization
The following uses and disclosures will be made only with your written authorization, which you may revoke at any time in writing:
- Most uses and disclosures of psychotherapy notes.
- Uses and disclosures for marketing purposes.
- Sale of your PHI.
- Disclosure of substance use disorder records protected by 42 CFR Part 2.
- Any other use or disclosure not described in this Notice.
5. Your Rights Regarding Your PHI
- Right to Access & Copy: You may inspect or get a copy of your medical record. We will provide it in the form you request (including electronic) when readily producible, generally within 30 days.
- Right to Amend: You may request that we correct PHI you believe is inaccurate or incomplete.
- Right to an Accounting of Disclosures: You may request a list of certain disclosures we made of your PHI.
- Right to Request Restrictions: You may ask us to limit how we use or disclose your PHI. We must agree to your request to restrict disclosure to a health plan if the service was paid out-of-pocket in full.
- Right to Confidential Communications: You may ask us to contact you in a specific way (e.g., only by mobile, not at home).
- Right to a Paper Copy of This Notice: You may request a paper copy at any time, even if you have agreed electronically.
- Right to Be Notified of a Breach: We will notify you in the event of a breach of your unsecured PHI.
6. Our Responsibilities
- We are required by law to maintain the privacy of your PHI and to provide you with this Notice.
- We will abide by the terms of the Notice currently in effect.
- We will not use or share your information other than as described here unless you give us written permission.
- We reserve the right to change this Notice. The new Notice will apply to all PHI we maintain and will be posted on our website and available in the office.
7. Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights, at 200 Independence Avenue SW, Washington, D.C. 20201, by calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.
8. Contact Us
Bridge Medical — Privacy Officer
1420 N Academy Blvd, Colorado Springs, CO 80909
Phone: (719) 799-6977
Email: md@bridgemedical.co