1258 W South Jordan Parkway Suite 101 South Jordan, Utah 84095
Privacy Policy
Notice of Your Personal Information Rights and Responsibilities
We keep a record of the health care services we provide you. This notice describes how personal health information (PHI) about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Your Rights Regarding your PHI
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
- You can ask to see or get a copy of your record. Ask us how to do this.
- We will provide a copy, or a summary, of your health information, usually within 30 days of request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete.
- We may say “no” to your request, but we will respond with reason within 60 days of request.
Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail (or email) to a different address.
- We will accommodate all reasonable requests.
Ask us to limit what we use or share
- You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, particularly if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. Such requests may be limited by federal or local laws.
Get a list of those with whom we have shared information
- You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date of your request, including with whom shared and purpose.
Get a copy of this privacy notice
- You can ask for a paper copy of this notice at any time.
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before fulfilling the request.
File a complaint if you feel your rights have been violated
- You can notify of a complaint if you feel we have violated your rights of this notice by contacting us.
- You can file a complaint with the Utah State Department of Health.
- You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
- We will not retaliate against you for filing a complaint.
Your Choices Regarding your PHI
For certain health information, you can tell us your choices about what we share. These other uses and disclosures of your PHI will be made only with your written authorization.
- You have both the right and the choice to tell us to share specific information with your family, close friends, or others involved in your care.
- We will not make any other use or disclosure of your PHI or psychotherapy notes.
- We will not use or disclose your PHI for marketing purposes.
- We will not sell your PHI.
Our Uses and Disclosures
For Treatment. We may use medical and clinical information about you to provide you with treatment services.
For Payment. We may use and disclose medical information about you so that we can receive payment for the treatment services provided to you.
Required by Law. We may use or disclose you PHI to the extent that the use or disclosure is required by law, made in compliance with the law, and limited to the relevant requirements of the law.
Health Oversight. We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies and organizations that provide financial assistance to the program (such as third-party payors). If we disclose PHI to a health oversight agency, we will have an agreement in place that requires the agency to safeguard the privacy of your information.
Abuse or Neglect. We may disclose your PHI to a state or local agency that is authorized by law to receive reports of abuse or neglect. However, the information we disclose is limited to only that information which is necessary to make the required mandated report.
Criminal Activity or Threats to Personal Safety. We may disclose your PHI to law enforcement officials if we reasonably believe that the disclosure will avoid or minimize an imminent threat to the health or safety of yourself or any third party.
Compulsory Process. We may be required to disclose your PHI if a court of competent jurisdiction issues an appropriate order, and if the rule of privilege has been determined not to apply. We may be required to disclose your PHI if we have been notified in writing at least fourteen (14) days in advance of a subpoena or other legal demand, no protective order has been obtained, and a competent judicial officer has determined that the rule of privilege does not apply.
Essential Government Functions. We may by required to disclose your PHI for certain essential government functions. Such functions include: assuring proper execution of a military mission, conducting intelligence and national security activities that are authorized by law, and determining eligibility for or conducting enrollment in certain government benefit programs.
Law Enforcement Purposes. We may be authorized to disclose your PHI to law enforcement officials for law enforcement purposes under the following circumstances, and subject to specified conditions: (1) as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; (2) to identify or locate a suspect, fugitive, material witness, or missing person; (3) in response to a law enforcement official’s request for information about a victim or suspected victim of a crime; (4) to alert law enforcement of a person’s death, if we suspect that criminal activity caused the death; (5) when we believe that protected health information is evidence of a crime that occurred on our premises; and (6) in a medical emergency not occurring on our premises, when necessary to inform law enforcement about the commission and nature of a crime, the location of the crime or crime victims, and the perpetrator of the crime.
Psychotherapy Notes. If kept as separate records, we must obtain your authorization to use or disclose psychotherapy notes with the following exceptions.
- We may use the notes for your treatment.
- We may also use or disclose, without your authorization, the psychotherapy notes for our own training, to defend ourself in legal or administrative proceedings initiated by you, as required by the Utah Department of Health or the U.S. Department of Health and Human Services to investigate or determine our compliance with applicable regulations, to avoid or minimize an imminent threat to anyone’s health or safety, or as otherwise required by law.
Practice Contact Information
Our Privacy and Security Officer is designated below. Please contact this person for questions about this Notice of Privacy Practices.
Bryan Skiles, CMHC
Brighter Skies Services PLLC
1258 W South Jordan Pkwy Ste 101
South Jordan, UT 84095
Copyright © 2024 Brighter Skies Services - All Rights Reserved.
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