HIPAA Privacy Notice


HIPAA Privacy Notice

This notice describes how medical information about you may be used and shared and how you can get access to this information. Please review it carefully.



Uses and Disclosures of Your Medical Information

1. Treatment. Your “Protected Health Information” is routinely shared among health care professionals involved in your care to coordinate or manage treatment, both within and outside Denali Performance Clinic Services and collaborating clinics. History and Examination findings, X-ray results, Laboratory results, etc., may be shared with collaborating providers as part of your treatment.

2. Payment. Your medical information may be shared with your medical insurer so that Denali Performance Clinic Services can be paid by your insurer for services provided to you. A summary of your treatment may be provided to your insurer.

3. Health Care Operations. Your medical information is sometimes used to assess and improve quality of care or reallocate resources. Non-patient-specific information is used wherever possible. The details of your procedure, for instance, may be shared among providers at a department meeting to evaluate your procedure based on the outcome.

4. Facility Directory. Unless you tell us not to, we may use the following information in a facility directory: (a) your name; (b) your location in Denali Performance Clinic Services; (c) your general condition; and (d) your religious affiliation. We may share this information (except for your religious affiliation) with members of the clergy or other persons who ask for you by name. You may limit or prohibit these uses and disclosures by notifying a Denali Performance Clinic Services representative, doctor or nurse orally or in writing of your restriction or prohibition. In an emergency or if you cannot tell us what you want us to do, we will do what we think you would want us to do, based on your other visits to Denali Performance Clinic Services and it’s collaborating clinics (if any). We will tell you about any uses or disclosures as soon as we can and give you a chance to object as soon as practicable.

5. State Law. State law mandates sharing of your medical information with state agencies under certain circumstances, without your consent. Examples include abuse reporting to the Department of Social Services and death reports to the Office of the Medical Examiner.

6. Medical Research. Your medical information may be used to further medical research, but only after approval by the Institutional Review Board, when written permission is not required by federal or state law.

7. Other Uses and Disclosures. Any other sharing of your medical information will be made only with your written permission, and you may take back your permission at any time so long as you tell us in writing. Exceptions include if Denali Performance Clinic Services or collaborating clinic has acted in reliance upon your permission or if your permission was obtained so that the services provided would be covered by insurance.

In addition, Denali Performance Clinic Services may contact you to remind you about your appointment or tell you about health-related benefits or services that may be of interest to you. We may use certain information (name, address, telephone number, email, dates of service, age and gender) to contact you in the future about special offers and opportunities.



Your Rights

1. You may ask us to limit our sharing of your information, but under Federal Law Denali Performance Clinic Services and collaborating clinics do not have to agree to what you ask.

2. You have the right to receive confidential communications of your information at alternative locations or by alternative means.

3. You have the right to see and get a copy of your medical records.

4. If you think there is something wrong or missing in your medical information, you can ask that it be changed, unless the information was created elsewhere, is unavailable or is determined to be already accurate and complete. This will be done under collaboration with the provider, and will requisitely be within legal parameters, and maintain provider’s right to diagnose, prescribe, and treat.

5. You have a right to ask us for a limited accounting of disclosures of your information. The medical records department can provide you with more details.



The Duties of Denali Performance Clinic Services

1. Denali Performance Clinic Services is required by law to keep your medical information private and to give patients this notice of its legal duties and privacy practices for medical information. Denali Performance Clinic Services is required to agree to the terms of this notice. Denali Performance Clinic Services reserves the right to change the terms of this notice and to make the new terms apply to all medical information it keeps. This notice and any changed notices will be conspicuously posted in public spaces at the Clinic, made available on the Denali Performance Clinic Services Web site (www.denalimedicalonline.com) and given to you in paper copy upon your request.

2. Any patient believing that his or her privacy rights have been violated may complain through the Denali Performance Clinic Services Customer Relationship Management Department at 801-675-0987 or file a complaint directly with the Secretary for the United States Department of Health and Human Services. Visit www.hhs.gov/ocr/privacy/hipaa/complaints to learn more. Patients will not be retaliated against for filing a complaint.


By signing below, I acknowledge that I have read through the above information, and confirm understanding and compliance.

Leave this empty:

Signature arrow

Signature Certificate
Document name: HIPAA Privacy Notice
lock iconUnique Document ID: 83dd6b80cbd970783ca86e86f11aff3047106f0a
Timestamp Audit
July 3, 2019 4:32 pm MDTHIPAA Privacy Notice Uploaded by Denali Medical - accounts@denalimed.com IP 107.191.1.156
July 10, 2019 8:39 pm MDTCindy Meldrum - cmeldrum@denalimed.com added by Lisa Strauss - accounts@denalimed.com as a CC'd Recipient Ip: 107.191.1.119