Effective date: September 15, 2026
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.
Moderation Medical is required by law to maintain the privacy of your health information and to provide you with a notice of its legal duties and privacy practices with respect to your protected health information. We are required to abide by the terms of the Notice of Privacy Practices currently in effect. We will not use or disclose your health information except as described in this notice. This notice applies to all of the medical records generated by Moderation Medical, as well as records we receive from other providers.
Use & Disclosure of Protected Health Information in Treatment, Payment & Health Care Operations
Treatment: Moderation Medical may use and disclose your protected health information in the course of providing or managing your health care as well as any related services. For the purpose of treatment, we may coordinate your health care with a third party. For example, we may disclose your protected health information to a pharmacy to fulfill a prescription for medication, to a laboratory to order testing, or to another provider who is assisting in your health care. In addition, we may disclose protected health information to other health care providers related to the treatment provided by those other providers.
Payment: When needed, Moderation Medical will use or disclose your protected health information to obtain payment for its services. Such uses or disclosures may include disclosures to your health insurer to get approval for a recommended procedure or to determine whether you are eligible for benefits or whether a particular service is covered under your health plan. When obtaining payment for your health care, we may also disclose your protected health information to your insurance company to demonstrate the medical necessity of the care or for utilization review when required to do so by your insurance company. Finally, we may also disclose your protected health information to another provider where that provider is involved in your care and requires the information to obtain payment.
Operations: Moderation Medical may use or disclose your protected health information when needed for the practice’s health care operations for the purposes of management or administration of the practice and for offering quality health care services. Health care operations may include: (1) quality evaluations and improvement activities; (2) employee review activities and training programs; (3) accreditation, certification, licensing, or credentialing activities; (4) reviews and audits such as compliance reviews, medical reviews, legal services, and maintaining compliance programs; and (5) business management and general administrative activities. For instance, we may use, as needed, protected health information of patients to review their treatment course when making quality assessments regarding the care or treatment we provide. In addition, we may disclose your protected health information to another provider or health plan for their health care operations.
Other Uses and Disclosures: As part of treatment, payment, and health care operations, Moderation Medical may also use or disclose your protected health information to: (1) remind you of an appointment; (2) inform you of potential treatment alternatives or options; or (3) inform you of health-related benefits or services that may be of interest to you.
Uses & Disclosures to Which You May Object
Family/Friends: Moderation Medical may disclose your protected health information to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. In addition, we may disclose protected health information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location. If you have any objection to the use and disclosure of your protected health information in this manner, please tell us.
Uses & Disclosures That are Required or Permitted Without Your Authorization
Regulatory Agencies: Moderation Medical may disclose your protected health information to government and certain private health oversight agencies, e.g., the Colorado Department of Public Health and Environment or the Colorado Medical Board, for activities authorized by law, including, but not limited to, licensure, certification, audits, investigations and inspections. These activities are necessary to monitor compliance with the requirements of government programs.
Law Enforcement/Litigation: Moderation Medical may disclose your protected health information for law enforcement purposes as required by law or in response to a court order or other process in litigation.
Public Health: As required by law, Moderation Medical may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury or disability. For example, we are required to report the existence of certain communicable diseases to the Colorado Department of Public Health and Environment to protect the health and well-being of the general public.
Workers’ Compensation: Moderation Medical may release protected health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
As Otherwise Required or Permitted By Law: Moderation Medical will disclose your protected health information in any situation in which such disclosure is required by law (e.g., child abuse, domestic abuse) or any other use permitted under HIPAA, its amendments or regulations.
Uses and Disclosures Requiring Your Authorization
Other than the circumstances described above, Moderation Medical will not disclose your protected health information unless you provide written authorization. An authorization is specifically required in most situations involving uses or disclosures of protected health information for marketing purposes, for the sale of protected health information, or for the use or disclosure of psychotherapy notes. You may revoke your authorization in writing at any time except to the extent that we have already taken action in reliance upon the authorization.
Your Rights Related to Your Health Information
Although all records concerning your treatment obtained at Moderation Medical are the property of Moderation Medical, you have the following rights concerning your protected health information:
Right to Confidential Communications: You have the right to receive confidential communications of your protected health information by alternative means or at alternative locations. For example, you may request that we contact you at work or by mail.
Right to Inspect and Copy: You generally have the right to inspect and copy your protected health information, except as restricted by your provider or by law. Further, if we maintain your health records on an electronic health records system, you have the right to request an electronic copy of your health records.
Right to Amend: You have the right to request an amendment or correction to your protected health information. If we agree that an amendment or correction is appropriate, we will ensure that the amendment or correction is attached to your medical record.
Right to an Accounting: You have the right to obtain a statement of the disclosures that have been made of your protected health information other than by your authorization, other than to you and other than for the purpose of treatment, payment or routine operational purposes.
Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your protected health information. If we agree, we will abide by the restrictions. Additionally, if you (or anyone on your behalf besides a health plan) pay for the care or services at issue in full out of your own pocket, we are required to comply with your request not to disclose your protected health information to a health plan, unless required by law to do so.
Right to Receive a Copy of this Notice: You have the right to receive a paper copy of this Notice, upon request, if this Notice has been provided to you electronically.
Right to Revoke Authorization: You have the right to revoke your authorization to use or disclose your protected health information, except to the extent that action has already been taken in reliance on your authorization.
Right to Notice of Breach of Security: You have the right to be notified in the event of a breach of unsecured protected health information.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with Moderation Medical using the contact information below. You may also file a complaint with the Secretary of 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 online at www.hhs.gov/ocr/privacy/hipaa/complaints/. All complaints must be submitted in writing.
We will not retaliate against you, and you will not be penalized in any way, for filing a complaint.
Changes to This Notice
We reserve the right to change the terms of this Notice at any time, and to make the revised Notice effective for all protected health information we maintain, including information created or received before the change. If we materially change this Notice, we will post the revised Notice on our website at moderationmedical.com and make paper copies available upon request. The effective date of the current Notice appears at the top of the first page.
For More Information or to Exercise Your Rights
Privacy Officer
Moderation Medical, LLC
720 Austin Ave, STE 100 PMB 312
Erie, CO 80516
Email: privacy@moderationmedical.com