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.
Gallus Detox Center is required by law to maintain the privacy and confidentiality of your health information and provide you with notice of its legal duties and privacy practices concerning your health information. Please respect the privacy of others you may encounter in treatment. Gallus Detox Center collects information about you and stores it in an electronic health record. This is your medical record. The medical record is the property of Gallus Detox Center, but the information belongs to you. The Health Insurance Portability and Accountability Act (HIPPA) requires Gallus Detox Center to maintain the privacy of your medical record. HIPPA generally requires that any uses or disclosures of information in your medical record be limited to the minimum necessary to the purposes of the uses and disclosures. HIPPA also provides you with certain rights with respect to the information in your medical record. These rights are described below.
Information relating to your treatment at Gallus Detox Center is protected by federal regulations specific to drug and alcohol treatment, which are known as 42 CFR Part 2. These regulations protect the confidentiality of information relating to the identity, diagnosis, prognosis, or treatment of any patient in a drug or alcohol treatment program. Gallus Detox Center may not disclose records relating to your treatment without your written consent, except in narrowly limited circumstances. Under 42 CFR Part 2, the terms of a written consent to disclose information must specify the scope and types of information disclosed, the parties to whom the information may be disclosed, the purpose of the disclosure, and the timeframe of the consent. You may revoke a consent to disclose information relating to drug and alcohol verbally or in writing at any time.
Gallus Detox Center may ask for your written consent to disclose treatment information for certain purposes, including releasing treatment information to or obtaining from your other medical providers, obtaining payment from insurance or other payers, and contacting your family either for treatment purposes or in case of an emergency. Gallus Detox Center will not disclose your treatment information without your written consent.
Gallus Detox Center may disclose treatment information without your written consent under certain narrow circumstances as permitted by 42 CFR Part 2. For treatment purposes, Gallus Detox Center is permitted to use and disclose treatment information internally and to entities with which it shares administrative control. Gallus Detox Center is permitted to share treatment information as it is necessary with qualified service organizations that agree to maintain the confidentiality of the information. Gallus Detox Center may also disclose treatment information to outside auditors, regulatory agencies, and evaluators, and for certain research purposes. Gallus Detox Center may disclose treatment information without your written consent if necessary in a life-threatening medical emergency. They may also disclose to report a crime on the premises or Gallus personnel. Gallus Detox Center may also disclose patient information without consent where the state mandates child abuse and neglect reporting, when the cause of death is being reported, or when a valid court order that contains specified findings. Gallus Detox Center may contact you to share information about Gallus Detox Center’s treatment services, or to send reminder notices of future appointments.
I. Your Health Information Rights
In addition to protecting privacy and confidentiality, HIPPA and 42 CFR PArt 2 afford you the following rights concerning your medical record and drug or alcohol treatment information:
You have the right to a paper copy of this written notice of Gallus Detox Center’s privacy record.
You have a right to request a paper copy of your treatment record or to receive your health information through a reasonable alternative method or at an alternate location. Gallus Detox Center requires that all such requests be put in writing. A reasonable fee will be charged for copying your health information.
You have the right to request the Gallus Detox Center amend health information that is incorrect or incomplete. If Gallus Detox Center determines not to amend the health information, it will provide you with an explanation of the reason for the denial and your rights to disagree with the denial.
You have a right to request restrictions on otherwise permitted uses and disclosures of your health information. Gallus Detox Center is not obligated to reply with such requests.
You may request that we provide you with a written account of all disclosures made by us during a specific time period, which may not exceed 6 years. We ask that such requests be made in writing. Please note that an accounting will not apply to any of the following types of disclosures: disclosures made with your written consent for reasons of treatment, payment, or healthcare operations, disclosures made to you or your legal representative, or any other individual involved with your care. You will not be charged for your first accounting request in any 12-month period. However, for any requests that you make thereafter, you will be charged a reasonable, cost-based fee.
II. Changes to this Notice of Privacy Practices
Gallus Detox Center reserves the right to amend this Notice of Privacy Practices at any time in the future and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendments. Until amendments are made, Gallus Detox Center is required by law to comply with this notice. Should our privacy practices change, we will provide all current and future patients with a copy of the revised Notice of Privacy Changes.
Effective December 3, 2019
III. Complaints Regarding Privacy Practices
Complaints about this Notice of Privacy Practices or how Gallus Detox Center handles your health information should be directed to:
Gallus Detox Centers
4326 N. 75th St
Scottsdale, Arizona 85251
If you are not satisfied with how this office handles a complaint, you may submit a formal complaint to one of the following:
Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue, SW Room 509F, HHH Building
Washington, DC 20201
Arizona Department of Health Services
150 N. 18th Avenue Suite 500
Phoenix, AZ 85007
You may also address your complaint to one of the regional U.S Department of Health and Human Services Offices for Civil Rights. A list of these offices can be found online at: https://www2.ed.gov/about/offices/list/ocr/addresses.html
Personally identifiable information you disclose to us is kept secure. Only authorized Gallus Detox staff, agents, and contractors who have agreed to keep information secure and confidential have access to this information. All emails and newsletters from this site allow you to opt-out of further mailings. We do not share your personal information with any third party outside of Gallus Detox Center staff, our agents, and contractors.
Privacy Contact Information
By Phone: (720) 669-8178