A Message from AltaMed Health Services Corporation:
This Notice of Privacy Practices (“Notice”) explains how we may use your medical information, who we may
share it with, and how to get a copy of your medical records.
Our promise regarding your health information
AltaMed Health Services Corporation (“AltaMed”) is committed to safeguarding your protected health
information (“PHI”). We comply with all applicable laws to properly use, disclose, and maintain your PHI. We
are also in compliance with California laws requiring us to keep and handle protected categories of health
information appropriately. These protected categories include: mental health treatment, developmental
disabilities treatment, drug/alcohol abuse treatment, and HIV/AIDS treatment information. There are also
special ways of handling PHI for minors receiving services for reproductive health or pregnancy, mental
health, substance abuse, sexually transmitted diseases, rape, or sexual assault-related services.
This Notice explains:
• Laws to protect your PHI
• Your rights about your PHI
• How to file a privacy-related complaint
We will always notify you of any breach (unauthorized use) of unsecured PHI that aects you.
Changes to Notice of Privacy Practices
AltaMed follows all the privacy practices in this Notice. We also have the right to change these practices. If
we make important changes, we will provide you with an updated Notice during your next visit to AltaMed.
You can get a copy of this Notice from any AltaMed site or get it online at www.altamed.org.
How does AltaMed use and disclose protected health information?
AltaMed will only use or share your health information if it is needed to provide you with health services.
Some of the information AltaMed uses and shares is: your name, address, email, telephone numbers, health
care history, health care provided to you, and the cost of your health care. The following are other examples
of how AltaMed may use or disclose your PHI.
Treatment: AltaMed will use and share your PHI with doctors, hospitals, and others to provide, coordinate, or
manage your health care and any related services. For example, we may need to use your information to get
prior approval for certain services, to call you as a reminder about an upcoming appointment, or to follow
your health changes.
Payment: AltaMed will use and share your PHI, as needed, to obtain or provide payment for your health care
services. This may include sharing information with your insurance, provider, or personal representative who
is responsible for making decisions about payment of services.
Health care operations: Your information may be used for general administrative purposes. For example,
we may need to check how well we are providing services, as part of audits, to participate in programs to
stop fraud, and for AltaMed planning needs.
Other uses of your health information
Marketing: Most uses and sharing of your PHI for marketing purposes would require your prior written
authorization. There are some exceptions to marketing such as when a communication describes a
health-related product or service, or an announcement of new providers or equipment.
Fundraising: AltaMed may contact you to provide information about AltaMed sponsored activities such as
fundraising programs and events. The funds raised are used to expand and improve the services and
programs AltaMed can provide to the community.
Notice of Privacy Practices
If you do not want to receive fundraising materials or communications, and would like to opt-out, please
contact the AltaMed Patient Service Center at (888) 499-9303, or respond to any communication with a
request to opt-out. You are free to opt-out of fundraising communications at any time, and your decision will
have no impact on your treatment or payment for services.
To individuals involved in your care or payment for your care: AltaMed may share PHI with family members
or friends involved in decisions about your care, payment for care, or in the case of an emergency. You have
the right to request that AltaMed not share some or all of this information. Please contact the AltaMed
Privacy Ocer at altamedprivacyoc[email protected]g or the AltaMed site where you receive services to
make a written request to not share PHI.
Required by law: AltaMed may use or share your PHI if required by federal, state, or local law, or by court
order or subpoena.
Public health activities: AltaMed may share your PHI with a public health authority in order to prevent or
control disease, injury, or disability. For example, AltaMed may share proof of vaccines with a patient’s school.
Research: AltaMed may share health information for research projects. All research projects follow state and
federal laws that protect patient privacy. All research projects that require sharing PHI must be approved
through a special review process to protect patient safety, welfare, and confidentiality. If the special review
process approves sharing health information for a research project, other studies may also use this same
information. Researchers may contact patients to participate in certain research studies. Patients will only be
contacted if the special review process has given their approval. You do not need to participate in any
research project. If you agree to participate, you will need to sign an authorization form.
To avert a serious threat to health or safety: AltaMed may use and share your PHI if we believe it is necessary
to avoid abuse, neglect, or a serious threat to your health or safety or to someone else's. We limit the
information that is shared to that which is needed to respond to the emergency.
Deceased individuals: AltaMed may use or share the PHI of a deceased individual after the individual has
been deceased for 50 years.
When written permission is needed: If AltaMed needs to share your PHI for a reason not explained in this
Notice, we will first need your written permission unless required by law. You may cancel your authorization
in writing at any time. If you cancel your authorization, we will no longer use or disclose your PHI for the
purposes covered by your written authorization.
If you cancel your authorization, it will only eect new disclosures. You may contact the site that collected
your authorization or the Privacy Ocer at AltaMedPrivacyOc[email protected]g, to cancel the authorization.
What are your privacy rights?
The following is a statement of your rights about your PHI and a brief description on how to exercise these
rights.
You have the right to receive and review a copy of your PHI.
• You may receive and review a copy of your paper and electronic health records. Your health records
include medical and billing records and any other records that we use for making medical decisions
about your care.
• You have the right to receive your PHI in the format requested. If it is not available in that format, we will
give it to you in another format.
• Please submit your requests to receive or review a copy of your PHI to AltaMed Health Information
Management at RecordReques[email protected]g or the AltaMed site where you receive services.
• There may be a fee for providing you with your health records.
• Under some circumstances, your request to inspect or obtain a copy of your PHI may be denied. If your
request is denied, you may request that the decision be reviewed.
Notice of Privacy Practices
You have the right to request a restriction on disclosures of your PHI.
• You may request that we limit our use of your PHI for treatment, payment, and health care operations
purposes. We will review and consider your request.
• AltaMed does not have to agree to your request, unless it is to a health plan or insurer and you or
someone on your behalf will be paying for all services out-of-pocket.
• To request a restriction or to revoke your authorization, you must make your request in writing to
AltaMed Health Information Management at RecordRequest@AltaMed.org. Your request must include
what information you want to be restricted, whether you want to limit the use, disclosure, or both,
whether you paid for services in-full, and/or to whom you want the limits to apply.
You have the right to request to receive confidential communications from us by alternative means or at an
alternative location.
• You have the right to ask AltaMed to contact you only in writing at a dierent address or post oce box,
or by email, text message, or telephone.
• To request a change in how you receive confidential communications, send a written request to the
AltaMed Privacy Ocer and specify how you wish to receive confidential communications.
Attention: Privacy Ocer
AltaMed Health Services Corporation
2040 Camfield Avenue
Los Angeles, CA 90040
• AltaMed will accommodate all reasonable requests when necessary to protect your safety.
You have the right to request an amendment to your PHI.
• If you believe there is a mistake in your PHI or that important information is missing, you may request that
we correct or add to the record.
• To request a change, send a written request to AltaMed Health Information Management at
RecordReques[email protected]g. You must tell us what corrections or additions you are requesting, and
why the corrections or additions should be made. We will respond in writing after reviewing your request.
• If we approve your request, we will make the correction or addition to your PHI. If we deny your request,
we will tell you why and explain your right to file a written statement of disagreement.
• AltaMed cannot change records that were not created by AltaMed, are not part of your health record, or
have been gathered for legal purposes.
• AltaMed cannot change information that is determined to be accurate and complete.
You have the right to receive a list of when your PHI was shared.
• You have the right to request a list of organizations and places with whom we shared your PHI with.
• This list will include whom we shared the information with, when we shared the information, the reason
the information was shared, and a description of the information shared.
• This list will not include when information was shared with you, shared with your permission, shared for
treatment, payment, or health care operations, and other exceptions authorized by law.
• To request an accounting of disclosures, you must submit your request in writing to AltaMed Health
Information Management at RecordRequest@AltaMed.org. Your request must include a time-frame that
is less than six-years old.
• You may receive one list every 12-months for no charge. If you require additional lists, there may be a fee.
AltaMed will inform you of this fee at the time you make your request.
You have the right to request a paper copy of this Notice of Privacy Practices.
• An electronic version of this Notice is on our website at www.AltaMed.org.
• For a paper copy of this Notice, you may contact the Privacy Ocer at
AltaMedPrivacyOce@AltaMed.org or the site where you received outpatient care.
Notice of Privacy Practices
Notice of Privacy Practices
How do you contact AltaMed to use your rights?
If you want to use any of the privacy rights explained in this Notice, you may contact the AltaMed program
or site from which you receive care or services. You may need to fill out a form to use your rights; if needed,
we can help you fill out the form. Alternatively, you can call or write to us for assistance at:
Attention: Privacy Ocer
AltaMed Health Services Corporation
2040 Camfield Avenue
Los Angeles, CA 90040
(888) 499-9303
AltaMedPrivacyOce@AltaMed.org
How do you contact AltaMed about your protected health information?
If you have questions about your PHI, call or write to us at:
Attention: Privacy Ocer
AltaMed Health Services Corporation
2040 Camfield Avenue
Los Angeles, CA 90040
(888) 499-9303
AltaMedPrivacyOce@AltaMed.org
How do you contact the AltaMed Patient Service Center?
Call the Patient Service Center at (888) 499-9303.
Complaints/questions
If you believe that we have not protected your privacy, you have the right to complain. You may file a
complaint (or grievance) by calling or writing to us at the AltaMed address below. If you have any questions
about this Notice and want further information, please contact our Privacy Ocer:
Attention: Privacy Ocer
AltaMed Health Services Corporation
2040 Camfield Avenue
Los Angeles, CA 90040
(888) 499-9303
AltaMedPrivacyOce@AltaMed.org
Use your rights without fear. We will not take retaliatory action against you if you file a complaint about our
privacy practices.
You may also file a complaint by contacting:
U.S. Department of Health and Human Services
Oce for Civil Rights – Pacific Region
90 7th Street, Suite 4-100
San Francisco, CA 94103
Toll-Free Center: (800) 368-1019
Fax: (202) 619-3818 | TDD: (800) 537-7697
Email: [email protected]v
www.hhs.gov/ocr/privacy/hipaa/complaints/
To view the most current Notice of Privacy Practices, visit www.AltaMed.org/regulatory-notices or scan
this QR code:
Notice of Privacy Practices Eective Date 6/15/23
