Notice of Privacy Practices

Montana Pediatrics

1297 Burns Way #1, Kalispell, MT 59901

Attention:
Chelsea Bodnar, Chief Executive Officer and Privacy Officer
406-272-4631
contact@montanapediatrics.org

The effective date of this notice is March 17, 2025.

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.

Your Rights

When it comes to your medical information, you have certain rights. This section explains your rights and Logan Health’s responsibilities to help you.

Get an electronic or paper copy of your medical record

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health information, usually within 30 days of your 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. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We will say “yes” to 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 operations. We are not required to agree to your request, and we may say “no” 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. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared your information

• You can ask for a list (accounting) of the times we’ve shared your medical information for six years prior to the date you ask, who we shared it with, and why.
• Please let us know what form you want the list (e.g., on paper, electronically).
• We will include all the disclosures except for those about treatment, payment, to run our organization, and certain other ways we share (such as any you asked us to make).
• We will provide one list per year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

• You can ask for a paper copy of this Notice at any time, even if you have agreed to receive this Notice electronically. We will provide you with a paper copy promptly.

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 we take any action.

File a complaint if you feel your privacy rights are violated

• You can call the Logan Health Corporate Compliance Office at (833) 594-0321 with questions.
• All complaints need to be submitted in writing to Logan Health, Corporate Compliance Office, 310 Sunnyview Lane, Kalispell, MT 59901 or in writing by email at complianceoffice@logan.org.
• 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 (877) 696-6775, or visiting https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf
• We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, we never share your information unless you give us written permission.

• Marketing purposes
• Sale of your protected health information
• Most sharing of psychotherapy notes

Drug or Alcohol Abuse Treatment

In the event that Logan Health facilities, units, and staff provide substance use disorder treatment (Programs), the confidentiality of substance use disorder patient records maintained by these Programs is protected by special federal law and regulations, in addition to HIPAA. Generally, such a Program may not say to a person outside the Program that a patient attends the Program, or share any information identifying a patient as having or having had a substance use disorder unless: the patient consents in writing, the disclosure is allowed by a court order, or the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation.

Other Information

Who is Covered by this Notice

This notice applies to the following Logan Health entities and providers:

• Any health care professional authorized to enter information into your Logan Health facility medical record, such as doctors, nurses, physician assistants, and technologists.
• All departments and units of Logan Health facilities, including hospitals, outpatient facilities, physician practices, skilled nursing facilities, home health agencies, hospices, urgent care centers, and emergency departments.
• All Logan Health facility employees, staff, students, volunteers, contractors, and other personnel.
• All third party business partners that assist Logan Health with providing technology tools or other healthcare operations.

If you would like a list Logan Health entities, please send a written request to the Privacy Officer at the address listed at the top of this Notice.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach of your unsecured protected health information.
• We must follow the duties and privacy practices described in this Notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

Changes to this Notice

Logan Health can change the terms of this Notice, and the changes will apply to all information we have about you. The new Notice will be available upon request, in our offices and clinics, and on our web site at www.logan.org.

Disclaimer: Montana Pediatrics is a participating member of the Logan Organized Health Care Arrangement (OHCA). As part of this affiliation, Montana Pediatrics follows the Logan OHCA Notice of Privacy Practices (NPP). This participation may be reflected on our website through the posting of the Logan OHCA NPP. Montana Pediatrics regularly reviews its HIPAA policies to ensure compliance and may align with Logan’s policies as needed. Additionally, as part of the OHCA, Montana Pediatrics engages in required joint activities, such as utilization review and quality assessment and improvement initiatives.