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   For All of Life's Little
   Medical Emergencies


Mountain Medical
Immediate Care

1302 NE 3rd Street

Bend, OR 97701

Phone: 541-388-7799

No Appointment

8:00   – 7:00  Mon-Fri

10:00 – 3:00  Sat-Sun

9:00   – 2:00  Holidays

Privacy Policy



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.


Mountain Medical Group (MMG) takes the privacy of your health information seriously.  We are required by law to maintain that privacy and to provide you with this Notice of Privacy Practices.  This Notice is provided to inform you about our duties and practices with respect to your information. 


In this Notice we describe the ways that we may use and disclose health information about our patients.  The HIPAA Privacy Rule requires that we protect the privacy of health information that identifies a patient, or where there is a reasonable basis to believe the information can be used to identify a patient.  This information is called “Protected Health Information” or “PHI”.  This Notice describes your rights as our patient and our obligations regarding the use and disclosure of PHI.  We are required by law to:

  • Maintain the privacy of PHI about you.
  • Give you this Notice of our legal duties and privacy practices with respect to PHI.
  • Comply with the terms of our Notice of Privacy Practices that is currently in effect.


We reserve the right to make changes to this Notice and to make such changes effective for all PHI we may already have about you.  If and when this Notice is changed, we will post a copy in our office in a prominent location.  We will also provide you with a copy of the revised Notice upon your request made to our Privacy Official.


  • For Treatment  We may use and disclose PHI about you to provide you with treatment, health care and related services.  We may disclose your health information to doctors, nurses, aids, technicians, or other employees who are involved in your care.  Additionally, we may use and disclose your PHI to your health insurance company to obtain approval for a specific procedure or treatment.  We may use and disclose your PHI to a hospital or extended health care facility if you are transferred from our facility to another.


  • For Payment  We may use and disclose PHI so that we can bill and collect payment for the treatment and service we provide to you.  We may send your health information to an insurance company or third party, including to a collection service, for billing, claims management and collection activities.


  • Health Care Operations  We may use and disclose PHI in performing business activities which are called health care operations.  These uses and disclosures are necessary to run MMG, to make sure you receive competent, quality health care, and to maintain and improve the quality of health care we provide.  This would include follow-up contact via phone or by written communication.  We may also provide your health information to accreditation entities to maintain our accreditation. 


  • Communication From Our Office  We may contact you regarding an appointment, and to provide you with information about treatment alternatives or other health related benefits and services that may be of interest to you.


  • As Required By Law  We will disclose your health information when required to do so by federal, state or local law.  MMG may disclose your health information when required by law for such incidents as suspected abuse, workman’s compensation or by a court order.


  • For Public Health Purposes  We may disclose your health information for public health activities.  While there may be others, public health activities generally include the following:  Preventing or controlling disease, injury or disability.  Reporting births and deaths.  Reporting defective medical devices or problems with medications.  Notifying people of recalls of products they may be using.  Notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition. 


  • About Victims of Abuse  We may disclose your health information to notify the appropriate government authority if we believe an individual has been the victim of abuse, neglect or domestic violence.  We will only make this disclosure if you agree or when required or authorized by law.


  • Health Oversight Activities We may disclose your health information to a health oversight agency for activities authorized by law.  These oversight activities might include audits, investigations, inspections, and licensure.  These activities are necessary for the government to monitor the health care system, government benefit programs, and compliance with civil rights laws.


  • Judicial Purposes  We may disclose your health information in response to a court or administrative order.  We may disclose your health information in response to a subpoena, discovery request, or other lawful process by someone else involved in a dispute, but only if efforts have been made to tell you about the request, in which you were given an opportunity to object to the request, or to obtain an order protecting the information requested.


  • Law Enforcement  We may disclose health information if asked to do so by a law enforcement official, if such disclosure is:  Required by law.  In response to a court order, subpoena, warrant, summons or similar process.  To identify or locate a suspect, fugitive, material witness, or missing person.  About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement.  About a death we believe may be the result of criminal conduct.  About criminal conduct at MMG.  In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.


  • Coroners, Medical Examiners and Funeral Directors  In certain circumstances, we may disclose health information to a coroner or medical examiner.  This may be necessary, for example, to identify a deceased person or determine the cause of death.  We may also release health information about individuals to funeral directors as necessary to carry out their duties.


  • Organ and Tissue Donation  We may disclose your health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation if you are an organ donor.


  • To Avert a Serious Threat to Health or Safety  We may use and disclose your health information when we believe it is necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.


  • Specialized Government Functions  Under certain circumstances we may disclose PHI for:  Certain military and veteran activities, including determination of eligibility for veterans for veterans benefits and where deemed necessary by military command authorities.  For national security and intelligence activities.  To help provide protective services for the president and others.  For the health or safety of inmates and others at correctional institutions or other law enforcement custodial situations for the general safety and health related to corrections facilities.


  • Workers’ Compensation  We may disclose your health information as authorized by and to the extent necessary to comply with workers’ compensation laws or laws relating to similar programs.


  • Individuals Involved in Your Care or Payment for Your Care  We may disclose health information about you to a family member, other relative or any other person identified by you who are involved in your health care. If you are present and able to consent or object then we may only use or disclose PHI if you do not object after you have been informed of your opportunity to object.  If you are not present or you are unable to consent or object, we may exercise professional judgment in determining whether the use or disclosure of PHI is in your best interests.


  • Other Uses of Health Information  Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written authorization.  If you provide us with authorization to use or disclose your PHI, you may revoke this authorization in writing. 



  • Right to Request Restrictions  You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations.  You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care.  We are not required to agree to your request.  If we do agree to your request, we are required to comply with our agreement except in certain cases, including where the information is needed to treat you in the case of an emergency.  To request restrictions, you must make your request in writing to our Privacy Official.  In your request, please include the information that you want to restrict, how you want to restrict the information, and to whom you want those restrictions to apply.


  • Right to Receive Confidential Communications  You have the right to request that you receive communications regarding PHI in a certain manner or at a certain location.  You must make your request in writing to our Privacy Official and you must specify how you would like to be contacted.  We are required to accommodate reasonable requests.


  • Right to Inspect and Copy  You have the right to request the opportunity to inspect and receive a copy of PHI about you in certain records that we maintain.  This includes your medical and billing records but does not include psychotherapy notes or information gathered or prepared for a civil, criminal, or administrative proceeding.  We may deny your request to inspect and copy PHI only in limited circumstances.  If you request a copy of PHI about you, we may charge you a reasonable fee for the copying, postage, labor and supplies used in meeting your request.  This request must be in writing.


  • Right to Amend  You have the right to request that we amend PHI about you as long as such information is kept by or for our office.  To make this type of request you must submit your request in writing to our Privacy Official.  You must also give us a reason for your request.  We may deny your request in certain cases, including if it is not in writing or if you do not give us a reason for the request.


  • Right to Receive an Accounting of Disclosures  You have the right to request an accounting of certain disclosures that we have made of PHI about you.  This is a list of disclosures made by us during a specified period of up to six years other than the disclosures made for treatment, payment and health care operations, for use in or related to a facility directory, to family members or friends involved in your care, to you directly, or pursuant to an authorization by you or your personal representative.


  • Right to a Paper Copy of this Notice  You have a right to receive a paper copy of this Notice at any time.  You are entitled to a paper copy of this Notice even if you have previously agreed to receive this Notice electronically.  To obtain a paper copy of this Notice, please contact our Privacy Official listed on the last page of this Notice. 


  • Complaint   If you believe your privacy rights have been violated, you may file a complaint with us or the Secretary of the United States Department of Health and Human Services.  To file a complaint with our office, please contact our Privacy Official at the address and number listed below.  We will not retaliate or take action against you for filing a complaint.


Privacy Offical

1302 NE 3rd Street

Bend, OR 97701

541-317-0909 ext.222