Notice of Privacy Practices
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. Effective date August 8th, 2023.
Introduction
Skyreach Behavioral Health LLC is committed to protecting the confidentiality of information about You and is required by law to do so. This notice describes how we may use information about You within Skyreach Behavioral Health LLC and how we may disclose it to others outside Skyreach Behavioral Health LLC. We will notify you if there is a breach of your unsecured protected health information. This notice also describes the rights you have concerning your own health information.
How will we use and disclose information about you?
Treatment
Skyreach Behavioral Health LLC may use information about you to provide you with behavioral health services and supplies. We may also disclose information about you to others that need the information to treat you, such as doctors, physician assistants, nurses, medical and nursing students, technicians, therapists, emergency service and medical transportation providers, medical equipment providers and others involved in your care. For example, we will allow your physician to have access to your medical record to assist in your treatment and for follow up care. We may make your medical information available electronically through an electronic health information exchange to other health care providers and health plans that request your information for their treatment and payment purposes.
We may also use and disclose information about you to contact you to remind you of an upcoming appointment, to inform you about possible treatment options or alternatives, or to tell you about health-related services available to you.
Facility Directory
Unless you object, Skyreach Behavioral Health LLC will include your name, location in our facility, your general condition (e.g., fair, stable, critical) and your religious affiliation in our facility directory. All of this information, except religious affiliation, will be disclosed to people that ask for you by name. Information in the facility directory may be shared with clergy.
Patient Rights and Responsibilities
Patient Satisfaction
We know you have a choice. Our staff is dedicated to provide you an exceptional patient experience.
Patient Rights
As a patient, according to AS R9-10-1008 you have the right to:
Public Health
Skyreach Behavioral Health LLC may report certain medical information for public health purposes. For instance, we are required by law to report births, deaths, and communicable diseases to the state.
We may also need to report patient problems with medications or medical products to the manufacturer and to the FDA.
Public Safety
Skyreach Behavioral Health LLC may disclose medical information for public safety purposes in limited circumstances. We may disclose medical information to law enforcement officials or to the court in response to a search warrant or other court order. We may also disclose medical information to assist law enforcement officials in identifying or locating a person, to prosecute a crime of violence, to report deaths that may have resulted from criminal conduct at the facility. We may also disclose information about you to law enforcement officials and others to prevent a serious threat to health or safety.
Health Oversight Activities
Skyreach Behavioral Health LLC may disclose medical information to a government or oversight agency that oversees Skyreach Behavioral Health LLC or its personnel, such as the state’s department of health services, or other federal agencies that oversee Medicare, or licensing agencies who govern physicians and other healthcare professionals.
Coroners, Medical Examiners and Funeral Directors
Skyreach Behavioral Health LLC may disclose medical information concerning deceased patients to coroners, medical examiners and funeral directors to assist them in carrying out their duties.
Organ and Tissue Donations
Skyreach Behavioral Health LLC may disclose medical information to organizations that handle organ or tissue donation or transplantation.
Military Veterans, National Security and Other Government Purposes
If you are a member of the armed forces, we may release information about you as required by military command authorities or to the Department of Veterans Affairs. We may also disclose medical information to federal or state officials for intelligence and national security purposes.
Judicial Proceedings
Skyreach Behavioral Health LLC may disclose medical information in a lawsuit where your health status is an issue. For example, Skyreach Behavioral Health LLC may be ordered to do so by court order or search warrant.
Right to Request Restrictions on How Skyreach Behavioral Health LLC Will Use or Disclose Information About You for Treatment, Payment, or Health Care
Operations
You have the right to request us not to use or disclose information about you to treat you, to seek payment for care, or to operate the health care system. We are not required to agree to your request, but if we do agree, we will comply with that agreement unless that information is necessary to provide you emergency treatment. You may request that we withhold information from your health plan for the purpose of payment or healthcare operations provided it is not otherwise required by law. If you want to request a restriction to your medical information, you may contact Health Information Management Services or for billing information, you may contact the Business Office.
You have the right to pay for an item or service and elect not to have this information about vou submitted to your health plan.
We are not required to accept your request until you have paid for this service or item. We are not required to notify other healthcare providers of these types of restrictions, this is your responsibility.
Right to Request Confidential Communications
You have the right to requests us to communicate with you in a way that you feel is more confidential. You can ask to speak with your health care providers in private, outside the presence of other patients. We will accommodate reasonable requests including alternative addresses or alternative means. For example, you can ask us not to call your home, but to communicate only by mail. To do this, submit your request in writing to Health Information Management Services.
Right to a Copy of Skyreach Behavioral Health LLC’s Notice of Privacy Practices
You have the right to a paper copy of the Notice at any time. You may obtain a copy of the Notice from our web site at www.skyreachbh.com or you may obtain a paper copy of the Notice at the Business Office.
Changes To This Notice
We may amend or revise our practices concerning how we will use or disclose patient medical information, or how we will implement patient rights concerning their information. We reserve the right to change this Notice and to make the provisions in our new notice effective for all your information. If we change these practices, we will publish a revised Notice of Privacy Practices.
Fee Schedule
In accordance with ARS 5 36-436001 (C) A schedule of rates is available
For review upon patient request, If you wish to see the fee schedule, please ask a staff member and they will assist you.
License Inspection Reports
In accordance with ADRS 5 36-425 (D)
Current license inspection reports are maintained on site, License Inspection Reports are maintained by the Office Manager, Administrator, or designee and are available for review.
Patient information is redacted, If you wish to see fee schedule, please ask a staff member and they will assist you.
How to file a complaint
If you or your personal representative experience concerns about your visit, you may contact the Office Manager by phone at (602) 314-4745 or by email at admin@skyreachbh.com.
You or your representative may also submit a concern directly to: Arizona
Department of Health Services
602-364-3030
150 N 18th Avenue, Suite 450
Phoenix, AZ 85007-3245
www.azdhs.gov
It is the policy of Skyreach Behavioral Health LLC not to discriminate against any patient and/or visitor on the basis of disability, race, color, national origin, age, sexual orientation, gender identity or gender expression.
We adhere to an equal opportunity policy for all persons seeking admission and treatment. It is our policy to promptly resolve any complaints regarding care, services or alleged action prohibited by section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, the Age Discrimination Act, or Title VI of the Civil Rights Act. The use of this complaint policy does not preclude the filing of a complaint with the Department of Health & Human Services Office for Civil Rights or with the State Attorney General.
Family Members and Others Involved in Your Care
Skyreach Behavioral Health LLC may disclose information about you to a family member or friend who is involved in your medical care. If you do not want the facility to disclose information about you to family members or others, you must notify the registration and clinical staff at the facility. In the event of a disaster, we may disclose information about you to help locate a family member or friend in a disaster.
Payment
Skyreach Behavioral Health LLC may use and disclose information about you to get paid for the behavioral health services and supplies we provide to you. For example, your health plan or health insurance company may request to see parts of your medical record before they will pay us for your treatment.
Health Care Operations
Skyreach Behavioral Health LLC may use and disclose information about you if it is necessary to improve the quality of care we provide to patients or for health care operations. We may use information about you to conduct quality improvement activities, to obtain audit, accounting or legal services, or to conduct business management and planning. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you.
Fundraising
Many of our patients like to make contributions to support the care provided by Skyreach Behavioral Health LLC. Skyreach Behavioral Health LLC may contact you in the future to raise funds for this purpose. You will be provided the option of not receiving these communications. Your medical information is not shared for the purpose of fundraising.
Research
Skyreach Behavioral Health LLC may use or disclose information about you for research projects, such as studying the effectiveness of a treatment you received. These research projects must go through a special process that protects the confidentiality of your information.
Required by Law
Federal, state, or local laws do not require patient consent to disclose information which is required to be reported. For instance, we are required to report child abuse and neglect, gunshot wounds, etc. Public policy has determined that these types of needs outweigh the patient’s right to privacy. Skyreach Behavioral Health LLC is also required to give information to the state workers’ compensation program for work-related injuries.Information with Additional
Protection
Certain types of medical information may have additional protection under state or federal law. For instance, medical information about communicable disease, HIVIAIDS, drug and alcohol abuse treatment, psychotherapy notes, genetic testing, or a court-ordered mental evaluation. Skyreach Behavioral Health LLC may obtain your authorization to release this information except as required by law.
Other Uses and Disclosures
Other uses and disclosures not described in this Notice will be made only with your written authorization such as sale of medical information. You may revoke such an authorization by sending us a written request.
What are your rights?
Right to Request Information About You
You or your legally authorized representative are entitled to online access of documents available, review or receive paper copies, or request an electronic delivery of your health information. This includes your medical and billing information. If you request a copy of your information, we may charge you for our costs. We will tell you in advance what this cost will be.
Right to Request to Amend or Supplement Information About You That You Believe is Incorrect or Incomplete
If you see information about you and believe that some of the information is incorrect or incomplete, you may ask us to amend your record. You may submit a request to amend your medical information by contacting Health Information Management Services or the Business Office for your billing information.
Right to Get a List of Certain Disclosures of Information About You
You have the right to request a list of certain disclosures we made of information about you. If vou would like to receive such a list, contact Health Information Management Services. We will provide the first list to you at no charge, but we may charge you for any additional lists you request during a twelve-month period. We will tell you in advance what this list will cost.
Which healthcare providers does this notice cover?
This Notice of Privacy Practices applies to Skyreach Behavioral Health LLC and its personnel, volunteers, students, and trainees. The Notice also applies to other health care providers that come to the facility to care for patients, such as physicians, physician assistants, therapists, emergency services providers, medical transportation companies, medical equipment suppliers, and other health care providers not employed by Skyreach Behavioral Health LLC unless these health care providers give you their own Notice of Privacy Practices. Skyreach Behavioral Health LLC may share your medical information with other health care providers for their treatment, payment, and health care operations.
Do you have concerns or complaints?
Please tell us about any problems or concerns you have with your privacy rights or how Skyreach Behavioral Health LLC uses or discloses information about you. If you have a concern, you may contact Patient Relations/Administration by calling our main switchboard at (602) 314-4745 and they will direct your call to the appropriate department. You may also file a complaint with the U.S. Department of Health & Human Services Office for Civil Rights. We will not penalize you or take any retaliatory action against you in any way for filing a complaint with the federal government.
Do you have questions?
Skyreach Behavioral Health LLC is required by law to give you this Notice and to follow terms of the Notice that is currently in effect. If you have any questions about this Notice, or have further questions about how we may use and disclose information about you, please contact Patient Relations/Administration.
Important Phone Numbers
Arizona Department of Health Services: (602) 542-1025
150 N 18th Avenue
Phoenix, AZ 85007
May contact the phone number above to submit a complaint
AHCCCS Clinical Resolution Unit: (602) 364-4558
Arizona Department of Health Services Office of Human Rights Advocates: (602) 364-4585
Arizona Department of Health Services Bureau of Medical Facilities Licensing: (602) 364-3030
Arizona DES Adult Protective Services: (602) 542-5978
Arizona Department of child Services: (888) 767-2445
Arizona Center for Disability Law: (602) 274-6287
Skyreach Behavioral Health LLC Patient Advocate: (602) 314-4745
We Offer Compassionate Support as Well as Professional Treatment to Assist You in Finding Your Path to Wellness.
