Notice of Privacy Practices


Cheyenne Regional Medical Center and Cheyenne Regional Medical Group (Cheyenne Regional) are committed to the confidentiality of your medical records as set forth in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). We are required by law to follow our Notice of Privacy Practices that is currently in effect. This notice describes the following:

  • How your medical information may be used and disclosed both inside and outside of Cheyenne Regional
  • How you may gain access to your medical information
  • Your medical information
  • How we will notify you in the event of a breach of your protected health information (PHI)



  1. Uses and disclosures of your medical information that Cheyenne Regional may make without your authorization.
    1. TREATMENT: We will use your medical information to provide you with medical care. This includes disclosures to other healthcare providers inside and outside of Cheyenne Regional so that they may provide you with medical and follow-up care. We may also provide you with appointment reminders, provide you with information about treatment options, have nurses call you upon discharge to inquire about your recovery and provide you with a survey after discharge so that you may evaluate your stay or appointment at Cheyenne Regional.
    2. PAYMENT: We may use and disclose your medical information to facilitate payment for services provided to you (such as communicating with your insurance company to obtain pre-authorization for services or payment for treatments provided).
    3. OPERATIONS: We may use and disclose your information for certain practices, including quality improvement, education and workforce training.
    4. OTHER USES AND DISCLOSURES AS REQUIRED BY LAW: There are other uses and disclosures of your protected health information that we may need to make without your authorization that are either allowed under HIPAA (specifically 42 CFR § 164.512) or are required by other laws, including the following:
      1. To avert or avoid a serious threat to your health or safety or the health or safety of others
      2. For public health oversight activities such as reporting certain diseases, audits, investigations or licensure actions
      3. For reporting certain instances of abuse or neglect as required by state or federal law
      4. For workers compensation purposes if making a claim
      5. To respond to court order, warrant, subpoena or administrative hearings, or to respond to certain requests from law enforcement officials
      6. For research purposes if certain conditions are satisfied
      7. For specialized government functions such as for the military or for correctional institutions
      8. To respond to coroners, funeral directors or organ procurement organizations to allow them to perform their duties
  2. Disclosures we may make unless you object.
    1. Please note that in certain situations when Cheyenne Regional feels it is appropriate, we may disclose your information unless you instruct us otherwise.
      1. To a family member, friend or other individual who is involved in your healthcare or who is involved in the payment for your healthcare. In these situations, we will be sure to limit the disclosure to only the relevant information to assist with your care or to effectuate payment.
      2. For the facility directory. For inpatients only, we maintain a facility directory. If someone asks for you by name, we will disclose information about your general condition (for example, critical, poor, fair or good) and where you are located within the hospital. You may at any time during your stay request to be made a ‘”privacy patient,” at which time your name will not be listed in the facility directory.
      3. If you denote your religious affiliation, we will disclose that information to clergy, if you do not object.
      4. For fundraising purposes. To opt out of fundraising materials, please contact that Cheyenne Regional Medical Center Foundation at (307) 633-7667.
  3. Uses and disclosures made with your Written Authorization.
    1. Uses and disclosures not described in this notice will only be made with your written authorization, including the following:
      1. Most uses and disclosures of psychotherapy notes
      2. Uses of your identifiable information for marketing purposes
      3. If Cheyenne Regional wishes to sell any of your information
  4. Your rights regarding your protected health information.
    1. When it comes to your protected health information, you have the following rights. These rights can be exercised by submitting a written request to Cheyenne Regional’s Privacy Officer or Cheyenne Regional’s Health Information Management Department.
      1. Additional restrictions: You may request restrictions when it comes to your protected health information and how we use it for your treatment or payment operational purposes. We are NOT required to agree with your request, unless you have paid for a service and you do not want information about that service going to your health insurer.
      2. Normal contact requests: We typically call and send mail to your home. You can request that we contact you through alternate means, and we will try to honor all reasonable requests.
      3. Inspection and copies of medical records: You have a right to a copy of your medical records or to inspect an electronic version of your medical records. We may charge a reasonable cost-based fee to fulfill your request. We may deny your request for medical records under certain limited circumstances.
      4. Amendments: You may request that your personal health information be amended. We may deny such a request if we believe the record is accurate or if we did not create the medical record which you are asking to be amended.
      5. Accounting for disclosures: You have the right to receive an accounting of certain disclosures we have made of your protected health information. The first request in a twelve (12)-month period will be free of charge. Subsequent requests during the same 12-month period may be charged a reasonable cost-based fee.
      6. Paper copy of notice: You have a right to receive this notice in a paper format upon your request.
  5. Changes to this notice: Cheyenne Regional reserves the right to change the terms of this privacy notice when deemed necessary, and to make any subsequent notices effective for all protected health information we maintain. The current privacy notice in effect will be posted on Cheyenne Regional’s website.
  6. Complaints: You may complain to the Privacy Officer at Cheyenne Regional Medical Center or to the Health and Human Services Office of Civil Rights if you believe your privacy rights have been violated. All complaints must be in writing. You will not be retaliated or discriminated against because you lodge a complaint.
  7. Contact Information: If you have any questions about this notice, or if you want to object to or complain about any use or disclosure of your protected health information, or to exercise any rights explained above, please contact the following: Privacy Officer, (307) 432-6624, 214 East 23rd Street, Cheyenne WY 82001; or
  8. Effective Date: This notice is effective September 23, 2013.