The privacy practices at the West Seattle, Lynwood and White Center locations may differ from those in place here.
If you have any questions about this Notice please contact our Privacy Officer.
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain at that time. The most current version of this notice is available by accessing our website www.seattledoctors.com, calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment. You may also opt to be notified of any changes to this notice via e-mail by contacting our Privacy Officer.
1. Uses and Disclosures of Protected Health Information Based On Your Written Consent
You will be asked by your physician to sign a consent form which permits your physician to use or disclose your protected health information to provide treatment, obtain payment for treatment and in the business operations of our practice as follows:
Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. For example, we may disclose your protected health information from time-to-time to another physician or health care provider who becomes involved in your care by providing assistance with your health care diagnosis or treatment such as a medical laboratory or anesthesiologist.
Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it pays for the health care services we recommend for you, such as reviewing services provided to you for medical necessity.
Healthcare Operations: We may use or disclose your protected health information in order to support the business activities of your physician’s practice. For example, we may disclose your protected health information to medical school students or other medical professionals that see patients or observe treatment at our office. We may also call you by name in the waiting room when your physician is ready to see you. It is also our practice to contact you by phone to remind you of appointments.
We will share your protected health information with third party “business associates” that perform various activities such as transcription services for the practice.
2. Uses and Disclosures of Protected Health Information Based upon Your Written Authorization
Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke any authorization you grant, at any time. On revoking an authorization, you will be asked to sign a release of responsibility and liability for any use or disclosure previously made by your physician or the physician’s practice in reliance on the authorization while it was in effect.
3. Other Permitted and Required Uses and Disclosures That May Be Made With Your Consent, Authorization or Opportunity to Object
We may use and disclose your protected health information in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information. If you are not present or able to agree or object to the use or disclosure of the protected health information, then your physician may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the protected health information that is relevant to your health care will be disclosed.
Facility Directories: Unless you object, we will use and disclose in our facility directory your name, the location at which you are receiving care, your condition (in general terms), and your religious affiliation. All of this information, except religious affiliation, will be disclosed to people that ask for you by name. Members of the clergy will be told your religious affiliation.
Others Involved in Your Healthcare: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.
Emergencies: We may use or disclose your protected health information in an emergency treatment situation. If this happens, your physician shall try to obtain your consent as soon as reasonably practicable after the delivery of treatment.
Communication Barriers: We may use and disclose your protected health information if your physician or another physician in the practice attempts to obtain consent from you but is unable to do so due to substantial communication barriers and the physician determines, using professional judgment, that you intend to consent to use or disclosure under the circumstances.
4. Other Permitted and Required Uses and Disclosures that may be made without your consent, authorization or opportunity to object
You will be notified of any occurrence when we are required by law to disclose your information without first obtaining your authorization. Circumstances that require us to make disclosures without your authorization include:
Public Health: We may disclose your protected health information for public health purposes to a public health authority that is permitted by law to collect or receive the information.
Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.
Abuse or Neglect: We may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental agency authorized to receive such information.
Food and Drug Administration: We may disclose your protected health information to a person or company as required by the Food and Drug Administration in the interest of public health.
Legal Proceedings: We may disclose protected health information in accordance with an order of a court or administrative tribunal or in response to a subpoena, discovery request or other lawful process.
Law Enforcement & Criminal Activity: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes. Examples of such purposes include, but are not limited to:
1. Pertaining to victims of a crime
2. Suspicion that death has occurred as a result of criminal conduct
3. To prevent or lessen a personal or public threat
4. To aid in the identification or apprehension of an individual.
Coroners, Funeral Directors, and Organ Donation: We may disclose protected health information to a coroner, funeral director or medical examiner to perform duties authorized by law and to facilitate authorized organ donations.
Research: We may disclose information to researchers when their research is approved by an institutional review board that has established protocols to ensure the privacy of your protected health information.
Military Activity and National Security: We may disclose information related to military personnel to an appropriately authorized military authority. We may also disclose protected health information to authorized federal officials for national security and intelligence activities.
Workers’ Compensation: Your protected health information may be disclosed by us as authorized to comply with workers’ compensation laws and other similar legally-established programs.
Inmates: We may use or disclose your protected health information if you are an inmate of a correctional facility and your physician created or received your protected health information in the course of providing care to you.
Required Uses and Disclosures: Under the law, we must make disclosures to the Secretary of the Department of Health and Human Services to investigate or determine our compliance with privacy laws.
5. Your Rights
The following is a summary of your rights with respect to your protected health information and a brief description of how you may exercise these rights. Your rights under federal law do not extend to the following records; psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to laws prohibiting access to protected health information. Please contact our Privacy Officer if you have questions about exercising your rights.
You have the right to inspect and copy your protected health information. You may inspect and obtain a copy of protected health information about you that is contained in our records for as long as we maintain the protected health information including billing records and any other records we maintain about you.
You have the right to request a restriction of your protected health information. You may ask us not to use or disclose your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends. Your request must state the specific restriction requested and to whom you want the restriction to apply.
If your physician believes it is in your best interest to permit use and disclosure of your protected health information, it will not be restricted. If your physician does agree to the requested restriction, we may not use or disclose restricted information unless needed to provide emergency treatment. You may request a restriction by completing a Request for Restriction Form (available at the front desk).
You have the right to request confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled, specification of an alternative address or other method of contact. We will not request an explanation from you as to the basis for the request.
You have the right to request an amendment to your protected health information. You may request an amendment to information about you in our records for as long as we maintain this information. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement. Please contact our Privacy Officer if you have questions about requesting an amendment to your medical record.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. You have the right to receive specific information regarding disclosures that occurred after April 14, 2003. You may request a shorter timeframe. The right to receive this information is subject to certain exceptions, restrictions and limitations.
You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.
6. Complaints
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer of your complaint. We will not retaliate against you for filing a complaint.
If you have questions about the complaint process, or any other questions regarding this notice, please contact our reception desk and ask to speak with our Privacy Officer.
This notice was published and becomes effective on April 24th, 2003.
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