The privacy of your health information is important to us. We will maintain the privacy of your health information and we will not disclose your information to others unless you tell us to do so, or unless the law authorizes or requires us to do so.
A federal law commonly known as HIPAA requires that we take additional steps to keep you informed about how we may use information that is gathered in order to provide health care services to you. As part of this process, we are required to provide you with the following Notice of Privacy Practices and (when you come to our clinics) to request that you sign a written acknowledgement that you received a copy of the Notice.
The Notice 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. This Notice also describes your rights regarding health information we maintain about you and a brief description of how you may exercise these rights.
Please take a moment to review our Notice of Privacy Practices. If you have any questions about this Notice please contact the Care Center Manager at your provider’s office, or our Privacy Officer at (425) 259-4041.
WESTERN WASHINGTON MEDICAL GROUP
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.
We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, legal obligations, and your rights concerning your health information (“Protected Health Information” or “PHI”). We must follow the privacy practices that are described in this Notice (which may be amended from time to time).
For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.
I. USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
A. Permissible Uses and Disclosures without Your Written Authorization
We may use and disclose PHI without your written authorization for certain purposes as described below. The examples provided in each category are not meant to be exhaustive, but instead are meant to describe the types of uses and disclosures that are permissible under federal and state law.
- Treatment: We may use and disclose PHI in order to provide treatment to you. For example, we may use PHI including your medication history to diagnose, treat, and provide medical services to you. In addition, we may disclose PHI to other health care providers involved in your treatment.
- Payment: We may use or disclose PHI for the purposes of determining coverage, billing, claims management, and reimbursement. For example, a bill sent to your health insurer may include information about a surgery you received so that the insurer will pay us for the surgery. We may also inform your health plan about a treatment you are going to receive in order to determine whether the plan will cover the treatment.
- Health Care Operations: We may use and disclose PHI in connection with our health care operations, including quality improvement activities, training programs, accreditation, certification, licensing or credentialing activities. For example, we may use PHI to review our treatment and services and to evaluate the performance of our staff. We may also disclose PHI to our health care professionals for review and learning purposes.
Western Washington Medical Group is part of a HIPAA organized health care arrangement (“OHCA”) with participating providers of the Physician Care Alliance. As participants in the OHCA, Western Washington Medical Group and the other OHCA participants engage in quality assessment and improvement activities through which treatment provided by each organization is assessed by the other participants. As permitted by HIPAA, Western Washington Medical Group may share the health information of its patients with the OHCA participants when necessary for health care operations purposes of the OHCA. - Required or Permitted by Law: We may use or disclose PHI when we are required or permitted to do so by law. For example, we may disclose PHI to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. In addition we may disclose PHI to the extent necessary to avert a serious threat to your health or safety or the health or safety of others. Other disclosures permitted or required by law include the following: disclosures for public health activities; health oversight activities including disclosures to state or federal agencies authorized to access PHI; disclosures to judicial and law enforcement officials in response to a court order or other lawful process; disclosures for research when approved by an institutional review board; disclosures for workers’ compensation claims; and disclosures to military or national security agencies, coroners, medical examiners, and correctional institutions as otherwise as authorized by law.
- Fundraising. We may contact you for the purpose of raising funds for our own benefit. We may also disclose PHI to a foundation that is related to us so that the foundation may contact you in an effort to raise funds for our benefit. Any fundraising communications with you will include a description of how you may opt out of receiving any further fundraising communications.
B. Permissible Uses and Disclosures That May be Made Without Your Authorization, But for Which You have an Opportunity to Object
- Family and Other Persons Involved in Your Care. We may use or disclose health information to notify, or assist in the notification of (including identifying or locating) a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination using our professional judgment disclosing only health information that is directly relevant to the person’s involvement in your healthcare. We will also use our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays, or other similar forms of PHI.
- Disaster Relief Efforts. We may use or disclose PHI to a public or private entity authorized by law or its charter to assist in disaster relief efforts for the purpose of coordinating notification of family members of your location, general condition, or death.
C. Uses and Disclosures Requiring Your Written Authorization.
- Marketing Communications; Sale of PHI. We must also obtain your written authorization prior to using or disclosing PHI for marketing purposes or the sale of PHI, consistent with the related definitions and exceptions set forth in HIPAA.
- Psychotherapy Notes. We must also obtain your authorization for any use or disclosure of psychotherapy notes, except if our use or disclosure of psychotherapy notes is: (1) by the originator of the psychotherapy notes for treatment purposes; (2) for our own training programs in which mental health students, trainees or practitioners learn under supervision to practice or improve their counseling skills; (3) to defend ourselves in a legal proceeding initiated by you; (4) as required by law; (5) by a health oversight agency with respect to the oversight of the originator of the psychotherapy notes; (6) to a coroner or medical examiner; or (7) to prevent or lessen a serious and imminent threat to the health or safety of a person or the general public.
- Uses and Disclosures of Your Highly Confidential Information. In addition, federal and state law requires special privacy protections for certain highly confidential information about you, including the subset of your PHI that: (1) is about mental health and developmental disabilities services; (2) is about alcohol and drug abuse prevention, treatment and referral; (3) is about HIV/AIDS testing, diagnosis or treatment; (4) is about venereal disease(s); (5) is about genetic testing; (6) is about child abuse and neglect; (7) is about domestic abuse of an adult with a disability; or (8) is about sexual assault. In order for us to disclose your Highly Confidential Information for a purpose other than those permitted by law, we must obtain your written authorization.
- Other Uses and Disclosures. Uses and disclosures other than those described in this Notice will only be made with your written authorization. For example, you will need to sign an authorization form before we can send PHI to your life insurance company, to a school, or to your attorney. You may revoke any such authorization at any time by providing us with written notification of such revocation.
II. YOUR INDIVIDUAL RIGHTS
A. Right to Inspect and Copy
You may request access to your medical record and billing records maintained by us in order to inspect and request copies of the records. All requests for access must be made in writing. Under limited circumstances, we may deny access to your records. We may charge a fee for the costs of copying and sending you any records requested.
B. Right to Alternative Communications
You may request, and we will accommodate, any reasonable written request for you to receive PHI by alternative means of communication or at alternative locations.
C. Right to Request Restrictions
You have the right to request a restriction on PHI we use or disclose for treatment, payment or health care operations. You must request any such restriction in writing addressed to the Privacy Officer as indicated below. We are not required to agree to any such restriction you may request, except if your request is to restrict disclosing PHI to a health plan for the purpose of carrying out payment or health care operations and is not otherwise required by law, and the PHI pertains solely to a health care item or service which has paid in full by you or another person or entity on your behalf.
D. Right to Accounting of Disclosures
Upon written request, you may obtain an accounting of certain disclosures of PHI made by us subject to certain restrictions and limitations.
E. Right to Request Amendment
You have the right to request that we amend your PHI. Your request must be in writing, and it must explain why the information should be amended. We may deny your request under certain circumstances.
F. Right to Obtain Notice
You have the right to obtain a paper copy of this Notice by submitting a request to our Privacy Officer at any time.
G. Right to Receive Notification of a Breach
We are required to notify you if we discover a breach of your unsecured PHI, according to requirements under federal law.
H. Questions and Complaints
If you desire further information about your privacy rights, or are concerned that we have violated your privacy rights, you may contact the Privacy Officer at (425) 259-4041. You may also file a written complaint with the Director, Office for Civil Rights of the U.S. Department of Health and Human Services.
We will not retaliate against you if you file a complaint with the Director or our Privacy Officer.
III. EFFECTIVE DATE AND CHANGES TO THIS NOTICE
A. Effective Date
This Notice is effective on January 24, 2019.
B. Changes to this Notice
We may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective for all PHI that we maintain, including any information created or received prior to issuing the new notice. If we change this Notice, we will post the revised notice in the waiting area of our office(s) and on our website at www.wwmedgroup.com. You may also obtain any revised notice by contacting the Privacy Officer at (425) 259-4041.
Acknowledgment of Conditions for Treatment & Financial Disclosures (PDF)