Washington Mountlake Terrace Occupational Therapy And Physical Therapy Course
 
 

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Notice of Privacy Practices

HIPAA (Health Insurance Portability an Accountability Act) (Rev: 03.23.09)

This notice is to describe how your medical information may be used and disclosed and also how you may access this information. Please read and review this carefully.

ACKNOWLEDGEMENT: We will use your protected health information (PHI) for the purpose of treatment, payment and health care operations.

TREATMENT: This may include disclosure of health information to other providers who have referred services for you or that are involved in your care.

PAYMENT: Disclosure of your health information will be shared with your insurance company, including Medicare and Medicaid, Office of Worker’s Compensation Programs and the Department of Labor and Industries, for the purpose of reimbursement for services rendered. Your insurance company may request to review your medical record to determine if care was needed.

HEALTH CARE OPERATIONS: Your records may be audited to monitor the quality of care that has been provided to you

OTHER SPECIAL USES: We also may need to use your PHI when sending or contacting you for a reminder of an appointment, or to inform you of an offer of promotional or charitable activities. Your confidential information will not be used for the purposes of marketing or advertising of products, goods or services unless you have granted us permission. We also utilize a number of vendors in the conduct of business. These vendors may have access to PHI but must agree to abide by the confidentiality rules of HIPAA.  

USES AND DISCLOSURES REQUIRED BY LAW: According to the federal health information privacy regulations may permit or require us to disclose or use your PHI with a family member if you have given permission, in an emergency situation if you are not capable of expressing yourself, for research purposes if assurance that your privacy has been protected. PHI may need to be disclosed if required by law. Disclosures sometimes are needed to oversee health agencies. Also if there could be a serious threat to the health or safety of you or others we may disclose PHI. Armed forces and workers’ compensation and programs that provide these benefits may require your PHI. All other purposes your authorization is needed to before we disclose PHI.

YOUR PRIVACY RIGHTS:

RESTRICTIONS: You have the right to request restrictions on how your PHI is used, but we may not grant your request.  

CONFIDENTIAL COMMUNICATIONS: You have the right to request confidential information from us at a location of your choosing. But we need this request to be in writing.

ACCESS TO PHI: You have a right to request a copy of your medical record. This request is needed in writing and there may be a fee charged to cover the copying and mailing.

AMMENDMENTS: You have the right to request an amendment be made to your PHI, if you disagree with what it says about you. Request must be in writing. We may disagree with you, and are not required to make the change. We may not amend records in the medical record that we did not make. 

ACCOUNTING OF DISCLOSURES: After April 14, 2003, you have the right to request an accounting of disclosures in the last six years. These disclosures will not include those made for treatment, payment, or health care operations of for which we have obtained authorization.

COMPLAINTS: If you feel that your privacy rights have been violated, you have the right to make a complaint in writing without fear of retaliation. Your complaint must have enough specific information for us to investigate and respond to your concerns. If you are not satisfied with our response, you can complain directly to the Secretary of Health and Human Services. 

OUR DUTY TO PROTECT YOUR PRIVACY: We are required to comply with the federal health information privacy regulations by the maintaining of your PHI. These rules require us to provide you with this document, our notice of privacy practices. We reserve the right to update this notice if required by law. If we do not update this notice at any time in the future, you will receive a revised notice when you next seek treatment from us.

WASHINGTON STATE WORKER’S COMPENSATION (if applicable): WorkAble Solutions is required by Washington State Law to disclose health information to the Department of Labor and Industries or a self-insured employer for workers' compensation or crime victims' claims. WorkAble Solutions can disclose health information to an employer including work related injury or illness, physical restrictions, physical capacities, or return to work planning. Washington State law requires your medical care provider to submit health information to the Department of Labor and Industries or Self-Insured carrier when it is required or requested.

Privacy Officer:

If you would like more information about our privacy practices or to file a complaint you may contact:

Sue Lancaster
Privacy Officer
6601 220th St. SW, #1
Mountlake Terrace, WA 98043
425-775-7274

Effective Date:
After April 14, 2003   

E-Zine Subscribers:

WorkAble Solutions is committed to protecting your privacy and safeguarding your personal information.

Our promise to you is we will never sell, rent or trade your information to others.

When you sign up for our e-newsletter, we will need an email address, which we use to send the information you requested. You will have the option to unsubscribe at any time.

If you have any questions concerning our privacy policy please call us direct at 425-775-7274 or email us at info@workable-solutions.com.