JOINT NOTICE OF PRIVACY PRACTICES
Effective Revised Date: April 1, 2013 – Original Effective Date: April 14, 2003
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.
This joint notice of privacy practices applies to all of the health information created or received by the medical staff members, healthcare workers, employees, contract staff, students, trainees and volunteers at all Northwest Kidney Centers buildings and programs, including:
Solely for purposes of complying with the federal privacy laws, Northwest Kidney Centers and its medical staff, which includes members of the Division of Nephrology from the University of Washington, characterize themselves as an “organized health care arrangement” and have agreed to follow this notice for services provided by, at, or through Northwest Kidney Centers. These providers may share health information with each other for treatment, payment, and the health care operations of the organized health care arrangement and as described in this notice. Northwest Kidney Centers is not responsible for actions by independent medical staff members.
Personal Health Information About You
When you are first admitted, and each time you visit a center, a record of your visit is made. This information serves as a:
We are required to retain our records of the care that we provided to you. The following lists categories of different ways we use and disclose health information. Not every use of disclosure in a category will be listed. In most of these situations, we will use and disclose only the minimum health information necessary for the intended purpose. Certain health information may be subject to additional confidentiality protections.
Uses and Disclosures of Your Health Information
for Treatment, Payment and Health Care Operations
Treatment: We may use and disclose your health information to give you care and to coordinate and manage your treatment or other services. For example, a doctor needing to perform surgery on you may need to know if you are on dialysis because this may affect the surgery care plan. Also, we will provide your health information to a doctor who is seeing you in his or her office.
Payment: We may use and disclose your health information to bill and collect payment from you or your health insurance plan for services received. We will get your authorization to disclose this information. For example, we may give information about your dialysis to your health plan or Medicare so we can be paid. We also may share your information with other providers who are involved in your care for their payment purposes.
Health Care Operations: We may use and disclose information about you for our business operations (and for the operations of our organized health care arrangement). For example, our quality improvement teams may use your health information to assess the care and outcomes in your case and others like it.
Uses and Disclosures of Health Information Unless You Object
The following categories describe different ways we use and disclose health information about you but we first will give you an opportunity to object to any disclosures for these purposes, unless otherwise permitted by law:
· To family and friends who are involved in your care or to notify family and friends of your condition or location.
· For emergency and notification purposes, such as to a disaster relief agency to coordinate disaster relief efforts.
Other Uses and Disclosures of Health Information
The following categories describe different ways we use and disclose health care information. We may use and disclose health information about you:
· To avert serious threat to health or safety.
· For public health and safety, for health and safety oversight activities.
· To other businesses that we contract with to assist us. We require these businesses to protect the privacy and confidentiality of health information about you.
· As incidental disclosures that may occur as a by-product of permitted uses and disclosures, such as, someone in the waiting room may hear your name called.
· For education. We may send educational materials and newsletters to you to keep you informed of issues relating to your care.
· For fundraising. We may contact you as part of a fundraising effort but you have the right to opt out of receiving fundraising communications.
· To personal representatives for minors and incapacitated adults.
· For research, in very limited situations. Although most clinical research studies require your authorization, there are instances where a record review may be conducted without patient authorization, as we are permitted to do so by law.
· As de-identified information and limited data sets, in which certain identifiers (such as your name and address) have been removed, making it unlikely that you could be identified, as allowed by law.
· To organ procurement organizations or persons who obtain, store, or transplant organs for organ donation purposes.
· To federal, state and local governments or regulatory agencies who require specific types of information to be reported or disclosed.
· For specialized government functions, such as for national security purposes.
· In response to court orders, subpoenas, search warrants, discovery requests and similar legal proceedings.
· For law enforcement purposes.
· To correctional institutions if are in jail or prison.
· To report suspected child abuse or neglect or other abuse or neglect
· To military or veteran’s authorities if you are or were affiliated with the military.
· To comply with workers’ compensation laws if you make a workers’ compensation claim.
· As otherwise required by law.
Certain health information about you may be subject to additional confidentiality protections, and we provide these additional protections. This information includes such things as certain sexually transmitted and other communicable disease, drug and alcohol abuse, and certain mental health services. Laws often require us to get special written permission from you to share this information.
Other uses and disclosures will be made only with your written permission or authorization. Generally, we would need an authorization to use and disclose health information for: marketing; if we are receiving something of value for the health information; or if the information is psychotherapy notes. In most cases you have the right to revoke or cancel your authorization, in writing, at any time.
You have personal rights over the use and sharing of your personal health information, including the rights listed below. You may act on these rights by contacting your Northwest Kidney Centers social worker, or the Northwest Kidney Centers privacy officer at 206-720-8505.
Restrict use and disclosure: You may ask in writing that we restrict uses or disclosures of information about you for treatment, payment and business purposes, or for people involved in your care. We will consider your request, but we may deny your request in certain situations. If we do agree, then we will comply with your request except in certain circumstances. We will agree to a request to not disclose health information about you to a health plan if the disclosure is for payment or health care operations (and is not required by law) and the information is about only a health care item or service for which you (or someone on your behalf other than the health plan) has paid in full.
Receive confidential information: You have the right to receive confidential communication in other ways or at other locations. This includes a different mailing address or an email address.
Inspect and copy: In most cases, you have the right to look at your health information or request a paper or electronic copy of it. You also may ask us to send an electronic copy of information about you to another person (as long as your request is in writing, signed by you, and clearly says who the person is where to send the health information).
Request changes: You have the right to request that we correct information in the record that contains information about you that you believe is incorrect, or that we add information that you believe is missing. We will consider your request, but we may deny your request in certain situations.
Know about disclosures: You have the right to request and receive a list of times where we have disclosed information about you, except for disclosures for treatment, payment, related business purposes or other disclosures specified by law.
Copy of this notice: You have the right to receive a paper copy of this Notice, even if you received an electronic copy of this Notice.
Concerns or Questions
If you are concerned that your privacy rights or have any questions, then you may contact our Privacy Officer Palmer Pollock at 206-720-8505 or our Patient Relations Coordinator at 206-720-8518. You also may file a complaint with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.
Changes to This Notice
We reserve the right to change this notice. The revised notice will be effective for information we already have about you as well as any information we receive in the future. Unless required by law, the revised notice will be effective on the new effective date of the notice. If you would like a copy of the current notice, please ask at one of our registration areas. The current notice is also posted on our website and in our facilities. The notice will state an effective date.
We are required by law to keep health information about you private. We must give you this Notice of our legal duties and privacy practices, and we must follow the practices that are stated in the Notice. We will notify you if there is a breach of unsecured health information about you.
Changes to This Notice
We reserve the right to change this Notice. The revised Notice will be effective for information we already have about you as well as any as any information we receive in the future. Unless required by law, the revised notice will be effective on the new effective date of the notice. If you would like a copy of the current notice, please ask your dialysis staff or social worker. The current notice is also on our website (www.nwkidney.org) and in our facilities.