HIPAA stands for the Health Insurance Portability and Accountability Act. This act, approved by Congress in 1996, provides patients with uniform access to their medical records and more control over how their personal health information is used and disclosed. It also requires health care providers to safeguard the security and confidentiality of medical records. Full information about the Act is provided on the US Department of Health & Human Services web site.

NOTICE OF PRIVACY PRACTICES - Bainbridge Pediatrics

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.

The law protects the privacy of the health information we create and obtain in providing our care and services to you. Bainbridge Pediatrics is required by law to maintain the privacy of your health information, to provide you with a notice of its legal duties and privacy practices, and to follow the information practices that are described in this notice. This notice explains how your health information may be used and/or disclosed. You have a right to request and receive a paper copy of this notice. We will not use or disclose your health information except as described in this notice.

Examples of Disclosures of Protected Health Information for Treatment, Payment, and Health Operations

Each time you visit a physician or other health care provider a record is made of your visit. Your Protected Health Information (PHI) includes your symptoms, test results, diagnoses, treatment, health information from other providers, and billing and payment information relating to these services. Federal and state law allows us to use and disclose your protected health information for purposes of treatment and health care operations. State law requires us to get your authorization to disclose this information for payment purposes. The following categories describe ways we may use and disclose your health information, without obtaining specific consent for each use and disclosure.

Treatment

Treatment means providing and arranging health care, and health related service with other providers. It may include coordinating your care with a third party, obtaining a consultation from another provider, or making a referral. As an example, information obtained by a nurse, physician, or other member of our health care team will be recorded in your medical record. We may also provide other health care providers with copies of various records containing protected health information that could assist them in treating you.

Payment

We use your health information as documentation to request payment for our services. For example a bill may be sent to you or a third party payer. The Information provided on or accompanying the bill may include information that identifies you, your diagnoses, date of service, procedures performed, and supplies used.

Routine health care operations

Bainbridge Pediatrics may use your personal health information to assess quality, to improve service and to train our staff. We may contact you to remind you about appointments and give you information about treatment alternatives or other health related benefits and services. We may use and disclose your information to conduct or arrange for services, including medical quality review by your health plan, accounting, legal, risk management, and insurance services, audit functions, including fraud and abuse detection and compliance programs.

Other Disclosures and Uses of Protected Health Information

We may also use and disclose your protected health information without your authorization as follows:

• For Notification of Family and Others: unless you object, we may release health information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. You have the right to object to this use or disclosure of your information. If you object, we will not use or disclose it.
  
• To Businesses with whom we contract for services (examples include consultants, accountants, lawyers, medical transcription, and third party billing companies). We require these businesses to protect the confidentiality of your personal health information.
• To Medical Researchers—if the research has been approved and has policies to protect the privacy of your health information. We may also share information with medical researchers preparing to conduct a research project.
• To Funeral Directors/Coroners consistent with applicable law to allow them to carry out their duties.
• To Organ Procurement Organizations or persons who obtain, store, or transplant organs
• To the Food and Drug Administration (FDA) relating to problems with food, supplements, and products.
• To Comply With Workers’ Compensation Laws—if you make a workers’ compensation claim. • For Public Health and Safety Purposes as Allowed or Required by Law: to prevent or reduce a serious, immediate threat to the health or safety of a person or the public; to public health or legal authorities to protect public health and safety, to prevent or control disease, injury, or disability or to report vital statistics such as births and deaths
  
• To Report Suspected Abuse or Neglect to public authorities.
• For Law Enforcement Purposes such as when we receive a subpoena, court order, or other legal process, or you are the victim of a crime.
• For Specialized Government Functions, for example, as required by the military
• For Health and Safety Oversight Activities. For example, we may share health information with the Department of Health. We may participate in state vaccine registries and we report communicable diseases as required.
• For Disaster Relief Purposes. For example, we may share health information with disaster relief agencies to assist in notification of your condition to family or others.
• In the Course of Judicial/Administrative Proceedings at your request, or as directed by a subpoena or court order.
  

Special Authorization

Specific federal and state protections apply to certain classes of health records. For example, additional protections may apply to mental heath, alcohol and drug abuse, sexually transmitted disease and HIV records. There are exceptions set forth in each of these laws that permit disclosure without your authorization, but only in limited situations. Where a minor has the right to consent to medical treatment, he or she also has the right to control information related to treatment. A competent minor patient’s signature may be required to release information related to

1. birth control for minors deemed sexually mature
2. treatment of sexually transmitted diseases (14 yrs and above)
3. to receive HIV or STD results (15 yrs and above)
4. treatment for alcoholism or drug abuse (13 yrs and above) and treatment for mental health conditions (13 yrs and above).

Your Health Information Rights Although your health information record is part of our business record, you have certain rights to your information under Washington and federal privacy law. You have the rights to:

• Inspect and obtain a copy of your health record. You may request a release of Information in writing.
• Ask us to amend your health information. You may give us this request in writing. You may write a statement of disagreement if your request is denied. It will be stored in your medical record, and included with any release of your records
• Ask us to restrict certain uses and disclosures. You must deliver this request in writing to us. We are not required to grant the request.
• When you request, we will give you a list of disclosures of your health information. The list will not include disclosures to third-party payers.
• Ask that your health information be given to you by another means or at another location. Please sign, date, and give us your request in writing.
• Cancel prior authorizations to use or disclose health information by giving us a written revocation. Your revocation does not affect information that has already been released. It also does not affect any action taken before we have it. Sometimes, you cannot cancel an authorization if its purpose was to obtain insurance.
• Obtain a paper copy of our privacy practices by asking for it, even if you previously agreed to accept notice by email or over the Internet.

We require you to make most of these requests in writing and we charge a reasonable fee for copies, summaries, explanations and mailing cost. You must make an appointment with us to inspect your record. For help with these rights during normal business hours, please contact our Office Manager at 206-780-KIDS

Our Responsibilities

We are required to:

• Keep your protected health information private;
• Give you this Notice;
• Follow the terms of this Notice.

We have the right to change our practices regarding the protected health information we maintain. If we make changes, we will update this Notice. You may receive the most recent copy of this Notice by calling or visiting our office or here on our website

To Ask for Help or to Voice a Complaint

If you have questions, want more information, or wish to report a problem about the handling of your protected health information, you may contact:

Office Manager
9431 Coppertop Loop, Suite A
Bainbridge Island, WA 98110
206-780-5437 (780-KIDS)

If you believe your privacy rights have been violated, you may discuss your concerns with any staff member. You may also deliver a written complaint to our Office Manager. You may also file a complaint with the U.S. Secretary of Health and Human Services. We respect your right to file a complaint with us or with the U.S. Secretary of Health and Human Services.

If you do so, we will not retaliate against you.

Other Uses and Disclosures of Protected Health Information

Uses and disclosures not in this Notice will be made only as allowed or required by law or with your written authorization.

Effective Date April 2007.