COMPLEX CARE CENTER 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.
Complex Care Center (“Complex Care” or “We”) and its employees are dedicated to maintaining the privacy of your Protected Health Information (“PHI”), as required by applicable federal and state laws. These laws require us to provide you with this Notice of Privacy Practices (“Notice”) and to inform you of your rights and our obligations concerning PHI. PHI is information about you, including demographic information, that may identify you and that relates to your past, present or future physical health or condition, treatment or payment for health care services. We have the right to change this Notice at any time in accordance with applicable law. If we make changes to this Notice, you will see the updated version on our website.
A. PERMITTED USES AND DISCLOSURES OF PHI We may use and disclosure your PHI for the following purposes:
1. Treatment. We will use and disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we may disclose your PHI to physicians, nurses, technicians or personnel who are involved with the administration of your care.
2. Payment. We may use and disclose your PHI to bill and collect payment for your health care services. For example, we may send a bill to you or to a third-party payor for the rendering of services by us. The bill may contain information that identifies you, your diagnosis and procedures and supplies used. We may need to disclose this information to insurance companies to establish insurance eligibility benefits for you. We may also provide your PHI to our business associates, such as billing companies, claims processing companies and others that process our health care claims.
3. Health Care Operations. We may use or disclose your PHI, as needed, for our health care operations. These activities include, but are not limited to, quality assessment, employee review, data aggregation and research, licensing, and conducting or arranging for other business activities. In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name. We may also call you by name in the waiting room when we are ready to see you. We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment, and inform you about treatment alternatives or other healthrelated benefits and services that may be of interest to you.
4. Emergency Treatment. We may disclose your PHI if you require emergency treatment or are unable to communicate with us.
5. Family and Friends. We may disclose your PHI to a family member, friend or any other person who you identify as being involved in your care or payment for care, unless you object.
6. Required by Law. We may use or disclose your PHI for law enforcement purposes and as required by federal and state law. For example, we may disclose your PHI to law enforcement to report instances of abuse, neglect or domestic violence; to report certain injuries, like a gunshot wound; and to assist law enforcement in locating a suspect, fugitive, material witness or missing person. We will inform you or your representative if we disclose your PHI because we believe you are a victim of abuse, neglect or domestic violence, unless we determine that informing you or your representative would place you at risk. In addition, we must provide PHI to comply with an order in a legal or administrative proceeding. Finally, we may be required to provide PHI in response to a subpoena discovery request or other lawful process, but only if efforts have been made, by us or the requesting party, to contact you about the request or to obtain an order to protect the requested PHI.
7. Serious Threat to Health or Public Safety. We may disclose your PHI if we believe it is necessary to avoid a serious threat to the health and safety of you or the public.
8. Public Health. We may disclose your PHI to public health or other authorities charged with preventing or controlling disease, injury or disability, or charged with collecting public health data.
9. Health Oversight Activities. We may disclose your PHI to a health oversight agency for activities authorized by law. These activities include audits; civil, administrative or criminal investigations or proceedings; inspections; licensure or disciplinary actions; or other activities necessary for oversight of the health care system, government programs and compliance with civil right laws.
10. Research. We may disclose your PHI for certain research purposes, but only if we have protections and protocols in place to ensure the privacy of your PHI.
11. Workers’ Compensation. We may disclose your PHI to comply with laws relating to works’ compensation or other similar programs.
12. Specialized Government Activities. If you are active military or a veteran, we may disclose your PHI as required by military command authorities. We may also be required to disclose PHI to authorized federal officials for the conduct of intelligence or other national security activities.
13. Organ Donation. If you are an organ donor, or have not indicated that you do not wish to be a donor, we may disclose your PHI to organ procurement organizations to facilitate organ, eye or tissue donation and transplantation.
14. Coroners, Medical Examiners, Funeral Directors. We may disclose your PHI to coroners or medical examiners for the purposes of identifying a deceased person or determining the cause of death and to funeral directors as necessary to carry out their duties.
15. Disaster Relief. Unless you object, we may disclose your PHI to a government agency or private entity (such as FEMA or Red Cross) assisting with disaster relief efforts.
B. DISCLOSURES REQUIRING WRITTEN AUTHORIZATION
1. Not Otherwise Permitted. In other situations not described in Section A above, we may not disclose your PHI without your written authorization. You may revoke this authorization, at any time, in writing, except to the extent that we have taken an action in reliance of your authorization.
2. Psychotherapy Notes. We must receive your written authorization to disclose psychotherapy notes, except for certain treatment, payment or health care operations activities.
3. Marketing and Sale of PHI. We must receive written authorization to use or disclose your PHI for marketing purposes. We also may not sell your PHI without your authorization.
C. YOUR RIGHTS WITH RESPECT TO YOUR PHI
1. Right to Receive a Paper Copy of this Notice. You have the right to receive a paper copy of this Notice upon request.
2. Right to Access PHI. You have the right to inspect and copy your PHI for as long as we maintain your medical record. You must make a written request for access to the Privacy Officer at the address listed at the end of this Notice. We may charge you a reasonable fee for the processing of your request and the copying of your medical record pursuant to Washington law. In certain circumstances, we may deny your request to access your PHI, and you may request that we reconsider our denial. Depending on the reason for denial, another licensed health care processional chosen by us may review your request and the denial.
3. Right to Request Restrictions. You have the right to request a restriction on the use or disclosure of your PHI for the purpose of treatment, payment or health care operations, except for in the case of an emergency. You also have the right to request a restriction on the information we disclose to a family member or friend who is involved with your care or the payment of your care. However, we are not legally required to agree to such restriction.
4. Right to Restrict Disclosure for Services Paid by You in Full. You have the right to restrict the disclosure of your PHI to a health plan if the PHI pertains to health care services for which you paid in full directly to us.
5. Right to Request Amendment. You have the right to request that we amend your PHI if you believe it is incorrect or incomplete, for as long as we maintain your medical record. We may deny your request if (a) we did not create the PHI, (b) is not information that we maintain, (c) is not information that you are permitted to inspect or copy (such as psychotherapy notes), or (d) we determine that the PHI is accurate and complete. If you disagree with our denial, you have the right to submit a statement of disagreement or an addendum to be added to your medical record.
6. Right to an Accounting of Disclosures. You have the right to request an accounting of disclosures of PHI made by us (other than those made for treatment, payment or health care operations purposes) during the 6 years prior to the date of your request. You must make a written request for an accounting, specifying the time period for the accounting, to the Privacy Officer at the address listed at the end of this Notice.
7. Right to Confidential Communications. You have the right to request that we communicate with you about your PHI by certain means or at certain locations. For example, you may specify that we call you only at your home phone number, and not at your work number. You must make a written request, specifying how and where we may contact you, to the Privacy Officer at the address listed at the end of this Notice.
8. Right to Notice of Breach. You will be notified if we or one of our business associates become aware of a breach of your unsecured PHI.
D. QUESTIONS OR COMPLAINTS
If you would like more information about our privacy practices or have questions or concerns, please contact us. If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made regarding that use, disclosure, or access to your PHI, you may contact the Privacy Officer at the address and phone number listed at the end of this Notice. You may also submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file such a complaint upon request.
We support your right to the privacy of your PHI. We will not retaliate in any way if you file a complaint with us or with the U.S. Department of Health and Human Services.
Please direct any questions or complaints to:
Attn: Privacy Officer Complex Care Center 969 Stevens Dr., Ste 3A Richland, WA 99352
(509) 713-1315
This Notice is effective May 28, 2024.
