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.
If you
have any questions about this notice, please contact:
Inland Imaging Privacy Official
801 S Stevens
Spokane WA 99204
(509) 363-7797
This
Notice of Privacy Practices 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. It
also describes your rights to access and control your protected health
information. Please review it carefully.
“Protected
health information” is information about you, including information that may
identify you and that relates to your past, present, or future physical or
mental health or condition and related to health care services.
We
understand that medical information about you and your health is
personal. We are committed to protecting medical information about
you.
This
notice applies to all of the records of your care generated by Inland Imaging,
whether made by Inland Imaging personnel
or by your doctor.
Other
doctors may have different policies or notices regarding their use and
disclosure of your medical information.
1.
CHANGES TO THIS NOTICE
We are required by law to abide by
the terms of this Notice of Privacy Practices. We are required by law to keep
your protected health information private and to provide you with a notice of
our legal duties and our privacy practices. We may change the terms of our
notice, at any time. The new notice will be effective for all protected health
information that we maintain at that time. Upon your request, we will provide
you with any revised Notice of Privacy Practices. The Notice is available by
accessing our website at www.Inland-Imaging.com;
calling the phone number at the top of this page and requesting that a revised
copy be sent to you in the mail, or by asking for a copy at the time of your
next visit or admission.
2.
HOW WE MAY USE AND DISCLOSE MEDICAL
INFORMATION ABOUT YOU
The following categories describe
different ways that we use and disclose medical information. For each
category of uses or disclosures we will explain what we mean and try to give
some examples. Not every use or disclosure in a category will be
listed. However, all of the ways we are permitted to use and disclose
information will fall within one of the categories.
►
For Treatment:
We may use medical information about you to provide you with medical treatment
or services. We may disclose medical information about you to doctors,
nurses, technicians, or other healthcare personnel who are involved in taking
care of you. For example, a doctor treating you may request a copy of your
medical record. Your protected health information may be provided from
time-to-time to another doctor or health care provider who, at the request of
your doctor, becomes involved in your care. This is done to ensure that the
doctor has the necessary information to diagnose or treat you. In addition, if
you are hospitalized, medical information may be shared with different
departments of the hospital in order to coordinate the different services that
you need. We may also make your protected health information available to other
health care organizations that are involved in your care via our computer
network. We may also disclose medical information about you to people who may
be involved in your medical care after you leave the hospital, such as family
members, clergy, or others that are part of your care. We may also contact you
regarding treatment alternatives.
►
For Payment: We may use
and disclose medical information about you so that the treatment and services
you receive at Inland Imaging can be
billed and payment can be collected from you, an insurance company or a third
party. For example, we may need to give your health plan information about
services you received so your health plan will pay us or reimburse you for the
services. We may also tell your health plan or the
sponsor of the health plan about services or treatment you are going
to receive to obtain prior approval or to
determine whether your plan will cover the services. For example, your health
plan may require prior authorization before services are covered.
►
For Health Care Operations:
We may use and disclose medical information about you in order to support the
business activities of our organization. These uses and disclosures are
necessary to provide services and make sure that all of our patients receive
quality care. For example, we may use medical information to review our
treatment and services and to evaluate the performance of our staff in caring
for you. We may also combine medical information about many of our
patients to decide what additional services we should offer, what services are
not needed, and whether certain new procedures are effective. We may also
disclose information to your doctor, nurse, technician, or other personnel for
review and educational purposes. We may also combine the medical information we
have with medical information from other health care organizations to compare
how we are doing and see where we can make improvements in the care and
services we offer. We may remove information identifying you from such
combined sets of medical information so that others may use the information for
clinical studies without learning the identity of specific patients.
·
For Appointments:
We may call you by name in the waiting room when we are ready to see you. We
may use or disclose your protected health information, as necessary, to remind
you of your appointment.
·
For Billing and Transcription
Services: We will share your protected health
information with business associates that perform various activities (for
example, billing, or transcription services) for us.
·
For Health-Related Benefits and
Services: We may also use and disclose your
protected health information, as necessary, to provide you with information
about health-related benefits and services that may be of interest to you.
·
Individuals Involved in Your Care or
Payment for Your Care: We may release medical
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. We may disclose medical
information about you to an entity assisting in a disaster relief effort so
that your family can be notified about your condition, status or location.
►
As Required By Law:
We will disclose medical information about you when required to do so by
federal, state or local law.
►
For Fundraising: We
may disclose protected health information about you for fundraising. For
example, we may provide your name and phone number to an organization to enable
them to solicit a donation.
►
For Marketing: We
may provide you with general marketing information about our services or give
you small promotional gifts when we see you in person without your written
authorization.
·
For example, we may send you a newsletter or a list of our
health classes or we may give you a pen with our organization’s name on it. We
must obtain your written authorization before we can send you marketing
information about specific products or services that we provide. You may
contact our Privacy Officer to request that these materials not be sent to you.
►
To Avert a Serious Threat to Health or Safety:
We may use and disclose medical information about you when necessary to prevent
a serious threat to your health and safety or the health and safety of the
public or another person. Any disclosure would only be to someone able to
help prevent the threat.
3.
Other Permitted and Required Uses and
Disclosures of Protected Health Information That May be Made Without Your
Authorization or Opportunity to Object
►
Military Activity and National Security:
When the appropriate conditions apply, we may use or disclose protected health
information of individuals who are Armed Forces personnel (1) for activities
deemed necessary by appropriate military command authorities; (2) for the
purpose of a determination by the Department of Veterans Affairs of your
eligibility for benefits; or (3) to foreign military authority if you are a
member of that foreign military services. We may also disclose your protected
health information to authorized federal officials for conducting national
security and intelligence activities, including for the provision of protective
services to the President or others legally authorized.
►
Workers' Compensation:
Your protected health information may be disclosed by us as authorized to
comply with workers’ compensation laws and other similar legally-established
programs. For example, we are 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. We can disclose health information to an employer about light
duty work without any authorization from you. We can disclose health
information to an employer without an authorization from you if the information
is about a workplace injury or illness, a workplace medical surveillance or a
return-to-work examination.
►
Public Health Risks. We
may disclose your protected health information for public health activities and
purposes to a public health authority that is permitted by law to collect or
receive the information. The disclosure will be made for the purpose of
controlling disease, injury or disability; to report the abuse or neglect of
children, elders or dependent adults; to notify the appropriate government
authority if we believe a patient has been the victim of abuse, neglect, or
domestic violence. We may also disclose your protected health information, if
directed by the public health authority, to a foreign government agency that is
collaborating with the public health authority. We may disclose your protected
health information, if authorized by law, to a person who may have been exposed
to a communicable disease or may otherwise be at risk of contracting or
spreading the disease or condition.
►
Health Oversight Activities.
We may disclose your protected health information to a health oversight agency
for activities authorized by law, such as audits, investigations, and
inspections. Oversight agencies seeking such information would include:
government agencies that oversee health care systems, government benefit
programs and government agencies that oversee compliance with civil rights
laws.
►
Legal Proceedings, Lawsuits and Disputes.
We may disclose your protected health information in response to a court or
administrative order or in response to a subpoena, discovery request, or other
lawful process to the extent such disclosure is expressly authorized.
►
Law Enforcement.
We may disclose your protected health information for law enforcement purposes
when applicable legal requirements are met. These law enforcement purposes
include: (1) legal processes, or as otherwise required by law, (2)
identification or location of a suspect, fugitive, material witness, or missing
person; (3) investigations pertaining to victims of a crime; (4) suspicion that
death has occurred as a result of criminal conduct; (5) investigations of a
crime that occurred on our premises; and (6) in a medical emergency (not on our
premises) in which it is likely that a crime may have been committed.
►
Coroners, Medical Examiners, Funeral Directors, and Organ
Donation: We may disclose your
protected health information to a coroner or medical examiner for
identification purposes, for determining cause of death, or for the coroner or
medical examiner to perform other duties authorized by law. We may also
disclose protected health information to a funeral director, as authorized by
law, in order to permit the funeral director to carry out their duties.
Protected health information may be used and disclosed for cadaveric organ,
eye, or tissue donation purposes.
►
Research:
Under certain circumstances, we may use and disclose protected health
information about you for research purposes. For example, a research project
may involve comparing the health and recovery of all patients who receive one
medication to those who received another, for the same condition. All research
projects, however, are subject to a special approval process. This
process evaluates a proposed research project and its use of protected health
information, trying to balance the research needs with patients' need for
privacy of their protected health information. Before we use or disclose
protected health information for research, the project will have been approved
through this research approval process, but we may, however, disclose protected
health information about you to people preparing to conduct a research project,
for example, to help them look for patients with specific medical needs, so
long as the information they review does not leave Inland Imaging. We
will ask for your specific permission if the researcher will have access to
your name, address or other information that reveals who you are, or will be
involved in your care at Inland Imaging.
►
Inmates: If
you are an inmate of a correctional institution or under the custody of a law
enforcement official, we may disclose your protected health information to the
correctional institution or law enforcement official. This release would
be necessary (1) for the institution to provide you with health care; (2) to
protect your health and safety or that of others; or (3) for the safety and
security of the correctional institution.
►
Other uses and disclosures will be made only with your written
authorization: You may revoke such
authorization at any time.
4.
YOUR RIGHTS REGARDING YOUR MEDICAL
INFORMATION
You have the following rights
regarding your protected health information:
►
Right to Inspect and Copy:
You have the right to inspect and copy protected health information that may be
used to make decisions about your care. Usually, this includes medical
and billing records. Under Federal law, however, you may not inspect or copy
the following records: psychotherapy notes; information compiled in reasonable
anticipation of, or use in, a civil, criminal, or administrative action or
proceeding; and protected health information that is subject to law that
prohibits access to protected health information.
·
To inspect and copy protected health information that may be
used to make decisions about your care, you must submit your request in writing
to Inland Imaging Medical Records. If you request a copy of the information, we
may charge a fee for the costs of copying, mailing or other supplies associated
with your request.
·
We may deny your request to inspect and copy in certain very
limited circumstances. If you are denied access to protected health
information, you may request that the denial be reviewed. Another
licensed health care professional chosen by Inland Imaging will review your
request and the denial. The person conducting the review will not be the
person who denied your request. We will comply with the outcome of the
review.
►
Right to Amend:
If you feel that protected health information we have about you is incorrect or
incomplete, you may ask us to amend the information. You have the right
to request an amendment for as long as the information is kept by Inland
Imaging.
·
To request an amendment, your request must be made in writing
and submitted to Inland Imaging Medical Records. In addition, you must
provide a reason that supports your request.
·
We may deny your request for an amendment if it is not in
writing or does not include a reason to support the request. In addition,
we may deny your request if you ask us to amend information that: (1) was not
created by us, unless the person or entity that created the information is no
longer available to make the amendment; (2) is not part of the protected health
information kept by or for Inland Imaging; (3) is not part of the information
which you would be permitted to inspect and copy; or (4) is accurate and
complete.
►
Right to an Accounting of Certain Disclosures:
You have the right to request an "accounting of disclosures.” An
accounting of disclosures is a listing of the disclosures we have made of your
health information, except as it was used for treatment, payment, or health
care operations. It also excludes disclosures we may have made to you, to
family members or friends involved in your care, or for notification purposes.
You have the right to receive specific information regarding these disclosures
that occurred after April 14, 2003.
·
To request this list or accounting of disclosures, you must
submit your request in writing to the Privacy Officer identified at the
beginning of this Notice of Privacy Practices. Your request must state a
time period which may not be longer than six years and may not include dates
before April 14, 2003. The first list you request within a 12 month
period will be free. For additional lists, we may charge you for the
costs of providing the list. We will notify you of the cost involved and
you may choose to withdraw or modify your request before any costs are
incurred.
►
Right to Request Restrictions:
You have the right to request a restriction or limitation on the protected
health information we use or disclose about you for treatment, payment or
health care operations. This means you may ask us not to use or disclose
any part of your protected health information for the purposes of treatment,
payment, or healthcare operations. You may also request that any part of your
protected health information not be disclosed to family members or friends who
may be involved in your care or for notification purposes as described in the
Notice of Privacy Practices.
·
We are not required to agree to a restriction that you may
request. If we believe it is in your best interest to permit use
and disclosure of your protected health information, use and disclosure of your
protected health information will not be restricted. If we do agree to the
requested restriction, we agree to comply with your request, unless the
information is needed to provide you with emergency treatment. With this in
mind, please discuss any restriction you wish to request with your physician.
·
To request restrictions, you must make your request in
writing to the Privacy Officer identified at the beginning of this Notice of
Privacy Practices. In your request, you must tell us: (1) what
information you want to limit; (2) whether you want to limit our use, our
disclosure or both; and (3) specifically, to whom you want the restriction to
apply.
►
Right to Request Confidential Communications:
You have the right to request that we communicate with you about medical
matters in a certain way or at a certain location or alternative address.
For example, you can ask that we only contact you by mail at a different
address. We will accommodate reasonable requests. We will not ask the reason
for your request. We may, however, ask you for information as to how payment
will be handled.
·
To request confidential communications, you must make your
request in writing to the Privacy Officer identified at the beginning of this
Notice of Privacy Practices. Your request must specify how or where you wish to
be contacted.
►
Right to a Paper Copy of This Notice:
You have the right to obtain a paper copy of this notice. You may ask us
to give you a copy of this notice at any time. Even if you have agreed to
receive this notice electronically, you are still entitled to a paper copy of
this notice. Or, you can obtain a copy of this notice from our website at
www.Inland-imaging.com.
5.
PRIVACY COMPLAINTS
If you believe your privacy rights
have been violated, you may file a complaint with Inland Imaging
or with the Secretary of the Department of Health and Human
Services. To file a complaint with Inland Imaging, contact the Privacy
Officer identified at the beginning of this Notice of Privacy Practices. All
complaints must be submitted in writing. You will not be penalized for filing a
concern.
This
notice is effective as of April 1, 2003.