PRIVACY NOTICE

 

This Privacy 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.

A.   Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.

We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

We must follow the duties and privacy practices described in this notice and give you a copy of it.

We will not use or share your information other than as described here unless you tell us that we can in writing.  If you tell us we can, you may change your mind at any time, and you will be required to notify us in writing.

We can change the terms of this notice and the changes will apply to all the information we have about you. The new notice will be available at the time of any changes.

Our Uses and Disclosures

1.   Treatment: We can use your health information and share it with other professionals who are treating you.  For example, your information may be disclosed to your primary care physician or to another specialist who referred you to WNA for treatment.

2.   Healthcare Operations:  \'(/ e can use and share your health information to run our practice, improve your care, and contact you when necessary.  For example, your information may be used and disclosed by WNA to engage in case management, coordinate your care, schedule your appointments and inform you of your lab results.  We may contact you to give you information about treatment alternatives or other health benefits and services that may be of interest to you.

3.    Payment:  We ca n use and share your health information to bill and get payment from health plans or other entities.  For example, your information may be used and disclosed to submit claims to your insurer and/ or to obtain payment for services provided.

 

B.  Your Choices:  Uses and Disclosures with Your Verbal Consent

For certain health information, you can tell us your choices about what we share.  If you have a clear preference for how we share your information in the situations described below, please tell us what you want us to do.

In these cases, you have both the right and choice to tell us to:

  •  Share information with your family, close friends or others involved in your care.
  •  Share information in a disaster relief situation
  •  Include your information in a hospital directory
  •  Contact you for fundraising efforts- We may contact you for fundraising, but you can tell us not to contact you again for fundraising.

Please note: If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. 

In these cases, we never share your information unless you give us written permission: For marketing

For the sale of your information

For most sharing of psychotherapy notes

 

C.  Other Uses and Disclosures without your consent.

We are allowed or required to share your information in other ways- usually in ways that contribute to the public good, such as public health and research.  We have to meet many conditions in the law before we can share your information for these purposes.

Public Health and Safety

We can share health information about you for certain situations such as:

  •  Preventing disease
  •  Helping with product recalls
  •  Reporting adverse reactions to medications
  •  Reporting suspected abuse, neglect or domestic violence
  •  Preventing or reducing a serious threat to anyone’s health or safety

Research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner or funeral director when an individual dies.

Address worker’s compensation. law enforcement and other government requests

We can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official o   With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services.

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

 

D.  Your Rights

When it comes to your health information, you have certain rights.  This section explains your rights and some of our responsibilities to help you.

  1.  Get a copy of your medical record. You can ask to see or get a copy of your medical record and other health information we have about you. We will provide a copy or a summary of your health information, usually within 30 days of your request.  We will charge a reasonable, cost-based fee.
  2.  Ask us to correct your medical record. You can ask us to correct health information about you if you think it is incorrect or incomplete.   We may say “no” to your request, but we’ll tell you why in writing within 60 days.
  3.  Request confidential communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.  We will say “yes” to all reasonable requests. Please note that email is not always secure.  We will do our best to protect your health information, but we do not guarantee privacy through email.
  4.  Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment or our operations.   We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.  We will say “yes” unless a law requires us to share that information.
  5.  Get a list of those with whom we’ve shared information. You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date yo1,1 ask, who we shared it with and why. We will include all the disclosures except for those about treatment, payment and health care operations and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
  6.  Get a copy of this Privacy Notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.  We will provide you with a paper copy promptly.
  7.  Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure that a person has this authority and can act for you before we take action.  We will require an executed medical power of attorney form for our records.
  8.  File a complaint. If you feel your rights have been violated, you can contact us at:

Barbara Rotter, Privacy Officer

Administration

Washington Nephrology Associates, LLP

1201 Seven Locks Rd, Suite 200,

Rockville, MD 20854

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to

200 Independence Ave, SW

Washington, DC 20201

1-877-696-6775

www.hhs.gov/ocr/privacy/hipaa/complaints/

We will not retaliate against you for filing a complaint.