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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.
Eastside Pulmonary Associates respects
your privacy. We understand that your personal health information is
very sensitive. We will not disclose your information to others unless
you tell us to do so, or unless the law authorizes or requires us to do
so.
The law protects the privacy of the health information we create and
obtain in providing our care and services to you. For example, your
protected health information 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.
Examples of Use and Disclosures of Protected Health Information for
Treatment, Payment, and Health Operations
For treatment:
Information obtained by a nurse, physician, or other member of our
health care team will be recorded in your medical record and used to
help decide what care may be right for you.
We may also provide information to others providing you care. This will
help them stay informed about your care.
For payment:
We request payment from your health insurance plan. Health plans need
information from us about your medical care. Information provided to
health plans may include your diagnoses, procedures performed, or
recommended care.
For health care operations:
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We use your medical records to assess
quality and improve services.
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We may use and disclose medical
records to review the qualifications and performance of our health
care providers and to train our staff.
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We may contact you to remind you about
appointments and give you information about treatment alternatives
or other health-related benefits and services.
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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.
Your Health Information Rights
The health and billing records we create and store are the property of
the practice/health care facility. The protected health information in
it, however, generally belongs to you. You have a right to:
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Receive, read, and ask questions about
this Notice;
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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. But we will comply with any
request granted;
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Request and receive from us a paper
copy of the most current Notice of Privacy Practices for Protected
Health Information ("Notice");
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Request that you be allowed to see and
get a copy of your protected health information. You may make this
request in writing. We have a form available for this type of
request.
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Have us review a denial of access to
your health information—except in certain circumstances;
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Ask us to change 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.
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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. You may receive this
information without charge once every 12 months. We will notify you
of the cost involved if you request this information more than once
in 12 months.
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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.
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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.
For help with these rights during normal
business hours, please contact:
Suzanne Lee, Privacy Officer
(425) 455-4929
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