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.
This Notice of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). It describes how we may use or disclose your protected health information, with whom the information may be shared, and the safeguards we have in place to protect it. This notice also describes your rights to access and amend your protected health information. You have the right to approve or refuse the release of specific information outside of your system except when the release is required or authorized by law or regulation.
ACKNOWLEDGEMENT OF RECEIPT OF THIS NOTICE:
Each patient is asked to sign a consent form referencing this notice.
WHO WILL FOLLOW THIS NOTICE:
This notice describes Vantage Radiology & Diagnostic Services, P.S. (VRADS) practices regarding your protected health information. For this notice, VRADS includes the following:
- Vantage Radiology & Diagnostic Services, a professional services corporation
OUR DUTIES TO YOU REGARDING PROTECTED HEALTH INFORMATION:
“Protected health information” (PHI) is individually identifiable health information. This information includes demographics, for example, age, address, e-mail address, and relates to your past, present, or future physical or mental health or condition and related health care services. VRADS is required by law to do the following: make sure that your PHI is kept private, give you this notice of our legal duties and privacy practices related to the use and disclosure of your PHI, follow the terms of the notice currently in effect, and communicate any changes in the notice to you.”
We reserve the right to change this notice. Its effective date is at the top of the first page and at the bottom of the last page. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. You may obtain a Notice of Privacy Practices by accessing our web site at www.vrads.com, or by asking for a copy from the billing office.
HOW WE MAY USE OR DISCLOSE YOUR PROTECTED HEALTH INFORMATION:
Following are examples of permitted uses and disclosures of your protected health information. These examples are not exhaustive.
Required Uses and Disclosures: By law, we must disclose your health information to you unless a competent medical authority has determined that it would be harmful to you. We must also disclose health information to the Secretary of the Department of Health and Human Services (DHHS) for investigations or determinations of your compliance with laws on the protection of your health information.
Treatment: We will use and disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination of management of your health care with a third party. We may disclose your PHI to another physician, or health care provider (a specialist for example) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment. In emergencies, we will use and disclose your PHI to provide the treatment you require.
Payment: We will use and disclose your PHI so that the treatment and services you received by our Radiologists may be billed to and payment may be collected from you, an insurance company or health plan or other third party. For example, we may need to give your health plan information about services you received at one of the facilities we staff that directly relates to the radiology services you received, so the health plan will reimburse you or pay us for these services. We may also tell your health plan about treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment. We may have our bills and payment arrangements outsourced to one or more third party service providers who issue, process and collect bills on our behalf. An example would be a collection agency.
Health Care Operations: We may use or disclose, as needed, your PHI to support the daily activities related to health care. These activities include, but are not limited to quality assessment activities, investigations, oversight or staff performance reviews, and licensing. We will share your protected health information with third-party “business associates” who perform various activities (for example, billing, transcription services). The business associates will also be required to protect your health information. We will share your PHI, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that might interest you. For example, your name and address may be used to send you a newsletter about VRADS and the services we offer. We may also send you information about services that we believe might benefit you.
Required by Law: We may use or disclose your PHI if law or regulation requires the use or disclosure.
Public Health: We may disclose your PHI to a public health authority who is permitted by law to collect or receive the information. The disclosure may be necessary to do the following:
- Prevent or control disease, injury or disability.
- Report births and deaths
- Report child abuse or neglect
- Report reactions to medications or problems with products
- Notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
- Notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.
Communicable Diseases: We may disclose your PHI, if authorized by law, to a person who might have been exposed to a communicable disease or might otherwise be at risk of contracting or spreading the disease or condition.
Health Oversight: We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. These health oversight agencies might include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.
Food and Drug Administration: We may disclose your PHI to a person or company required by the FDA to do the following: report adverse events, product defects, or problems and biologic product deviations, track products, enable product recalls, make repairs or replacements and conduct post-marketing surveillance as required.
Legal Proceedings: We may disclose your PHI during any judicial or administrative proceeding, in response to a court order or administrative tribunal (if such a disclosure is expressly authorized), and in certain conditions in response to a subpoena, discovery request, or other lawful process.
Law Enforcement: We may disclose your PHI for law enforcement purposes, including the following: responses to legal proceedings, information requests for identification and location, circumstances pertaining to victims of a crime, deaths suspected from criminal conduct. Research: We may disclose your PHI to researchers when authorized by law, for example, if an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your PHI has approved their research.
Military, Veterans, National Security and Other Government Purposes: We may disclose your PHI, if you are a member of the armed forces, as required by military command authorities or to the Department of Veterans Affairs.
Workers’ Compensation: We may disclose your PHI to comply with workers’ compensation laws and other similar legally established programs.
Inmates: We may disclose your PHI if you are an inmate of a correctional facility, and VRADS created or received your PHI while providing care to you. This disclosure would be necessary (1) of the institution to provide you with health care, (2) for your health and safety or the health and safety of others, or (3) for the safety and security of the correctional institution.
Parental Access: Some state laws concerning minors permit or require disclosure of PHI to parents, guardians, and persons acting in a similar legal status. We will act consistently with the Washington State law and will make disclosures following such laws.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION REQUIRING YOUR PERMISSION:
In some circumstances, you have the opportunity to agree or object to the use or disclosure of all or part of your PHI. Following are examples in which your agreement or objection is required.
Individuals Involved in Your Health Care: Unless you object, we may disclose to a member of you family, a relative, a close friend, or any other person you identify your PHI that directly relates to that person’s involvement in your health care. We may also give information to someone who helps pay for your care. Additionally, we may use or disclose PHI to notify or assist in notifying a family member, personal representative, or any other person who is responsible for your care, of your location, general condition or death.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION:
You may exercise the following rights by submitting a written request or electronic message to the Privacy Officer. Depending on your request, you may also have rights under the Privacy Act of 1974. The Privacy Officer can guide you in pursuing these options. Please be aware that your request may be denied; however, you may seek a review of the denial.
Right to Inspect and Copy: You may inspect and obtain a copy of your protected health information that is contained in a “designated record set” for as long as we maintain the PHI. A designated record set contains the billing records and any other records that VRADS uses for making decisions about you.
Right to Request Restrictions: You may ask us not to use or disclose any part of your PHI for treatment, payment, or health care operations. Your request must be made in writing to the Privacy Officer where you wish the restriction instituted. Restrictions are not transferable across all billing clients. In your request, you must tell us (1) what information you want restricted; (2) whether you want to restrict our use, disclose, or both; (3) to whom you want to restriction to apply, for example, disclosures to your spouse; and (4) and expiration date. If VRADS believes that the restriction is not in the best interest of either party, or VRADS cannot reasonably accommodate the request; VRADS is not required to agree. If the restriction is mutually agreed upon, we will not use or disclose your PHI in violation of that restriction, unless it is needed to provide emergency treatment. You may revoke a previously agreed upon restriction, at any time, in writing.
Right to Request Confidential Communications: You may request that we communicate with you using alternative means or at an alternative location. We will not ask you the reason for you request. We will accommodate reasonable requests, when possible.
Right to Request Amendment: If you believe that the information we have about you is incorrect or incomplete, you may request an amendment to your PHI as long as we maintain this information. While we will accept request for amendment, we are not required to agree to the amendment.
Right to an Accounting of Disclosures: You may request that we provide you with an accounting of the disclosures we have made of your PHI. This right applies to disclosures made for purposes other than treatment, payment, or health care operations as described in this Notice of Privacy Practices. The disclosure must have been made after April 14, 2003, and no more than 6 years from the date of request. This right excludes disclosures made to you, to family members or friends involved in your care, or for notification. The right to receive this information I subject to additional exceptions, restrictions, and limitations as described earlier in this notice.
Reservation Clause: We reserve the right to change this Notice. When we do, we may make the changed Notice effective for medical information we already have about you then, as well as any information we receive in the future. We will post a copy of the current Notice in our billing office, web site and facilities where our Radiologists perform services. Each Notice will contain on the first page, in the top right-hand corner, its effective date.
Right to Obtain a Copy of this Notice: You may obtain a paper copy of this notice from our business office located at 533 South 336th ST, Suite C, Federal Way, Washington 98003. You may also view it electronically at our web site, www.vrads.com
Federal Privacy Laws: This Notice of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). There are several other privacy laws that also apply including the Freedom of Information Act, the Privacy Act and the Alcohol, Drug Abuse, Washington State “Bill of Rights”, and Mental Health Administration Reorganization Act. These laws have not been superseded and have been taken into consideration in developing our policies and this notice of how we will use and disclose your PHI.
Complaints: Please tell us about any problems or concerns you have with your privacy rights or how VRADS uses or discloses your medical information. If you have a concern, please contact a manager or the Privacy Officer at 253-661-1700. If for some reason we cannot resolve your concern, you may also file a complaint with the federal government. We will not penalize you in any way for filing a complaint with the federal government.
Contact Information: You may contact Roxanne Olson, Compliance and Privacy Officer at the following numbers:
Phone: 253-661-1700 x1150
This notice is effective in its entirety as of April 14, 2003
Updated 03202006, 08082006, 05192009, May 2013, Nov 2017, Apr 2018 RJO