Privacy Policy
Effective Date: December 19, 2005
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.
About Us
In this Notice, we use terms like “"we",”"us"”or “"our" to
refer to Northwest Cancer Specialists, its physicians, employees, staff
and other personnel. All of the sites and locations of Northwest Cancer
Specialists follow the terms of this Notice and may share health information
with each other for treatment, payment or health care operations purposes
as described in this Notice.
Purpose of this Notice
This Notice describes how we may use and disclose your health information
to carry out treatment, payment or health care operations and for other purposes
that are permitted or required by law. This notice also outlines our
legal duties for protecting the privacy of your health information and explains
your rights to have your health information protected. We will create
a record of the services we provide you, and this record will include your
health information. We need to maintain this information to ensure
that you receive quality care and to meet certain legal requirements related
to providing you care. We understand that your health information is
personal, and we are committed to protecting your privacy and ensuring that
your health information is not used inappropriately.
Our Responsibilities
We are required by law to maintain the privacy of your health information
and provide you notice of our legal duties and privacy practices with respect
to your health information. We will abide by the terms of this Notice.
How We May Use or Disclose Your Health Information
The following categories describe examples of the way we use and disclose
health information:
For Treatment: We may use your health information to provide you
with medical treatment or services. For example, your health information
will be disclosed to the oncology nurses who participate in your care. We
may disclose your health information to another oncologist for the purpose
of a consultation. We may also disclose your health information to
your physician or another healthcare provider to be sure those parties have
all the information necessary to diagnose and treat you.
For Payment: We may use and disclose your health information to others
so they will pay us or reimburse you for your treatment. For example,
a bill may be sent to you, your insurance company or a third-party payer. The
bill may contain information that identifies you, your diagnosis, and treatment
or supplies used in the course of treatment.
We may share your health information with pharmaceutical company patient
assistance programs and patient support organizations in order to assist
you in obtaining payment for your care or payment for certain parts of your
care.
For Health Care Operations: We may use and disclose your health information
in order to support our business activities. For example, we may use
your health information for quality assessment activities, training of medical
students, necessary credentialing, and for other essential activities.
We may ask you to sign your name to a sign-in sheet at the registration
desk and we may call your name in the waiting room when we call you for your
appointment.
We may disclose your health information to a third party that performs services,
such as billing and collection, on our behalf. In these cases, we will
enter into a written agreement with the third party to ensure they protect
the privacy of your health information.
Appointment Reminders: We may use and disclose your health information
in order to contact you and remind you of an upcoming appointment for treatment
or health care services.
Treatment Alternatives and Health-Related Benefits and Services:
We may use your health information to inform you of services or programs
that we believe would be beneficial to you. We may call, mail or e-mail
you information about these services or goods. For example, we may
contact you to make you aware of new products, supply product information,
or a new patient assistance program that may be available to you.
Individuals Involved in Your Care or Payment for Your Care: We may
release your health information, including information about your condition,
to a family member or friend who is involved in your medical care or who
helps pay for your care. If you would like us to refrain from releasing
your health information to a particular family member or friend, please notify
our Privacy Officer. We may also disclose your health information to
disaster-relief organizations so that your family can be notified about your
condition, status and location.
We are also allowed by law to use and disclose your health information without
your authorization for the following purposes:
As Required by Law: We may use and disclose your health information
when required to do so by federal, state or local law.
Judicial and Administrative Proceedings: If you are involved in a
legal proceeding, we may disclose your health information in response to
a court or administrative order. We may also release your health information
in response to a subpoena, discovery request, or other lawful process by
someone else involved in the dispute, but only if efforts have been made
to tell you about the request or to obtain an order protecting the information
requested.
Health Oversight Activities: We may use and disclose your health
information to health oversight agencies for activities authorized by law. These
oversight activities are necessary for the government to monitor the health
care system, government benefit programs, compliance with government regulatory
programs, and compliance with civil rights laws.
Law Enforcement: We may disclose your health information, within
limitations, to law enforcement officials for several different purposes:
- To comply with a court order, warrant, subpoena, summons, or other
similar process;
- To identify or locate a suspect, fugitive, material witness, or
missing person;
- About the victim of a crime, if unable to obtain the victim's
agreement;
- About a death we suspect may have resulted from criminal conduct;
- About criminal conduct we believe in good faith to have occurred
on our premises; and
- To report a crime, the location of a crime, and the identity,
description and location of the individual who committed the crime,
in an emergency situation.
Public Health Activities: We may use and disclose your health information
for public health activities, including the following:
- To prevent or control disease, injury, or disability;
- To report births or deaths; to report child abuse or neglect;
- To report adverse events, product defects or problems;
- To track FDA-regulated products; to notify people and enable product
recalls; and
- To notify a person who may have been exposed to a communicable
disease or may be at risk for contracting or spreading a disease
or condition.
- To notify the State Cancer Registry
Serious Threat to Health or Safety: If there is a serious threat
to your health and safety or the health and safety of the public or another
person, we may use and disclose your health information to someone able to
help prevent the threat.
Organ/Tissue Donation: If you are an organ donor, we may use and
disclose your health information to organizations that handle organ procurement
or organ, eye, or tissue transplantation or to an organ donation bank.
Coroners, Medical Examiners, and Funeral Directors: We may use and
disclose health information to a coroner or medical examiner. This disclosure
may be necessary to identify a deceased person or determine the cause of
death. We may also disclose health information, as necessary, to funeral
directors to assist them in performing their duties.
Workers' Compensation: We may disclose your health information for
workers' compensation or similar programs. These programs provide benefits
for work-related injuries or illness.
Victims of Abuse, Neglect, or Domestic Violence: We may disclose
health information to the appropriate government authority if we believe
a patient has been the victim of abuse, neglect, or domestic violence. We
will only make this disclosure if you agree, or when required or authorized
by law.
Military and Veterans Activities: If you are a member of the Armed
Forces, we may disclose your health information to military command authorities.
Health information about foreign military personnel may be disclosed to foreign
military authorities.
National Security and Intelligence Activities: We may disclose your
health information to authorized federal officials for intelligence, counterintelligence,
and other national security activities authorized by law.
Protective Services for the President and Others: We may disclose
your health information to authorized federal officials so they may provide
protective services for the President and others, including foreign heads
of state.
Inmates: If you are an inmate of a correctional institution or under
the custody of a law enforcement official, we may disclose your health information
to the correctional institution or law enforcement official to assist them
in providing you health care, protecting your health and safety or the health
and safety of others, or for the safety of the correctional institution.
Research: We may use and disclose your health information for certain
limited research purposes. All research projects, however, are subject to
a special approval process. This process evaluates a proposed research project,
assesses a number of specific issues, and determines that appropriate privacy
safeguards are in place to allow the use of health information in the research
project. We may, however, disclose your health information to people preparing
to conduct a research project; for example, to help them look for patients
with specific medical needs, so long as the health information they review
does not leave the practice.
Other Uses and Disclosures of Your Health Information: Other uses
and disclosures of your health information not covered by this Notice or
the laws that apply to us will be made only with your authorization. If you
authorize us to use or disclose your health information, you may revoke that
authorization, in writing, at any time. If you revoke your authorization,
we will no longer use or disclose your health information as specified by
the revoked authorization, except to the extent that we have taken action
in reliance on your authorization.
Your Rights Regarding Your Health Information
You have the following rights regarding health information we maintain about
you:
Right to Request Restrictions: You have the right to request restrictions
on how we use and disclose your health information for treatment, payment
or health care operations. Under most situations we are not required to agree
to your request. If we do agree, we will comply with your request unless
the information is needed to provide you emergency treatment. To request
restrictions, you must make your request in writing and submit it to our
Privacy Officer.
Right to Request Confidential Communications: You have the right
to request that we communicate with you in a certain manner or at a certain
location regarding the services you receive from us. For example, you may
ask that we only contact you at work or only by mail. To request confidential
communications, you must make your request in writing and submit it to our
Privacy Officer. We will attempt to accommodate all reasonable requests.
Right to Inspect and Copy: You have the right to inspect and copy
health information that may be used to make decisions about your care. Usually,
this includes medical and billing records, but may not include psychotherapy
notes or information that is compiled in reasonable anticipation of, or use
in, a civil, criminal, or administrative action or proceeding. To inspect
and copy your health information, you must make your request in writing by
filling out the appropriate form provided by us and submitting it to our
Privacy Officer. If you request a copy of your health information, we may
charge a fee for the costs of copying, mailing or preparing the requested
documents.
We may deny your request to inspect and copy in certain very limited circumstances.
If you are denied access to your health information, you may request that
the denial be reviewed by a licensed health care professional chosen by us.
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 your health information is incorrect
or incomplete, you may request that we amend your information. You have the
right to request an amendment for as long as the information is kept by or
for us. To request an amendment, you must make your request in writing by
filling out the appropriate form provided by us and submitting it to our
Privacy Officer.
We may deny your request for an amendment. If this occurs, you will be notified
of the reason for the denial and given the opportunity to file a written
statement of disagreement with us.
Right to an Accounting of Disclosures: You have the right to request
an accounting of certain disclosures we make of your health information.
Please note that certain disclosures, such as those made for treatment, payment
or health care operations, need not be included in the accounting we provide
to you.
To request an accounting of disclosures, you must make your request in writing
by filling out the appropriate form provided by us and submitting it to our
Privacy Officer. Your request must state a time period which may not be longer
than six years, and which may not include dates before April 14, 2003. The
first accounting you request within a 12-month period will be free. For additional
accountings, we may charge you for the costs of providing the accounting.
We will notify you of the costs involved and give you an opportunity to withdraw
or modify your request before any costs have been incurred.
Right to a Paper Copy of This Notice: You have the right to a paper
copy of this Notice at any time, even if you previously agreed to receive
this Notice electronically. To obtain a paper copy of this Notice, please
contact our Privacy Officer. You may also print a copy of this Notice at
our web site, www.nwcancer.com.
Right to Complain: If you have any questions about this Notice or
would like to file a complaint about our privacy practices, please direct
your inquiries to:
Privacy Officer
Northwest Cancer Specialists
1498 SW Tech Center Place, Suite 240
Vancouver, WA 98683
You may also file a complaint with the Secretary of the Department of Health
and Human Services. You will not be retaliated against or penalized for filing
a complaint
Changes to this Notice
We reserve the right to change the terms of this Notice at any time. We
reserve the right to make the new Notice provisions effective for all health
information we currently maintain, as well as any health information we receive
in the future. If we make material or important changes to our privacy practices,
we will promptly revise our Notice. We will post a copy of the current Notice
in the waiting room of each office. Each version of the Notice will have
an effective date listed on the first page. Updates to this Notice are also
available at our web site www.nwcancer.com