Patient Privacy Policy
Northwest Oral & Maxillofacial Surgery
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.
We respect 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 insurance plan. Insurance plans need information from us about your care. Information provided to insurance plans may include your diagnoses; procedures performed, or recommended care.
For health care operations:
- We may use and disclose health information in connection with our healthcare operations. Healthcare operations include conducting training programs, accreditation, certification, licensing or credentialing activities, and practice assessment and improvement activities.
- We may contact you to remind you about appointments and give you information about treatment alternatives or other health-related benefits and services.
Your Health Information Rights
The health and billing records we create and store are the property of our office. The protected health information in it, however, generally belongs to you. You have a right to:
- Receive, read, and ask questions about this Notice;
- 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;
- 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.
- 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.
- 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.
- 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 our office at (360) 647-4262
Our Responsibilities
We are required to:
- Keep your protected health information private;
- Give you this Notice;
- Follow the terms of this Notice.
We have the right to change our practices regarding the protected health information we maintain. If we make changes, we will update this Notice. You may receive the most recent copy of this Notice by calling and asking for it or by visiting our office to pick one up.
To Ask for Help or Complain
If you have questions, want more information, or want to report a problem about the handling of your protected health information, you may contact our office at:
Northwest Oral & Maxillofacial Surgery
Ashoka Subedar2980 Squalicum Parkway #302
Bellingham, WA 98225
If you believe your privacy rights have been violated, you may discuss your concerns with any staff member. You may also deliver a written complaint to our office. You may also file a complaint with the U.S. Secretary of Health and Human Services.
Other Disclosures and Uses of Protected Health Information
Notification of Family and Others
We must disclose your health information to you. We may release health information about you to a friend or family member to the extent necessary to help with your healthcare or with payment for your healthcare, but only if you agree that we may do so.
We may use and disclose your protected health information without your authorization as follows:
- To Funeral Directors/Coroners consistent with applicable law to allow them to carry out their duties.
- To Comply With Workers’ Compensation Laws—if you make a workers’ compensation claim.
- To Report Suspected Abuse or Neglect to public authorities.
- For Law Enforcement Purposes such as when we receive a subpoena, court order, or other legal process, or you are the victim of a crime.
- For Health and Safety Oversight Activities. For example, we may share health information with the Department of Health.
- For Work-Related Conditions That Could Affect Employee Health. For example, an employer may ask us to assess health risks on a job site.
- Uses and disclosures not in this Notice will be made only as allowed or required by law or with your written authorization.