NOTICE OF PRIVACY POLICIES.

Soma Institute of Neuromuscular Integration and Olivia Ireland, LMT, Certified Soma® Practitioner (CSP) and A Little Wild Honey PLLC. This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

INTRODUCTION.

At the office of OLIVIA IRELAND, LMT, CSP + A Little Wild Honey, PLLC (“the Office” or “We”), We are committed to treating and using protected health information about you responsibly. We understand that your medical information is personal. This notice of health information practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information. This notice is effective April 14, 2003, and applies to all protected health information as defined by federal regulations.

UNDERSTANDING YOUR HEALTH RECORD + INFORMATION.

Each time you visit the Office, a record of your visit is made. Typically, this record contains the dates services were provided, health history and symptoms, description of services provided, treatment, and a plan for future care or treatment, as well as a physician's referral if appropriate. This information, often referred to as your health or medical record, serves as a:

  • basis for planning your care and treatment

  • means of communication among the health professionals who contribute to your care

  • legal document describing the care you received

  • means by which you or a third party payer can verify that Services build we're provided

  • a tool in educating health professionals

  • a source of data for medical research

  • a source of information for public health officials charged with improving the health of the state and the nation

  • a source of data for the Office  planning and marketing

  • a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve

Understanding what is in your record and how your health information is used helps you to ensure its accuracy, better understand who, what, when, where and why others may access your health information, and make more informed decisions when authorizing disclosure to others.

YOUR HEALTH INFORMATION RIGHTS.

Although your health record is the physical property of the Office, the information belongs to you. You have the right to:

  • obtain a paper copy of this notice of information practices upon request

  • look at or get copies of your medical information under RCW 70.02.080.  You must make your request in writing. If you request copies, we can charge you $19. 00 in clerical fees, $0.83  for each page, and postage if you want the copies mailed to you

  • amend your health record as provided in RCW 70.02.100

  • obtain an accounting of disclosures of your health information for purposes other than treatment, payment, and healthcare operations and other specified exceptions

  • request a restriction on certain uses and disclosures of your information as provided by RCW 70.02.090

  • revoke your authorization to use or disclose health information except to the extent that action has already been taken

 

OUR RESPONSIBILITIES

The Office is required to:

  • maintain the privacy of your health information

  • provide you with this notice as to our legal duties and privacy practices with respect to the information we collect and maintain about you

  • abide by the terms of this notice

  • notify you if we are unable to agree to a requested restriction

  • accommodate reasonable requests you may have to communicate health information by alternative means and locations

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will mail a revised notice to the address you have supplied us, or if you agree, email the revised notice to you. 

We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue using or disclosing your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.

FOR MORE INFORMATION OR TO REPORT A PROBLEM.

If you have any questions or would like additional information you may contact Olivia Ireland at 360-789-8254.

If you believe your privacy rights have been violated, you can file a complaint with Olivia Ireland or with the Office for Civil Rights at the US Department of Health and Human Services, or with the State Department of Health. There can be no retaliation for filing a complaint with any of these parties. Addresses for these governing agencies are listed below.

Office for Civil Rights, US Dept of Health and Human Svcs, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201

Washington State Dept of Health, Health Professions Quality Assurance, 1300 SE Quince St, PO Box 47867, Olympia, WA 98504

EXAMPLES OF DISCLOSURES FOR TREATMENT, PAYMENT, AND HEALTH OPERATIONS.

We will use your health information for treatment. For example, information obtained by a physician, Soma practitioner, licensed mental health counselor, licensed massage therapist or other member of your health care team will be recorded in your record and used to determine the course of treatment that works best for you. Your practitioner will document in your record his or her expectations. In that way the practitioner will know how you are responding to treatment. We will also provide your physician or a subsequent Health provider with copies of various reports that should assist them in treating you at your request

We will use your health information for payment. For example, members of the Office staff may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare we provide.

We will use your health information in certain business associations. There are some Services provided to our organization through contacts with business associates, for example, insurance billing. When these services are contracted, we may disclose your health information to our business associate so they can perform the job we've asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.

We will use your health information for notification. For example, medical information to notify or help notify a family member, your personal representative, or another person responsible for your care. We will share information about your location, general condition, or death. If you are present, we will get your permission if possible before we share, or give you the opportunity to refuse permission. In the case of an emergency, and if you are not able to give or refuse permission, we will only share the health information that is directly necessary for healthcare, according to our professional judgment to make decisions in your best interest, before allowing anyone medical information about you.

We will use your health information for communication with family. Health professionals using their best judgment may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care.

We will use your health information for research. We may disclose information to researchers when their research has been approved by an Institutional review board that reviewed the research proposal and established protocols to ensure the privacy of your information.

We will use your health information for marketing. We may contact you to provide appointment reminders, which will include the name of our clinic, or information about treatment alternatives or other health-related benefits and services that may be of interest to you. We can mail reminder postcards, which may contain the Office address or the amount of time since your last visit.

We will use your health information for FDA purposes. We may disclose to the FDA health information relative to adverse events with respect to food, supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacement.

We will use your health information for Worker’s Compensation. We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to Worker’s Compensation or other similar programs established by law.

We will use your health information for public health. As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability. 

We will use your health information for law enforcement purposes. We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

Federal law makes provisions for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a workforce member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards, potentially endangering one or more patients, workers or the public.

We keep a record of the healthcare services we provide you. You may ask to see and copy the record. You may also ask us to correct that record. We will not disclose your record to others unless you direct us to do so or unless the law authorizes or compels us to do so. You may see your record and get more information about it at:

Olivia Ireland, LMT, CSP, 1800 Cooper Point Rd SW, Olympia WA 98502 • 360-789-8254