Effective Date: March 17, 2003
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. If you have any questions, please contact the TRA Privacy Officer at:
TRA Medical Imaging
Privacy Officer
P.O. Box 1535, Tacoma, WA 98401
253-383-1099
This notice will describe the privacy practices of the following entities: Tacoma Radiological Associates, P.S dba TRA Medical Imaging and Union Avenue Open MRI, LLC. Although these entities are separate legal entities, they cooperate in providing services to patients and constitute an organized health care arrangement. The entities listed may be referred to in this notice individually as a “Provider” or collectively as the “Providers.” This notice covers and applies to the following service delivery sites: TRA Medical Imaging-on Cedar, TRA Medical Imaging-Lakewood, TRA Medical Imaging-Gig Harbor, TRA Medical Imaging-on Union, TRA Medical Imaging-on Lilly, TRA Medical Imaging-Tumwater, Union Avenue Open MRI, LLC. and Medical Imaging on 1st All of the Providers listed above will share your medical information as necessary to carry out the activities listed below in the section titled, “How We May Use and Disclose Medical Information About You,” which are related to the joint activities of the Providers.
This notice describes privacy practices of the Providers and that of:
Any health care professional authorized to enter information into your chart.
All departments of the Providers.
Any member of a volunteer group allowed to help you while you are at any of the Providers.
All employees, staff and other Provider personnel.
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive from a Provider. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by our physician and other personnel.
This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.
We are required by law to:
Make sure that medical information that identifies you is kept private.
Give you this notice of our legal duties and privacy practices with respect to medical information about you.
Follow the terms of the notice that is currently in effect.
The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
For treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to other doctors, nurses, technicians, or medical students who are involved in taking care of you. For example, your doctor treating you for back pain may need x-rays of your back and will need to know if you are pregnant prior to taking the x-rays to prevent harm to the unborn fetus. Different departments of a Provider also may share medical information about you in order to coordinate the different things you need, such as prescriptions and lab work.
For payment: We may use and disclose medical information about you so that the treatment and services you receive from a Provider may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about your care received so your health plan will pay us or reimburse you for a visit or procedure. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
For operations: We may use and disclose your medical information to assess and improve the quality of our services, to review the performance and qualifications of our staff, to arrange for treatment and services you require and other purposes relating to our operations.
Treatment alternatives: We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health-related benefits and services: We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
Individuals involved in your care or payment for your care: We may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care.
As required by law: We will disclose medical information about you when required to do so by federal, state, or local law.
To avert a serious threat to health or safety: We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
Authorization / Revocation: We may release medical information about you pursuant to a written authorization signed by you. If you give us such an authorization, you may, nevertheless, revoke it by a written revocation delivered to us, except to the extent we have acted in reliance upon the authorization.
Military and veterans: If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.
Workers’ compensation: We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public health risks: We may disclose medical information about you for public health activities. These activities generally include the following:
Health oversight activities: We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you 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.
Law enforcement: We may release medical information if asked to do so by a law enforcement official:
Coroners, medical examiners and funeral directors: We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients to funeral directors as necessary to carry out their duties.
National security and intelligence activities: We may release medical information about you 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 medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
You have the following rights regarding medical information we maintain about you:
Right to inspect and copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes.
Right to amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by the Provider.
Right to an accounting of disclosures: You have the right to request an “accounting of disclosures” (a list of the disclosures of medical information about you we have made) for disclosure other than for treatment, payment or operation, disclosure to you or disclosure made pursuant to an authorization given by you. This is a list of the disclosures we made of medical information about you.
Right to request restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about treatment you had.
Right to request confidential communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
Right to a paper copy of this notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time, or you may obtain a copy at our website at www.tramedicalimaging.com. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. To obtain a paper copy of this notice contact any delivery site.
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the office of each Provider. The notice will contain the effective date on the first page in the top right-hand corner.
If you believe your privacy rights have been violated, you may file a complaint with the Secretary of the Department of Health and Human Services. To file a complaint with the Provider, contact the TRA Privacy Officer. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
This Notice describes our privacy practices as required under the federal Health Insurance Portability and Accountability Act of 1996 and regulations issued pursuant thereto. Portions of the Washington Uniform Healthcare Information Act restrict use and disclosure of your health information to a greater degree than current federal laws may. To that extent, we will follow the more restrictive law.
Other persons may require access to your medical information to perform necessary functions on our behalf. If any of your medical information is disclosed to such persons, we will first require that such persons agree to use your information solely for the agreed-upon functions and in a manner consistent with this Notice.
