NOTICE OF PRIVACY PRACTICES – SUMMARY

Our Responsibilities. Your Information. Your Rights.

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 about this notice or matters covered by this notice, please contact our Health Insurance Portability and Accountability Act of 1996 (HIPAA) Compliance Officer at (206) 695-7600 ext. 2409.

There are exceptions to the summary statements listed below, which are explained in our complete Notice of Privacy Practices. We urge you to review the actual notice in order to fully understand our responsibilities, our uses and disclosures, your rights and the choices you have in regard to information we have about you.

ACRS is designated as a “hybrid entity.” This means that we perform both covered and non-covered functions (under HIPAA). Please review our list of HIPAA covered and non-covered programs for more information.

Our Responsibilities: Protecting Your Privacy

We must do the following and more:

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in the attached notice and give you a copy of it.
  • We must ask you to sign a document stating you received our notice of privacy practices. You don’t have to sign it and it will not affect your eligibility for ACRS services.
  • We will not use or share your information other than as described on our notice unless you tell us we can in writing. If you tell us we can, you may still change your mind at any time. Let us know in writing if you change your mind.

Uses and Disclosures of Information

We may use and share your information in order to:

  • Provide you services
  • Run our organization
  • Bill for your services
  • Help with public health and safety issues
  • Comply with the law
  • Address workers’ compensation and other government requests
  • Respond to lawsuits and legal actions

Your Choices

You have some choices in the way that we use and share information which include:

  • Whether family and friends should know about your condition
  • What information can be shared about you in a disaster relief situation
  • Whether we can share your information for marketing purposes
  • If we can use information about you to raise funds

Your Rights

You have the right to:

  • Get a copy of your paper or electronic medical record
  • Correct your paper or electronic medical record
  • Request confidential communication
  • Ask us to limit the information we share
  • Get a list of those with whom we’ve shared your information
  • Get a copy of our privacy notice
  • Choose someone to act for you
  • File a complaint if you believe your privacy rights have been violated

Disclaimer: This document is not to be provided in place of our actual Notice of Privacy Practices. The statements above are only a summary of some of the matters covered by our Notice of Privacy Practices. There are exceptions to the statements listed above which are explained in our complete Notice of Privacy Practices. We urge you to review the actual notice in order to fully understand our responsibilities, our uses and disclosures, your rights and the choices you have in regard to information we have about you.

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