- Treatment Purposes – For example, your Information may be disclosed to your primary care physician or to another specialist who referred you to WNA for treatment.
- Payment – For example, your Information may be used and disclosed to submit claims to your insurer and/or to obtain payment for services provided.
- Health Care Operations – For example, your Information may be used and disclosed by WNA to engage in case management, coordinate your care, schedule your appointments and inform you of your lab results.
- Health Care Services – Your Information may be used and disclosed to contact you and to give you information about treatment alternatives or other health benefits and services that may be of interest to you.
Uses and Disclosures With Your Verbal Consent
Your Information may be disclosed to a family member, friend or other person designated by you or as designated by the law, if you verbally agree. With your verbal consent, directory information also may be used and disclosed.
Uses and Disclosures With Your Authorization
Except as provided below, your Information will not be used for any non-routine purposes unless you give WNA your written authorization to do so. WNA may request your authorization to use and disclose your Information for research purposes. If you give WNA written authorization to use or disclose your Information for a purpose that is not described in this Notice, then, with certain exceptions, you may revoke it in writing at any time. Your revocation will be effective for the Information WNA maintains, unless WNA has taken action in reliance of your authorization.
Uses and Disclosures Without Your Consent or Authorization
- As required by law. WNA must provide your Information to the U.S. Department of Health and Human Services and to you, upon request.
- To Business Associates. Your Information may be disclosed to WNA’s business associates who require the Information to perform a function for WNA (i.e. accountant). Each business associate of WNA must agree in writing to ensure the continuing confidentiality and security of your Information.
Additionally, your Information may be used and disclosed without your consent, opportunity to agree or disagree or authorization for other reasons including, but not limited to:
- To comply with legal proceedings, such as a court or administrative order or subpoena;
- To law enforcement officials for limited law enforcement purposes;
- To a coroner, medical examiner, or funeral director about a deceased person;
- To an organ procurement organization in limited circumstances;
- To avert serious threat to your health or safety or the health or safety of others;
- To a governmental agency authorized to oversee the health care system or government programs;
- To federal officials for lawful intelligence, counterintelligence and other national security purposes;
- To public health authorities for public health purposes; and
- To appropriate military authorities, if you are a member of the armed forces.
You may make a written request to WNA to do one or more of the following concerning your Information:
- To put additional restrictions on WNA’s use and disclosure of your Information.
- To communicate with you in confidence about your Information by a different means or at a different location than WNA is currently doing.
- To see and get copies of your Information.
- To correct your Information.
- To receive a list of disclosures of your Information that WNA, and its business associates, make for certain purposes for six (6) years prior to your request (after April 14, 2003), with certain exceptions permitted by law including exceptions for disclosures made to you or made pursuant to your authorization.
- To send you a paper copy of this Notice if you receive this Notice by e-mail or on the Internet.
If you want to exercise any of these rights described or require further information about WNA’s privacy practices, please contact WNA’s Privacy Officer at the address below. Please know that in certain instances, WNA does not have to agree to your request. WNA will give you the necessary information and forms for you to complete and return. WNA will charge you a fee of $0.60 per page for copying and a preparation or retrieval fee, plus postage and handling.
If you believe your privacy rights have been violated by WNA, you have the right to complain to WNA or to the Secretary of the U.S. Department of Health and Human Services. You may file a written complaint with WNA by contacting WNA’s Privacy Officer at the address below. WNA will not retaliate against you if you choose to file a complaint with WNA or with the U.S. Department of Health and Human Services.
To request additional copies of this Notice or to receive more information about WNA’s privacy practices or your rights, please contact Ernest J. Durst at:
Washington Nephrology Associates, LLP
Telephone: (301) 907-3939 Fax: (301) 907-9021
Address: 4915 Auburn Avenue, Suite 200, Bethesda, MD 20814