11522 NE 20th Street, Bellevue, WA 98004
Tel: 425.462.2531 Fax: 425.454.6176

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How do we ensure that your PRIVACY AND CONFIDENTIALITY are being respected?

We respect your privacy and confidentiality. Here we attempt to explain how information about you may be used or disclosed. It’s important for you to know how you can access this information as well.

The policies below came into effect on April 14, 2003 and remain in effect until further notice.

We understand that your medical information is personal and we are committed to protecting it. We create a record of the care and services you receive in our clinic. This allows us to provide you will quality care and comply with certain legal requirements. We are required to keep your medical information private as per HIPAA regulations. The terms below will only be changed if permitted by law.

Information about you includes your name, address, phone number(s), place(s) of employment, medical diagnoses, full medical records (if available) including medical records forwarded by other clinics, insurance companies or law offices.

You may request that your records be sent to another healthcare provider. However, if you have come to our clinic upon the advice or at the request of another healthcare provider (such as for a rheumatologic consultation), then that provider will be sent copies of your medical consultation automatically and at no cost to you. If you have given us names of other healthcare providers who have participated in your medical care, as a professional courtesy we will also send them information about your healthcare if we feel this information will assist them with the management of your healthcare needs. Please do not forget to give us names of your complete healthcare team.

Under certain circumstances, we may disclose health information to law enforcement officials. Medical information may also be disclosed in response to a court or administrative order or other lawful process. This may include sharing of information concerning a suspect, fugitive, material witness, crime victim or missing person. We may disclose your medical information to public health or legal authorities involved with the prevention of child abuse or neglect. We may disclose medical information to appropriate authorities if we reasonably believe you are a possible victim of abuse, neglect or domestic violence or of other crimes. Similarly, your information may be disclosed to public health or legal authorities involved with the prevention or control of communicable diseases or with issues such as injury or disability. Your information may be disclosed for the purpose of reporting adverse events associated with product defects or medical side effects, such as to the Food and Drug Administration. We may also notify a person, when we are authorized by law to do so, who may have been exposed to a communicable disease or otherwise may be at risk of contracting or spreading a disease or condition.

We may share your medical information if it is necessary to prevent a serious threat to your health or safety of others.

These are YOUR rights:

1.Access to your medical information:  The request must be in writing, signed and dated by yourself. A standard clerical fee for searching and handling records, as well as a per page copying fee, will be charged in compliance with the State of Washington laws. If one of our healthcare providers personally edits confidential information, at your request, from the record, then the usual fee for a basic office visit will be charged as per WAC 246-08-400. Please note that we require at least one week’s notice but always appreciate a longer lead time.

2.You have a right to receive a list of all the times we or our business associates have shared your medical information for purposes other than treatment, payment and healthcare operations and other specified exceptions.

3.You have a right to place additional restrictions on our use or disclosure of your medical information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement herein, except in the case of an emergency.

4.You may request that we communicate with you about your medical information by different means or to different locations. We require this request in writing, signed and dated by you. Please note that we do not have a so-called “secure” email to handle confidential patient information.

5.You have a right to request that we change your medical information. This request will be added to your medical record as a “correction”.  However, we will not delete any of your medical record at any time as it remains a legal document.

What if you still have concerns regarding our privacy policies or have any concerns about any experience within our medical clinic?

Then we want to hear from you! We suggest you phone, send a letter by mail or by fax, addressed to Dr. Sue Romanick. Alternatively, you can bring it up at your next office visit.  It is important to us that you receive a high quality of medical care from our clinic.  It is our policy to follow up with you within 10 days. If you think we may have violated your privacy rights, we require your concerns in writing. It is important to notify the receptionist immediately by phone. You have a right to submit a written complaint to the U.S. Department of Health and Human Services. We will not retaliate in any way if you choose to file a complaint.

We like to consider the following our rights. Obviously, these help us deliver the highest possible quality of medical care for all of our patients.

We have a right to deliver caring, compassionate and comprehensive care to our patients. Any patient refusing to follow medical advice or who is disruptive to any of our healthcare providers, staff, or other patients will be asked to seek their health care at another clinic. We are happy to transfer copies of that patient’s medical care upon written request by the patient to the new healthcare provider. Please note that every patient has access, whether through our new patient packets or on our website, a list of office policies. We ask that each of our patients review these to prevent any misunderstandings.

We are grateful for the opportunity to provide ongoing, excellent medical care to so many satisfied patients. We appreciate your ongoing confidence. We also thank you for your ongoing referrals to our clinic. For us, they represent the highest form of compliment!
—Sue Romanick MD and staff