Office Information

Notice of Privacy Practices

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.

Tri-City Orthopaedic Clinics (TCO) respects your privacy. We understand that your personal health information is very sensitive. We will not disclose your information to others unless you tell us to do so, or unless the law authorizes or requires us to do so.

The law protects the privacy of the health information we create and obtain in providing our care and services to you. For example, your protected health information includes your symptoms, test results, diagnoses, treatment, health information form other providers, and billing and payment information relating to these services. Federal and state law allows is to use and disclose your protected health information for purposes of treatment and health care operations. Sate law requires us to get your authorization to disclose this information for payment purposes.

Examples of Use and Disclosures of Protected Health information for Treatment, payment, and Health Operations

For Treatment:

• Information obtained by a nurse, physician, or other member of our health care team will be recorded in your medical record and used to help decide what care may be right for you.

• We may also provide information to others providing you care (such as physical therapist, other specialist physicians, your PCP, a pharmacist or Durable Medical Equipment companies you may need supplies from, this list is just an example and is not all inclusive). This will help them stay informed about your care.

For Payment:

• We request payment from your health insurance plan. Health plans need information from us about our medical care.   Information provided to health plans may include your diagnoses; procedures performed, or recommended care.

For Health Care Operations:

• We use your medical records to assess quality and improve services.
• We may use and disclose medical records to review the qualifications and performance of our health care providers and to train our staff.
• We may contact you to remind you about appointments, change appointments and give you information about treatment alternatives or other health-related benefits and services.
• We may contact you to raise funds.
• We may use and disclose your information to conduct or arrange for services, including:
• Medical quality review by your health plan;
• Accounting, legal, risk management, and services;
• Audit functions, including fraud and abuse detection and compliance programs.

Your Health Information Rights

The health and billing records we create and store are the property of TCO.   The protected health information in it, however, generally belongs to you.   You have the right to:

• Receive, read, and ask questions about this notice.
• Ask us to restrict certain uses and disclosures. You must deliver this request in writing to us. We are not required to grant the request. But we will comply with any request granted.
• Request that you will be allowed to see and get a copy of your protected health information. You make this request in writing. We have a form available for this type of request.  
• Have us review a denial of access to your health information-except in certain circumstances.
• Ask us to change your health information. You may give us this request in writing. You may write a statement of disagreement if your request is denied. It will be stored in your medical records, and included with any release of your records.
• Cancel prior authorizations to use or disclose health information by giving us written revocation. Your revocation does not affect information that has already been released. It also does not affect any action taken before we have it. Sometimes, you cannot cancel an authorization, sign, date, time and return.

For help with these during normal business hours, please contact:

Tri-City Orthopaedic Clinics

821 Swift Boulevard

Richland, WA 99352

(509) 946-6144

Our Responsibilities

We are required to:

• Keep your protected health information private.
• Give you this Notice.
• Follow the terms of this notice.

We have the right to change our practices regarding the protected health information we maintain. If we make changes, we will update this notice. You may receive the most recent copy of this notice by calling and asking for it or by picking one up in our reception room.

Patient's Rights and Responsibilities

We believe that the patient's rights and responsibilities are an important part of providing quality healthcare. We consider you a partner in your healthcare. We want to inform you of your rights, as well as your responsibilities, to ensure you receive the best possible care and service.   When you are well informed, participate in treatment decision, and communicate openly with your physician and other healthcare professionals, you help make your care as effective as possible.

Your Rights To :

• Considerate, respectful medical care and services, responsive to your needs.
• Choose your health care provider (according to your health plan instructions) and have personal access to that provider.
• Understandable and complete information concerning your condition and care.   This includes clear explanation of procedures, test, or treatment before you consent to them.   It also includes information about risk, alternatives, effect, and appropriate costs.
• Supportive care including appropriate management of pain, treatment of uncomfortable symptoms, and support of your emotional and spiritual need regardless of you medical status or treatment decisions.
• Participate in and consent to all decisions involving your medical care, including making decisions on advanced directives, durable power of attorney for healthcare and living wealth.
• Obtain a second opinion with respect to your diagnosis and treatment, according to your health plan instructions.
• Voice concerns regarding your care without fear recrimination, to have those concerns reviewed, and, when possible, resolved.   You have the right to be informed of the responses to your concerns.
• Communication with the appropriate staff in order to resolve a question or concern about our office, or your care.
• All information about your care.   We keep a record of the health care we provide you.   You may ask to see your record in the presence of a staff member.   Arrangements must be made in advance with the medical records clerk or office manager, in order to assure the availability of staff member.
• You may request a copy of your record, with advance notice and a signed release stating where the record will be going.   There may be a copying fee for this service.
• You may also ask us to amend your record if you feel it is incomplete or incorrect, the statement which will be referenced and become a part of your record.
• Privacy and confidentiality of you medical records, we will not disclose your records to others unless you direct us to do so or unless the law authorizes or compels us to do so.
• Receive a detailed copy of your bill and explanation regarding the charges for services received.
• Use of a language interpreter, if necessary.
• Access to the facility regardless of physical or visual impairment.

Your Responsibilities

In order to ensure that you receive the best possible care and service at our office, our patients must assume certain responsibilities as described below.

• Patient Information : You must provide, to the best of your knowledge, accurate and complete information about present complaints, past illnesses, hospitalization, medications, allergies, family history, and other matters relating to your health.
• Appointments: You are responsible for keeping your appointments and for notifying the office at least 24 hours in advance when you are unable to keep an appointment.
• Communication: You should make every effort to clarify whether you understand your medical treatment and what is expected of you, and ask questions or state concerns to your physician.
• Participate in and Consent to: All decisions involving your medical care, including notifying our office if you had made a decision regarding advanced directives, durable power of attorney for healthcare and living wealth.
• Compliance with Instructions: You are responsible for following the recommended treatment plan. If you are unable to do so, you should consult your physician so that the problem can be solved. Provide information about unexpected matters or changes in an expected course of treatment, such as, change in medications and health status.
• Refusal of Treatment: You are responsible for the consequences if you refuse recommended treatment or if you do not follow the physician instructions.
• Prescription Refills: To meet the needs of all our patients, we request that you call your pharmacy 24-48 hours in advance for all prescription refills.
• Insurance Information: It is your responsibility to provide your complete and accurate insurance billing information, you should know your insurance requirements for authorization of treatment and to pay your co-payment at the time of you visit. Please understand that professional services are rendered to you and not the insurance company. In the event the insurance company rejects your claim, we hope you understand that all services provided to you through our office will be your financial responsibility.
• Finance Charges: You are responsible for meeting the finical obligations of your care as promptly as possible, finance charges are added on private balances over 60 days past due.
• Respect and Consideration for other patients and Staff: You are responsible for being considerate and respectful of the rights and property of other patients, and our personnel here at TCO.

All your health care needs are important to us. If you have any questions pertaining to rights and responsibilities as the patient, you can ask one of our staff members or ask to see the office manger. Our goal is to provide the highest level of quality healthcare in a manner that is both personal and compassionate. On behalf of the physicians and staff we invite you to let us know how we are doing.

Sincerely,

Tri-City Orthopaedic Clinics

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