Notice of Privacy Practices

How We May Use and Share Your Health Information

We may use and share your health information for the following purposes.

Treatment

We may use and share your health information to provide, coordinate, or manage your care.

Example: We may share information with a physician, nurse, care manager, pharmacy, laboratory, or other health care provider involved in your care.

Payment

We may use and share your health information to bill for services and obtain payment from health plans or other responsible payers.

Example: We may send information about your visit, diagnosis, or services provided to your health insurance plan so it can process payment.

Health Care Operations

We may use and share your health information to run our organization, improve our services, train staff, manage quality, and contact you when needed.

Example: We may review care records to evaluate the quality of our care management services.

Other Ways We May Use or Share Your Health Information

We may also use or share your health information as permitted or required by law, including:

• To help with public health and safety activities, such as preventing disease, reporting adverse events, or reporting suspected abuse, neglect, or domestic violence
• To comply with federal, state, or local law
• To respond to health oversight activities, such as audits, investigations, inspections, or licensure activities
• To respond to court or administrative orders, subpoenas, discovery requests, or other lawful legal processes
• For law enforcement purposes when permitted or required by law
• For workers’ compensation claims
• To prevent or reduce a serious and imminent threat to the health or safety of a person or the public
• To work with a coroner, medical examiner, or funeral director when an individual dies
• For certain specialized government functions, such as military, national security, or protective services, when permitted by law
• For health research, only as permitted by law and applicable privacy requirements

If another law gives greater protection to certain information, we will follow the more protective law.

Uses and Disclosures That Require Your Written Permission

We will not use or share your health information for purposes not described in this notice unless you give us written permission.

We will get your written permission before:

• Using or sharing your health information for marketing purposes, except as permitted by law
• Selling your health information
• Using or sharing your health information for any other purpose that requires written authorization under HIPAA

If you give us written permission, you may revoke it at any time by telling us in writing. We cannot undo uses or disclosures already made based on your earlier permission.

Substance Use Disorder Records

To the extent we receive or maintain substance use disorder patient records protected by 42 CFR Part 2, we will follow those additional privacy protections.

Records protected by 42 CFR Part 2, or testimony describing those records, will not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless permitted by law, such as with your written consent or with a qualifying court order and legal requirement compelling disclosure.

Reproductive Health Care Privacy

We will not use or share your health information for a purpose prohibited by HIPAA, including to investigate or impose liability on a person for seeking, obtaining, providing, or facilitating lawful reproductive health care.

When required by HIPAA, before disclosing health information potentially related to reproductive health care for certain purposes, such as health oversight, law enforcement, judicial or administrative proceedings, or disclosures to coroners or medical examiners, we will obtain a signed attestation that the request is not for a prohibited purpose.

Redisclosure Notice

When we share your health information as permitted by HIPAA, the person or organization receiving it may be allowed to share it again. In some cases, that information may no longer be protected by HIPAA after it is redisclosed.

Your Rights

You have the following rights regarding your health information.

Get a Copy of Your Medical Record

You can ask to see or get an electronic or paper copy of your medical record and other health information we maintain about you.

We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask Us to Correct Your Medical Record

You can ask us to correct health information about you that you believe is incorrect or incomplete.

We may say no to your request, but if we do, we will tell you why in writing, usually within 60 days.

Request Confidential Communications

You can ask us to contact you in a specific way or at a specific location.

For example, you can ask us to call a specific phone number or send mail to a different address. We will say yes to all reasonable requests.

Ask Us to Limit What We Use or Share

You can ask us not to use or share certain health information for treatment, payment, or health care operations.

We are not required to agree to your request, and we may say no if it would affect your care or if the law allows us to decline.

If you pay for a service or health care item out of pocket in full, you can ask us not to share information about that service or item with your health plan for payment or health care operations. We will say yes unless a law requires us to share the information.

Get a List of Certain Disclosures

You can ask for a list of certain times we shared your health information during the six years before your request.

The list will not include all disclosures. For example, it generally will not include disclosures for treatment, payment, or health care operations, or disclosures you asked us to make.

We will provide one accounting per year for free. We may charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a Paper Copy of This Notice

You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.

Choose Someone to Act for You

If someone has legal authority to act for you, such as a medical power of attorney or legal guardian, that person may exercise your rights and make choices about your health information.

We may verify that the person has this authority before taking action.

File a Complaint

You can file a complaint if you believe your privacy rights have been violated.

You can contact us at:

Privacy Contact: Chief Technology Officer
Phone: (352) 788-2993
Email: support@preemptiveclinic.com
Mailing Address: 1522 Western Ave STE 24105, Seattle WA 98101

You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

We will not retaliate against you for filing a complaint.

Our Responsibilities

We are required by law to:

• Maintain the privacy and security of your protected health information
• Give you this notice of our legal duties and privacy practices
• Follow the terms of the notice currently in effect
• Notify you if a breach occurs that may have compromised the privacy or security of your unsecured protected health information

We reserve the right to change the terms of this notice. If we make a material change, the new notice will apply to all health information we maintain. The updated notice will be available upon request and on our website.