Notice of Privacy Practices

Effective Date: 4/1/2003

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, please contact:
April Gibson, Administrator
Lakewood Orthopaedic Surgeons
(253) 582-7357 x 317

This Notice will describe the privacy practices of the following entities: Puget Sound Orthopaedics, Steven M. Teeny, MD, Julian S. Arroyo, MD, Alan B. Thomas, MD, Dale L. Hirz, MD, Spencer Coray, MD, W Brandt Bede, MD, John Blair, MD, Michael Martin, MD, Lindsay Rades, PA-C, Margaret Lyman, PA-C, Van Phan, PA-C, Alex Angeles, PA-C, Lakewood Surgery Center. These entities may be referred to in this Notice individually as a ""Provider" or collectively as the "Providers".

This notice describes privacy practices of the Providers and that of:

• Any health care professional authorized to enter information into your chart.

• All departments of the Providers.

• Any member of a volunteer group allowed to help you while you are at any of the Providers.

• All employees, staff and other Provider personnel.

Our Pledge Regarding Medical Information
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive from a Provider. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by our physician and other personnel.

This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

We are required by law to:

• Make sure that medical information that identifies you is kept private.

• Give you this notice of our legal duties and privacy practices with respect to medical information about you.

• Follow the terms of the notice that is currently in effect.

How We May Use and Disclose Medical Information About You
The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

• For treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to other doctors, nurses, technicians, or medical students who are involved in taking care of you. For example, your doctor treating you for surgery may need to know if you have acute/chronic disease because it could affect the surgical outcome. Different departments of a Provider also may share medical information about you in order to coordinate the different things you need, such as prescriptions and lab work.

• For payment: We may use and disclose medical information about you so that the treatment and services you receive from a Provider may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about your care received so your health plan will pay us or reimburse you for a visit or procedure. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

• For operations: We may use and disclose your medical information to assess and improve the quality of our services, to review the performance and qualifications of our staff, to arrange for treatment and services you require and other purposes relating to our operations.

• Treatment alternatives: We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

• Health-related benefits and services: We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.

• Individuals involved in your care or payment for your care: We may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care.

• As required by law: We will disclose medical information about you when required to do so by federal, state, or local law.

• To avert a serious threat to health or safety: We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.