Notice of Privacy Practices

Your health information is important, and at Cashmere Spine and Wellness, we are committed to protecting it. Health information belonging to you is collected by Cashmere Spine and Wellness and stored in an electronic chart as your medical record, which is owned by Cashmere Spine and Wellness. This notice explains how your medical information may be used and shared, your rights regarding this information, and how you can access it. Please review it carefully.

Your Rights

You have specific rights when it comes to your health information. Here’s what you need to know:

1. Get a copy of your medical record:

   • You can ask for an electronic or paper copy of your medical record and other health information we have about you.

   • We’ll provide this usually within 30 days of your request, and we may charge a reasonable, cost-based fee for paper copies.

2. Ask us to correct your medical record:

   • If you believe there’s incorrect or incomplete information in your record, you can ask us to correct it.

   • We may say “no” to your request, but we’ll explain why in writing within 60 days.

3. Request confidential communications:

   • You can ask us to contact you in a specific way (e.g., on your home or office phone) or send mail to a different address.

   • We will agree to all reasonable requests.

4. 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 operations. We may not always agree, especially if it affects your care or obtaining payment for services from your health plans.

   • If you pay for a service in full out-of-pocket, you can ask us not to share that information with your health insurer. We will agree unless required by law to share it.

5. Get a list of those with whom we’ve shared your information:

   • You can request a list of when, with whom, and why we’ve shared your health information for the past six years. This doesn’t include disclosures for treatment, payment, or healthcare operations.

6. Get a copy of this privacy notice:

   • You can request a paper copy of this notice at any time, even if you received it electronically.

7. Choose someone to act for you:

   • If you’ve given someone medical power of attorney or if someone is your legal guardian, they can make decisions about your health information.

   • We will ensure they have the authority before we take any action.

8. File a complaint if you feel your rights are violated:

   • If you believe we’ve violated your rights, you can file a complaint with us using the contact information at the end of this notice.

   • You can also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you have choices in how we share it. Let us know your preferences:

• Share with family, friends, or others involved in your care:

  • You can choose to allow us to share your information with your family or others involved in your care, or in a disaster relief situation.

  • If you’re unable to tell us your preference (e.g., if you’re unconscious), we may share your information if it’s in your best interest.

• Limit sharing for marketing or fundraising:

  • We may contact you about treatment-related products or services, but we won’t share or sell your information for further marketing purposes.

  • We may contact you for fundraising efforts, but you can opt-out if you prefer not to be contacted.

Our Uses and Disclosures

Here’s how we typically use or share your information:

1. Treat you:

   • We can share your health information with other professionals who are treating you.

   • Disclosures may also be made to notify family or others involved in your care about your condition, location, or in the event of your death. This includes disaster situations.

2. Run our organization:

   • We use your health information to run our practice, improve your care, and contact you when necessary.

   • Employees or volunteers at Cashmere Spine and Wellness may have access to your information and are subject to following the Privacy Practices to protect this information. 

   • Your information may be shared with business associates under contracts that require them to protect your privacy.

3. Bill for your services:

   • We can use and share your health information to bill and receive payment from health plans or other entities.

4. Comply with the law:

   • We will share your information if required by law, including with the Department of Health and Human Services to ensure we’re following privacy laws.

5. Help with public health and safety issues:

   • We may share your information to prevent disease, report adverse reactions to medications, report suspected abuse or neglect, and help with product recalls.

   • We also cooperate with law enforcement as required by law.

6. Do research:

   • We can use or share your information for health research, subject to strict legal conditions.

7. Respond to organ and tissue donation requests:

   • We can share health information with organ procurement organizations.

8. Work with medical examiners and funeral directors:

   • We can share information with a coroner, medical examiner, or funeral director when someone dies.

9. Address workers’ compensation, law enforcement, and other government requests:

   • We can share your health information for workers’ compensation claims to make periodic reports to your employer about your condition. We are also required by law to report cases of occupational injury or occupational illness to the employer or workers' compensation insurer.

   • Information may be shared with law enforcement when required by us for locating suspects, reporting crimes, and handling medical emergencies, or for special government functions like national security.

10. Respond to lawsuits and legal actions:

    • We can share your information in response to a court or administrative order or subpoena.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.

• We are required to obtain your explicit authorization prior to some sharing of information related to substance use disorders, mental health or psychotherapy treatment, and sexually transmitted diseases. 

• We will notify you promptly if a breach occurs that may have compromised your information.

• We must follow the duties and privacy practices described in this notice and give you a copy upon request.

• We will only use or share your information as described here unless you give us written permission. If you change your mind, let us know in writing.

Changes to the Terms of this Notice

We can change the terms of this notice at any time. The new notice will apply to all information we have about you, and it will be available upon request, in our office, and on our website.

Contact Information

Privacy Contact: Dr. Kathryn Skoglun

Physical Address: 101 Cottage Avenue, Suite F, Cashmere, WA 98815

Mailing Address: PO Box 3603, Wenatchee, WA 98807
Email: [email protected]
Phone: (509) 715-3140

This form is available electronically at https://cashmerespine.com/notice-of-privacy-practices/