Effective Date: December 31, 2018
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.
The protection of confidential healthcare information is a legal
requirement. The William C. Earhart Co., Inc. collects and maintains
a great deal of Protected Health Information (PHI). Disclosing confidential
information is an invasion of privacy and a violation of the Privacy
regulations contained in the Health Insurance Portability and Accountability
Act (HIPAA) of 1996. The law is effective April 14, 2003 .
We want to tell you about our privacy and the practices we use to
protect your personal health information.
How we use health information?
William C. Earhart Co., Inc. uses your health information to pay
providers and others who provide you with services and to conduct
normal health care operations. Examples of how we use your information
Payment- refers to activities by a plan to obtain contributions
and provide coverage and benefits. It includes determination of eligibility
or providing eligibility such as to a provider, processing of claims,
billing, claims management, utilization review and coordination of
Treatment - refers to patient care and coordination of care between
providers or management of care such as between provider and utilization
review or consultation and referrals among providers such as sharing
of information between diabetes programs and the patient's providers.
Health Care Operation - refers to activities related to health plan
functions such as auditing, training, setting of rates, arranging
for medical review, appeal resolution, vendor evaluation and legal
Information that is used/disclosed is limited to the "Minimum
accomplish the intended purpose. For example, if treatment notes
for a particular office visit are needed to determine benefits, we
would only ask for the notes for the visit in question, not all of
the treatment notes.
Information we share
There are limited times when we are permitted or required to disclose
health information without your signed permission. These situations
- To protect victims of abuse or neglect for federal
and state health oversight activities.
- For judicial
or administrative proceedings
- If required by law
or for law enforcement
- To coroners or medical examiner
to identify deceased or cause of death
- For specialized
government functions such as national security for individuals
who are in the Armed Forces or individuals in correctional
- To Workers' Compensation, if you
are injured at work
All other uses and disclosures not previously described, may only
be made with your signed authorization. You may revoke your authorization
at any time.
The William C. Earhart Co., Inc. is required by law to:
- Maintain the privacy of your health information
this notice of our duties and privacy practices
by the terms of the notice currently in effect.
You have the right to:
- Request that we restrict how we use or disclose your
protected health information (PHI).
- Request confidential
communications when communication contains PHI*
and copy your health information (fees will apply).*
accounting and disclosure of how your health information
was disclosed (excludes disclosures for treatment, payment,
healthcare operations, as well as disclosures that you authorize).*
to amend your health information.
*Requests must be in writing.
If you would like to exercise your rights, or if you feel your privacy
rights have been violated, or if you need more information, please
contact the proper Privacy Officer listed below in writing:
HIPAA Privacy Officer
William C. Earhart Co., Inc.
P.O. Box 4148
Portland Oregon 97208