Privacy Policy

Protecting patient privacy is an important element of the trust between our caregivers and their patients, and an important legal and ethical obligation. Washington Center for Pain Management is deeply committed to protecting our patients' rights to privacy, and to safeguarding patient information.

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.


Our Responsibilities:

Washington Center for Pain Management is required to maintain the privacy of your Protected Health Information ("Health Information"). This includes medical information about you that is collected during the course of your treatment maintained in either paper or electronic form. Typically, this information includes your symptoms, examination and test results, diagnoses, treatment, and a plan for future care. Information about care that you have received from other providers may also be included in the Washington Center for Pain Management’s medical record. Health Information also includes demographic information and payment information. Washington Center for Pain Management must abide by the terms of the Notice of Privacy Practices currently in effect.


Uses and Disclosures of your Health Information:

The following are examples of the types of uses and disclosures of your Health Information that Washington Center for Pain Management is legally permitted to make.


Uses and Disclosures of Health Information for Treatment, Payment and Operations

Your Health Information may be used and disclosed by your physician and the Washington Center for Pain Management staff who are involved in your care and treatment. Your Health Information may also be used and disclosed as necessary for Washington Center for Pain Management to obtain reimbursement for care provided to you, and to support the operation of our practice.

  • Treatment: Washington Center for Pain Management may use your Health Information to provide and manage your health care. If we refer you for treatment or consultation outside Washington Center for Pain Management -for example to another clinician or hospital - we will provide that health care provider with the necessary information to diagnose or treat you. We believe this type of sharing is critical in providing you the very best in health care and is necessary given the complexities of various illnesses and health conditions.
  • Payment: Washington Center for Pain Management may use and disclose your Health Information, as needed, to obtain payment for health care services. We may disclose information to your health plan or other third party payer in order to make sure your treatment is approved, to verify eligibility or coverage for insurance benefits, and to permit the payer to review services provided to you for medical necessity. For example, we may need to share relevant Health Information to your health plan to obtain approval for a hospital admission.
  • Health Care Operations: Washington Center for Pain Management may use or disclose your Health Information in order to conduct its business of providing health care. These "health care operations" may include quality assessment, training of medical staff, credentialing and various other activities that are necessary to run our practice and to improve the quality and cost effectiveness of the care that we deliver to you.

Other Permitted and Required Uses and Disclosures of Your Health Information:

In addition to treatment, payment and health care operations, there are other circumstances in which Washington Center for Pain Management is either permitted or required to disclose your Health Information, in accordance with applicable law.

  • Involvement of Others in Your Health Care: Washington Center for Pain Management will make an effort to ask you if we may share relevant Health Information about you with family members or any other person you identify. If you are not present, unable to communicate, or in an emergency situation, Washington Center for Pain Management staff may exercise their professional judgment to determine whether to share this information. In addition, we may need to disclose Health Information to notify a family member or any other person responsible for your care of your location, general condition or death. Finally, Washington Center for Pain Management may disclose your Health Information to an authorized public or private entity to assist in disaster relief efforts, and to coordinate efforts to notify someone on your behalf. Please be assured we will only do so if absolutely necessary and in the event of an emergency or disaster.
  • Appointments: Unless you ask us not to, we will contact you to remind you of your appointments with us. We may also provide you with information about treatment alternatives or other health- related benefits, products and services that may be beneficial to you, again with the hopes of improving your health and welfare.
  • Public Health: Washington Center for Pain Management may disclose your Health Information for public health activities, including the following:
    • to report Health Information (e.g., infectious diseases, such as chickenpox) to prevent or control disease, injury, or disability
    • to report births and deaths
    • to report reactions to medications or problems with products
    • to notify a person who may have been exposed to a communicable disease, or may be at risk for contracting or spreading the disease
  • Victims of Abuse, Neglect or Domestic Violence: If Washington Center for Pain Management reasonably believes you are a victim of abuse, neglect or domestic violence, Washington Center for Pain Management may disclose your Health Information to an appropriate agency authorized by law to receive such reports.
  • Health Oversight: Washington Center for Pain Management may be required to disclose Health Information to a health oversight agency for audits, investigations, inspections, and other health oversight activities. Oversight agencies include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.
  • Legal Proceedings: Washington Center for Pain Management may be required to disclose Health Information in the course of any judicial or administrative proceeding in response to a legal order or other lawful process, including a subpoena.
  • Law Enforcement: Washington Center for Pain Management may be required to disclose Health Information for law enforcement purposes.
  • Coroners, Funeral Directors, and Organ Donation: Washington Center for Pain Management may be required to disclose Health Information to a coroner or medical examiner to identify a deceased person or to determine the cause of death. We may also disclose Health Information to a funeral director or their designee, as necessary to carry out their duties. Health Information may also be disclosed to organizations that facilitate organ, eye or tissue donation and transplantation.
  • Research: Washington Center for Pain Management may use or disclose Health Information for research that is approved by an Institutional Review Board when written permission is not required by Federal or State law. This may include preparing for research or telling you about research studies in which you might be interested.
  • To avert a serious threat to health or safety: Washington Center for Pain Management may be required to use and disclose Health Information to prevent or lessen a serious threat to a person's or the public's health or safety.
  • Specialized Government Functions: Under certain circumstances, Washington Center for Pain Management may be required to disclose Health Information to units of the government with special functions, such as the U.S. military or the U.S. Department of State.
  • Workers' Compensation: Washington Center for Pain Management may use and disclose Health Information as required to comply with workers’ compensation laws, and other programs that provide benefits for work-related injuries or illnesses.
  • Required By Law: Washington Center for Pain Management may be required to use or disclose your Health Information to the extent that the use or disclosure is required by federal, state or local law. This includes any other law not already referred to in the preceding categories. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law.
  • Uses and Disclosures of Health Information Based upon Your Written Authorization: Uses and disclosures of your Health Information, other than those described above, will be made only with your written authorization. For example, you will need to sign an authorization form before Washington Center for Pain Management can send your Health Information to your life insurance company. With limited exceptions, we will also obtain your written authorization prior to using your Health Information for marketing purposes. You may revoke your authorization at any time, in writing, except to the extent that Washington Center for Pain Management has taken any action in reliance on the authorization.

Your Individual Rights

Although your medical record at Washington Center for Pain Management is Washington Center for Pain Management’s property, the Health Information it contains belongs to you. The following is a statement of your rights with respect to your Health Information, and a brief description of how you may exercise these rights.

  • You have the right to inspect and obtain a copy of your Health Information. At any time, you may inspect and obtain a copy of Health Information about you, including your medical and billing record, which may be used to make decisions about your care. Under limited circumstances we may limit your access to all or certain portions of your record. This includes, but is not limited to, psychotherapy "process" notes, or information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding. If you are denied access to portions of your record, in some circumstances you may have a right to have this decision reviewed. All requests to access your record must be made in writing to the Medical Records department, and will be processed within 30 days. If you request a copy of your records, we may charge you a fee to cover the copying and mailing costs.
  • You have the right to request an amendment of your Health Information. You may request Washington Center for Pain Management to amend your treatment and billing information if you think the information is incorrect or incomplete, for as long as Washington Center for Pain Management maintains the information. If for some reason we deny your request, we must give you a written statement with the reasons for the denial, and what other steps are available to you. Please don't hesitate to contact the Privacy Officer if you have questions about amending your medical record, or any registration staff to discuss amendments to your billing records.
  • You have the right to request a restriction of your Health Information. You have the right to ask for restrictions on the use and sharing of your health information for treatment, payment, or health care operations. Washington Center for Pain Management is not required to agree to your request. If we do, we must put the restriction in writing and abide by it except if you need to be treated in an emergency. You may not ask us to restrict uses and sharing of information that we are legally required to make. All requests must be in writing to Washington Center for Pain Management’s Privacy Officer.
  • You have the right to request to receive communications from us by alternative means or at an alternative location. We will make every effort to accommodate requests, provided you supply a valid alternative address or other method of contact. The Privacy Officer will handle all requests. In certain cases we may need to contact you and may do so at the original address or phone number if attempts to contact you at the alternative locations are not successful.
  • You have the right to receive an accounting of certain disclosures we have made, if any, of your Health Information. This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice. It does not apply to disclosures we may have made to you, that were authorized by you, information provided to family members or friends about your care, or for notification purposes. The right to receive this information is subject to certain exceptions, restrictions and limitations. Requests must be made to our Privacy Officer, and we will respond to your request within 60 days.
  • You have the right to obtain a paper copy of this notice. We will provide a paper copy of this Notice to you, upon request, even if you have agreed to accept this notice electronically.

Changes to this Notice

From time to time, we may change our practices concerning how we use or disclose patient medical information, or how we will implement patient rights concerning their information. We reserve the right to change this Notice and to make the provisions in our new notice effective for all medical information we maintain. If we change these practices, we will publish a revised Notice of Privacy Practices.


This Notice is effective on October 1, 2010