NOTICE OF PRIVACY PRACTICE 

This notice describes how medical information about you may be used and disclosed and how you can obtain access to this information.  

Please review it carefully. 

Our pledge and obligations regarding your health care information here at Breakthrough Recovery Group.  We are required by State and Federal law maintain the privacy of protected health information, give you this notice of our legal duties and privacy practices regarding health information about you.  

Breakthrough Recovery Group must follow the privacy practices as described below. This notice will remain in effect until it is amended or revised by Breakthrough Recovery Group. 

Breakthrough Recovery Group will keep your health information confidential, using it only for the following purposes listed below; Except for the purposes described below, we will use and disclose Health Information only with your written permission.  You may revoke such permission at any time.      

• Treatment: Breakthrough Recovery Group may use your health information to provide you with professional services that span across our organization. Breakthrough has an established infrastructure that limits employee access to your health information according to their primary job functions. Every employee or affiliated service provider is required to sign a confidentiality agreement.

• Payment: Breakthrough Recovery Group will use and disclose your protected health information to obtain payment for services provided to you. Breakthrough Recovery Group may share information with your insurance company or other businesses that may become involved in the process of mailing statements and/or collecting unpaid balances. 

• Healthcare or Family / Friend Disclosure: Breakthrough Recovery Group may disclose your health information with other health care professionals who provide treatment and/or services to you. These professionals will have a privacy and confidentiality policy like this one and whom agree to follow all state and federal regulations regarding confidentiality.   Health information about you may also be disclosed to your family, friends, and/or other persons you choose to involve in your care, only if you agree and sign a release of authorization form that is specific to the nature of the information being disclosed.  

• Business Operations Disclosure:  Breakthrough Recovery Group may use or disclose your protected health information, in regard to the care provided to you, for the purpose of education and training, legal requirements, and accounting or payment matters. Breakthrough Recovery Group may share information with other entities that provide assistance in your care and whom agree to follow all state and federal regulations regarding confidentiality.  

• Appointment Reminders: Breakthrough Recovery Group may use or disclose your health information to provide you with appointment reminders, including, but not limited to, voicemail messages, secure EMR messages notification applications, postcards, or letters.   

• Marketing Health-Related Services: Breakthrough Recovery Group will not use your health information for marketing purposes unless you have provided written authorization to do so.  

• Required by Law: The law provides that Breakthrough Recovery Group may use or disclose your protected health information in certain situations, including: 
• In an emergency or for disaster relief purposes, such as to notify family about your whereabouts and condition; 
• To report abuse or neglect (See Informed Consent form for detailed information regarding Breakthrough Recovery Group’s duty to disclose abuse or neglect); 
• To persons authorized by law to act on your behalf, such as a guardian, health care power of attorney or surrogate; 
• Where required by U.S. Department of Health and Human Services to determine our compliance; 
• To assist law enforcement in the event of a possible crime on the premises. Breakthrough Recovery Group may also share your information to prevent or lessen a serious or imminent threat to you or another person. 
• When requested by national security, intelligence, and other state and federal officials and/or if you are an inmate or otherwise under the custody of law enforcement. 
• By order of a court, subpoena or applicable legal discovery request. 

Other uses and disclosures will be made only with your written authorization. If you sign an authorization, you may revoke it at any time, except to the extent that we have already shared your information based upon your permission. 

Your Privacy Rights with respect to your protected health information as an individual enrolled in care with Breakthrough Recovery Group: 

You have the right to inspect and copy your protected health information, with the exception of coping of the evaluation.  This usually includes medical and/or billing records. You must submit a request to Breakthrough Recovery Group in writing and agree to be responsible for a fee before a copy will be provided. Copies, if requested, will be $0.25 per page. It will take a maximum of 10 business days from the date of the written request and receipt of fee to fulfill any records request.  If Breakthrough Recovery Group is unable to provide you with the records in the format you request, Breakthrough Recovery Group will provide records in a form that works for you and our office. You may also ask us to transmit your record to a specific person or entity via email if, 

1. a) you provide the email address in writing and, 
2. b) sign a statement that you fully understand that email comes with inherent risks that we cannot prevent and for whichBreakthrough Recovery Groupis not responsible. Under certain circumstances, your provider may not allow you to see certain parts of your record. You may ask that this decision be reviewed by another licensed professional.   

Breakthrough Recovery Group does not give out a printed copy of the full assessment to the individual clients.  You have the right to request a review of the assessment and all supporting documentation with either the assessing counselor or with the Administrator if you have any questions in regards to diagnosis or treatment placement.   

With properly signed release of information we will send the full assessment to another treatment facility if you are attending services there or seeking a second opinion.  Treatment providers are subject to strict confidentiality laws and cannot give printed release of 3rd party information that is received; we are able to review with you as a part of your records.    

You have the right to ask Breakthrough Recovery Group to contact you in a manner and/or place that you believe will keep your information private, for example, to contact you at a different address or telephone number. 

You have the right to request a restriction of your protected health information. This means you may ask us not to use or disclose all or part of your protected health information for the purpose of treatment, payment, or healthcare operations.  Breakthrough Recovery Group will consider your request carefully and may honor reasonable requests where possible. Breakthrough Recovery Group is not required to honor all requests. You may also ask that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must identify the specific restriction requested and to whom you want the restriction to apply. 

You have the right to receive an accounting of disclosures in which Breakthrough Recovery Group has made of your protected health information. This essentially means you may receive a listing of certain uses or disclosures made for other than treatment, payment or business operations, and which you have not received or authorized, such as where Breakthrough Recovery Group was required to share information for a public health purpose. 

You may ask Breakthrough Recovery Group to amend your record. While Breakthrough Recovery Group employees cannot erase your record, a written statement can be added to your protected health information to correct or clarify the record. Your provider may submit a response to the new correction, which will be provided to you. 

Breach Notification. If there is a breach in your health information, Breakthrough Recovery Group will notify you, government officials, and others, as the law requires. 

Questions and Complaints: 

You have the right to file a complaint with Breakthrough Recovery Group if you feel there has been a violation of Privacy Practices. Your complaint should be directed to Breakthrough Recovery Group Administrator. If you feel there has been a violation of your privacy rights, or if you disagree with a decision made regarding your access to your health information, you can direct this to the Administrator as well.  

Breakthrough Recovery Group supports your right to the privacy of your information and will not retaliate in any way if you choose to file a complaint with the facility or with the Washington State Department of Health. Contact information can be found below.