Notice of Privacy Practices

This notice describes how health information about you or your child may be used and disclosed and how you can get access to this information. Please review it carefully.

Evergreen Pathways LLC provides Applied Behavior Analysis (ABA) and related behavioral health services. We are required by law to protect the privacy of protected health information ("PHI"), which is information that identifies you or your child and relates to health care services. In this notice, "you" also means the child receiving services when a parent or legal guardian acts on the child's behalf.

Our responsibilities

• We must keep your PHI private and secure.
• We must give you this notice and follow what it says.
• We must tell you promptly if a breach may have compromised the privacy or security of your PHI.
• We will not use or share your PHI other than as described here without your written permission. You may withdraw that permission in writing at any time, and we will stop going forward.

How we may use and share PHI without your written permission

Treatment

We share PHI among the people involved in your care, such as behavior analysts, technicians and supervisors, and with your physician, school or other providers to coordinate services.

Payment

We use and share PHI to bill and collect payment, for example with your insurance plan to verify coverage, obtain authorization and submit claims.

Health care operations

We use PHI to run our practice: quality review, training, supervision, compliance and business planning. Outside companies that help us do this must sign an agreement to protect your PHI.

Other uses the law permits or requires

• When required by federal, state or local law.
• Reporting suspected abuse or neglect of a child or vulnerable adult, as required by law.
• Public health activities, such as preventing disease or injury.
• Health oversight, such as audits and investigations by government agencies and insurers.
• Court orders, subpoenas and other legal proceedings, as the law allows.
• Law enforcement purposes, as the law allows.
• Preventing or lessening a serious and imminent threat to health or safety.
• Workers' compensation, coroners and medical examiners, and specialized government functions, where applicable.

Washington state law may give your health care information additional protection. Where it does, we follow the stricter rule.

When we need your written authorization

We need your written authorization for most uses and sharing of psychotherapy notes, for marketing, and for any sale of PHI. Uses not described in this notice also require your authorization.

Your rights

• Get a copy of your records. You can ask to see and get a copy of your PHI, including an electronic copy. We will respond within 30 days and may charge a reasonable cost-based fee.
• Ask us to correct your records. If you believe something is wrong or incomplete, you can ask us to amend it. We may say no and will explain why in writing.
• Request confidential communications. You can ask us to contact you in a particular way or place. We will agree to reasonable requests.
• Ask us to limit what we share. We are not required to agree, except that we must agree if you pay for a service in full out of pocket and ask us not to share it with your health plan.
• Get a list of disclosures. You can ask for a list of certain times we shared your PHI in the six years before your request.
• Get a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. We will confirm that a legal guardian or someone with medical power of attorney has that authority before acting on their request.

Changes to this notice

We may change this notice, and the change will apply to all PHI we hold. The current notice is always available on this website and at our office.

Questions and complaints

If you think we have violated your privacy rights, you can file a complaint with us using the details below. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by mail at 200 Independence Avenue S.W., Washington, D.C. 20201, by phone at 1-877-696-6775, or online at hhs.gov/hipaa/filing-a-complaint. We will not retaliate against you for filing a complaint.

Contact us

Privacy Officer, Evergreen Pathways LLC
555 Andover Park W, Ste 200, Tukwila, WA 98188
Phone: (206) 796-4797 (Monday to Friday, 9 AM to 5 PM)
Email: admin@theevergreenpathways.com (please do not include health information)