Prime Body Solutions · For Our Patients
Required by the Health Insurance Portability and Accountability Act (HIPAA) and by Washington’s health care information law, RCW 70.02.
Section 01
Prime Body Solutions is a physician-led medical clinic at 2110 N Molter Road, Suite 119, Liberty Lake, Washington 99019. Cody Belkoff, DO is the owner, the treating physician, and the Privacy Officer.
We are required by law to protect the privacy of your protected health information, to give you this notice describing our legal duties and privacy practices, and to follow the terms of the notice currently in effect. Protected health information, or PHI, means information that identifies you and relates to your health, your care, or payment for your care.
Where Washington or Idaho law protects your information more strictly than HIPAA does — which is true for certain categories including mental health, HIV and sexually transmitted infections, and substance use treatment — we follow the stricter law.
Section 02
We may use and disclose your PHI without your written authorization for the following three purposes.
To provide, coordinate, and manage your care.
Example: Dr. Belkoff sends your testosterone, estradiol, PSA, and metabolic panel orders to the laboratory, then reviews the results to set your dose. If you need a prescription, we send it to your pharmacy.
To bill and collect for the care we provide.
Example: We charge the card on file for your monthly membership, or provide a superbill describing the services you received if you request one.
Prime Body Solutions does not bill insurance. We are a cash-pay clinic. We do not submit claims, and we do not send your clinical information to a health plan unless you specifically ask us to.
To run the clinic and keep the quality of care high.
Example: Reviewing outcomes across our hormone patients to evaluate whether a protocol is working, or training staff on how to handle lab results correctly.
Section 03
The law permits or requires us to use or disclose your PHI in the following situations, without your written authorization.
| Situation | What it means |
|---|---|
| When required by law | Federal, state, or local law may compel a disclosure. We disclose only what the law requires. |
| Public health activities | Reporting to public health authorities to prevent or control disease, or reporting an adverse event or product problem to the FDA. |
| Abuse, neglect, or domestic violence | Reporting to the authority authorized by law to receive such reports. |
| Health oversight | Audits, investigations, inspections, and licensure activities by agencies that oversee the health care system. |
| Judicial and administrative proceedings | In response to a court order, or to a subpoena or discovery request that meets the legal requirements for notice to you. |
| Law enforcement | In limited circumstances defined by law, such as responding to a court-ordered warrant or identifying a suspect or missing person. |
| Serious threat to health or safety | To prevent or lessen a serious and imminent threat to you or to someone else. |
| Coroners, medical examiners, funeral directors | To allow them to carry out their duties. |
| Organ and tissue donation | To organizations that handle procurement, banking, or transplantation. |
| Workers’ compensation | To the extent authorized by and necessary to comply with workers’ compensation laws. |
| Specialized government functions | Military and veterans activities, national security, and protective services for the President. |
| Research | Only when an institutional review board or privacy board has approved the use and put privacy protections in place. |
| Business associates | To vendors who perform services for us, such as our electronic health record and scheduling platform. Each is bound by a written agreement requiring them to protect your PHI. |
We may share information relevant to your care with a family member, friend, or anyone else you identify, and only the information relevant to that person’s involvement. If you are present and able to decide, we will ask you first or give you a chance to object. If you are not able to decide, we will use our professional judgment about what is in your best interest.
We may contact you to remind you about an appointment, to tell you your lab results are ready, or to tell you about treatment alternatives or other health-related benefits and services that may interest you. If you have given us a mobile number and consented to text messages, some of these may arrive by text. You can tell us to stop at any time.
Section 04
We will not use or disclose your PHI for any purpose other than those described above unless you give us written authorization. In particular, your written authorization is required for:
You may revoke an authorization at any time, in writing. Revoking it stops any future use or disclosure under that authorization. It cannot undo a disclosure we already made while the authorization was in effect.
Substance use disorder records. If we receive substance use disorder treatment records from a program covered by 42 CFR Part 2, those records may not be used or disclosed in a civil, criminal, administrative, or legislative proceeding against you without your written consent or a court order issued after notice and an opportunity for you to be heard.
Fundraising. Prime Body Solutions does not conduct fundraising and will not contact you for fundraising purposes.
Section 05
See and get a copy of your record, on paper or electronically. We respond within the time Washington law allows and may charge a reasonable, cost-based fee for copies.
Ask us to correct information you believe is wrong or incomplete. If we deny the request we will explain why in writing, and you may file a statement of disagreement.
Get a list of certain disclosures we made in the six years before your request, outside of treatment, payment, and operations.
Ask us to limit how we use or disclose your information. Except in the case below, we are not required to agree — but if we do agree, we will honor it.
Ask us to contact you a particular way or at a particular address — a specific phone number, or mail to an address other than your home. We will accommodate reasonable requests.
Ask for a printed copy at any time, even if you agreed to receive it electronically. Just ask at the front desk or call us.
If you pay for a service in full, out of your own pocket, you have the right to tell us not to disclose information about that service to your health plan — and we are required to agree, unless the law requires the disclosure for another reason.
At Prime Body Solutions this is the default rather than the exception. We are a cash-pay clinic and we do not bill insurance, so nothing about your care is routinely reported to any health plan.
Submit your request in writing to the Privacy Officer using the contact details below. Tell us which right you are exercising and give us enough detail to act on it. We will respond within the timeframes required by HIPAA and by RCW 70.02.
Section 06
We may change this notice at any time, and the changes may apply to information we already hold as well as information we receive in the future. The current notice is always posted at primebodysolutions.com with its effective date, and a copy is available at the clinic. We will offer you a copy of the revised notice at your next visit.
Section 07
If you believe your privacy rights have been violated, tell us. Contact the Privacy Officer at the phone number or address below. We take every complaint seriously and will investigate it.
You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights:
You will not be retaliated against for filing a complaint. Filing a complaint will never affect the care you receive at Prime Body Solutions.
Questions about this notice, requests to exercise a right, and privacy complaints all go directly to Dr. Belkoff.
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