Protecting customer information is a priority for Nordstrom. We understand that your
trust is our most important asset. The Nordstrom Prosthesis Program is committed
to the protection and proper use of your personal health 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.
Summary
Maintaining the privacy of your protected health information is a priority at Nordstrom.
The Nordstrom, Inc. Prosthesis Department ('we,' 'our' or 'us') has established a
policy to guard against any unnecessary disclosure of your medical records and other
information about your health that is created and used in conjunction with your
prosthesis-related purchase at Nordstrom. In this statement, we refer to this personal
medical information as Protected Health Information ('PHI'). These safeguards are
intended to comply with federal privacy regulations under the Health Insurance Portability
and Accountability Act ('HIPAA').
Our privacy notice will explain your legal rights and our legal responsibilities with respect
to your protected health information. Information on the following topics are explained
in our privacy notice:
• Your Rights
• Uses and Disclosures
• Our Responsibilities
• Contact Information
• Additional Information
Your Rights
You have the right to know how we use and disclose your PHI. You also have the right to:
• receive a copy of our written privacy notice upon request;
• inspect and copy your PHI;
• request to amend your PHI if it was created by us;
• receive an accounting of certain PHI disclosures during the 6 year period preceding your
request (but not earlier than April 14, 2003);
• request that you receive confidential communications from the Nordstrom Prosthesis
Department (for example, only to your office or to your home); and
• request additional restrictions on how we use or disclose your PHI; however, we are not
required to agree with any requested restrictions.
If you wish to exercise any of these rights, you must submit your request in writing to:
Nordstrom Corporate Prosthesis Manager, 1617 6th Ave, 5th Floor, Seattle, WA 98101.
If your request is denied, you generally have the right to appeal the denial. You will
receive more information about your appeal rights if you make a request and it is denied.
Uses and Disclosures
We may use or disclose your PHI without your permission in the following situations:
Treatment - We may use or disclose your PHI to provide you prosthesis-related services.
For example, we may contact your doctor for additional information about your medical
condition.
Payment - We may use or disclose your PHI to obtain payment for services we have
provided. For example, we may contact your health insurance carrier to verify eligibility.
Health Care Operations - We may use or disclose your PHI, as necessary, to perform
administrative activities that are necessary to manage Nordstromıs prosthesis
department. For example, we may use PHI to identify individuals who are entitled to
receive this notice and to arrange for and conduct internal audits, including fraud and
abuse detection programs.
As Permitted by Law - We may use or disclose your PHI as permitted by law. For
example, we can disclose PHI in the following situations:
• as authorized by and to the extent necessary to comply with laws relating to workerıs
compensation or similar programs that provide benefits for work-related injuries
or illnesses;
• to prevent or lessen a serious and imminent threat to your health and safety or to
the health and safety of the public;
• in response to an administrative or court order or a request for information in a
lawsuit involving you;
• to public health agencies, for example, for the licensure of health care providers;
• to authorized military personnel if you are a member of the armed forces.
In Our Communications with You - We may use or disclose your PHI to communicate
our health related products or services to you. For example, we may send you periodic
information about our new prosthesis-related products or services that we believe may
benefit you. We will not use PHI to communicate with you regarding other Nordstrom
products and services.
Certain Other Situations We may use or disclose your PHI if you are present and
agree to the disclosure, if we give you the opportunity to object to the disclosure and
you do not, or if it is an emergency. For example, we may discuss your PHI with you
while a family member is present if you agree.
As Authorized by You - We may use or disclose your PHI to other persons upon your
written authorization. For example, we may speak with a family member if we have
your permission. Please note, your authorization will remain effective until you revoke
it in writing. Also, Nordstrom cannot take back any disclosures of PHI we have already
made with your authorization, and we are required by law to retain certain medical records.
Our Responsibilities
We are required by law to maintain the privacy of your PHI and to provide you with a
notice of our legal duties and privacy practices with respect to PHI. In addition, we
are required to abide by the terms of the notice currently in effect.
Contact Information
Please direct any comments, questions or complaints regarding the privacy of your PHI to:
Nordstrom Corporate Prosthesis Manager
1617 6th Ave, 5th Floor
Seattle, WA 98101
1-800-804-1502
206-373-2008 (fax)
Additional Information
If you believe your privacy rights concerning your PHI have been violated, you may also
make a formal complaint directly to the Secretary of Health and Human Services at:
Office for Civil Rights, U.S. Department of Health & Human Services, 33 N. Michigan Ave.
Suite 240, Chicago, IL 60601. You will not be retaliated against for filing a complaint.
We reserve the right to change the terms of the privacy notice. New notice provisions will
be effective for all PHI we currently have and PHI we receive in the future. If this notice is
revised, the revised notice will be provided at your next visit in which we provide you
service.
Except as expressly noted, this policy relates to PHI only and does not affect our
information practices with respect to other information.
The examples contained in this Privacy Notice are illustrations only, and are not intended
to be exhaustive.
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