Let's Go! Physical Therapy & Pilates is in network with First Choice Health, Lifewise, Premera, L&I, Regence BlueShield, and FEP Blue Cross Blue Shield. If you have a different health insurance company I will provide you with a superbill for you to submit to your health insurance company for reimbursement.

Yes! I accept personal injury claims for motor vehicle collisions.

No. Physical therapy in the state of Washington is direct access, allowing you to see a physical therapist without a referral from your doctor. Some health insurance plans require a doctors referral for physical therapy in order to recieve benefits. If you do have a doctors referral please bring it to your first appointment.

All payment occurs online via my booking platform. You may pay via credit card, debit card, HSA or FSA. Payment is due at the time of service.

Socks are mandatory. Loose fitting clothing that allows you to move comfortably. No exposed zippers, these cut vinyl and ruin expensive equipment. Wear clothing that allows for exposure of painful joint - for example tank top for sore shoulder, shorts for sore knee. Masks are mandatory.

There is a Hepa air purifier in the treatment room, windows are open weather permitting and equipment is cleaned with a CDC approved disinfectant.

Let’s Go! Physical Therapy & Pilates PLLC Bellevue, WA 98008 Phone: 425-577-7258 HIPAA NOTICE OF PRIVACY POLICIES Let’s Go! Physical Therapy & Pilates PLLC understands that your medical and health information is personal. We are committed to protecting this 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. 1. Notice. We keep a record of the health care services we provide you. This enables us to provide you with the best care possible as well as meets certain legal requirements. You may ask us to see and copy that record. You may also ask us to correct that record. We will not disclose your record to others unless you direct us to do so or unless the law authorizes or compels me to do so. You may see your record or get more information about it at Let’s Go! Physical Therapy & Pilates PLLC. Your health record contains personal information about you and your health. State and Federal law protects the confidentiality of this information. Protected Health Information (PHI) is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical and mental health, or condition, and related health care services. If you suspect a violation of these legal protections, you may file a report to the appropriate authorities in accordance with Federal and State regulations. Provider reserves the right to change the terms of this Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that Provider maintains at that time. Provider will make available a revised Notice of Privacy Practices by sending you an electronic copy, sending a copy to you in the mail upon your request, or providing one to you in person. 2. How Provider is permitted to Use and Disclose Your PHI. a. For Treatment. Your PHI may be used and disclosed by Provider for the purpose of providing, coordinating, or managing your health care treatment and any related services. This may include coordination or management of your health care with a third party, consultation or supervision activities with other health care Providers, or referral to another Provider for health care services b. For Payment. Provider may use and disclose PHI in order to help you facilitate reimbursement for the health care services provided to you. c. For Healthcare Operations. Provider may use and disclose your protected PHI for certain purposes in connection with the operation of a professional practice, including, but not limited to: contacting you to remind you of appointments, supervision, health care education, quality insurance, peer review consultation, or administrative, legal, financial, or actuarial services to assist in the delivery of health care, provided Provider has a written contract with the business that prohibits it from re-disclosing your PHI and requires it to safeguard the privacy of your PHI. d. Other Uses and Disclosures That Do Not Require Your Authorization. State and Federal law permits Provider to disclose information about you without your authorization in a limited number of situations: Required by Law. Examples of this type of disclosure include healthcare licensure related reports, public health reports, and law enforcement reports. Under the law, Provider must make certain disclosures of your PHI to you upon your request. In addition, Provider must make disclosures to the US Secretary of the Department of Health and Human Services for the purpose of investigating or determining my compliance with the requirements of applicable privacy rules. Health Oversight. Provider may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, peer reviews, and inspections. If Provider discloses PHI to a health oversight agency, Provider will have an agreement in place that requires the agency to safeguard the privacy of your information in such an agreement is required by law. Abuse or Neglect. Provider may disclose your PHI to a state or local agency that is authorized by law to receive reports of abuse or neglect. However, the information we disclose is limited to only that information which is necessary to make the required mandated report. Deceased Clients. Provider may disclose PHI regarding deceased clients for the purpose of determining the cause of death, in connection with laws requiring the collection of death or other vital statistics. Research. Provider may disclose PHI to researchers if (a) an Institutional Review Board reviews and approves the research and a waiver to the authorization requirement; (b) the researchers establish protocols to ensure the privacy of your PHI; and (c) the researchers agree to maintain the security of your PHI in accordance with applicable laws and regulations. Criminal Activity or Threats to Personal Safety. Provider may disclose your PHI to law enforcement officials if Provider reasonably believe that the disclosure will avoid or minimize an imminent threat to the health or safety of yourself or any third party. Compulsory Process. Provider may be required to disclose your PHI if a court of competent jurisdiction issues an appropriate order, and if the rule of privilege has been determined not to apply. Provider may be required to disclose your PHI if Provider has been notified in writing at least fourteen days in advance of a subpoena or other legal demand, no protective order has been obtained, and a competent judicial officer has determined that the rule of privilege does not apply. Essential Government Functions. Provider may be required to disclose your PHI for certain essential government functions in some limited circumstances. Such functions include: assuring proper execution of a military mission, conducting intelligence and national security activities that are authorized by law, providing protective services to the President, making medical suitability determinations for U.S. State Department employees, protecting the health and safety of inmates or employees in a correctional institution, and determining eligibility for or conducting enrollment in certain government benefit programs. Law Enforcement Purposes. Provider may be authorized to disclose your PHI to law enforcement officials for law enforcement purposes under the following six circumstances, and subject to specified conditions: (1) as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; (2) to identify or locate a suspect, fugitive, material witness, or missing person; (3) in response to a law enforcement official’s request for information about a victim or suspected victim of a crime; (4) to alert law enforcement of a person’s death, if it is suspected that criminal activity caused the death; (5) when it is believed that protected health information is evidence of a crime that occurred on Provider premises; and (6) in a medical emergency not occurring on Provider premises, when necessary to inform law enforcement about the commission and nature of a crime, the location of the crime or crime victims, and the perpetrator of the crime. e. With Your Written Authorization. Other uses and disclosures of your PHI will be made only with your written permission. You may revoke such authorizations in writing at any time in accordance with 45 CFR. 164.508(b)(5). Such revocation of authorization will not be effective for actions Provider may have taken in reliance on your authorization of the use or disclosure. f. Incidental Use and Disclosure. Provider is not required to eliminate every risk of an incidental use or disclosure of your PHI. Specifically, a use or disclosure of your PHI that occurs as a result of, or incident to an otherwise permitted use or disclosure is permitted as long as Provider has adopted reasonable safeguards to protect your PHI, and the information being shared was limited to the minimum necessary. 3. Your Rights Regarding Your PHI. You have the following rights regarding PHI that Provider maintains about you. Any requests with respect to these rights must be in writing. A brief description of how you may exercise these rights is included. Right of Access to Inspect and Copy. You may inspect and obtain a copy of your PHI that is contained in a designated record set for as long as Provider maintains the record. A "designated record set" contains medical and billing records and any other records that Provider uses for making decisions about you. Your request must be in writing. Provider may charge you a reasonable cost-based fee for the copying and transmitting of your PHI. Provider can deny you access to your PHI in certain circumstances. In some of those cases, you will have a right of recourse to the denial of access. Please contact Provider if you have questions about access to your medical record. Right to Amend. You may request, in writing, that Provider amend your PHI that has been included in a designated record set. In certain cases, Provider may deny your request for an amendment. If Provider denies your request for amendment, you have the right to file a statement of disagreement with Provider. Provider may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Right to an Accounting of Disclosures. You may request an accounting of disclosures made for treatment purposes or made as a result of your authorization, for a period of up to six years, excluding disclosures made to you. Provider may charge you a reasonable fee if you request more than one accounting in any 12-month period. Please contact Provider if you have questions about accounting of disclosures. Right to Request Restrictions. You have the right to ask Provider not to use or disclose any part of your PHI for treatment, payment or health care operations or to family members involved in your care. Your request for restrictions must be in writing and Provider is not required to agree to such restrictions. You also have the right to restrict certain disclosures of your PHI to your health plan if you pay out of pocket in full for the health care Provider provides to you. Right to Request Confidential Communication. You have the right to request to receive confidential communications from Provider by alternative means or at an alternative location. Provider will accommodate reasonable written requests. Provider may also condition this accommodation by asking you for information regarding how payment will be handled or specification of an alternative address or other method of contact. Please contact Provider if you would like to make this request. Right to a Copy of this Notice. You have the right to obtain a copy of this notice from Provider. Any questions you have about the contents of this document should be directed to Provider. Right to Notice of Breach. You have the right to be notified of any breach of your unsecured PHI. 4. Contact Information. Marilyn Shannon is Provider’s Privacy and Security Officer. If you have any questions about this Notice of Privacy Practices, please contact the Provider Privacy Officer at: Marilyn Shannon Bellevue, WA 98008 marilyns@letsgopt.com 5. Complaints. If you believe Provider has violated your privacy rights, you may file a complaint in writing with Provider’s Privacy Officer, as specified above. You also have the right to file a complaint in writing to the Washington Department of Health or to the US Secretary of Health and Human Services. Provider will not retaliate against you in any way for filing a complaint. The U.S. Department of Health & Human Services Office of Civil Rights 200 Independence Avenue, S.W. Washington, D.C. 20201 (202) 619-0257/1-877-696-6775 Effective date of this notice: May 6, 2021