Privacy Notice
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.
We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give you a notice of our privacy pratices. This Notice describes how we protect your health information andd what rights you have regarding it.
TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS The most common reasons why we use or disclose your health information is for treatment, payment and health care operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you testing or examining your eyes prescribing glasses, contact lenses, or eye medications and faxing them to be filled showing you low vision aids referring you to another doctor or clinic for eye care or low vision aids or services or getting copies of your health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about your health or vision care plans, or other sources of payment preparing and sending bills or claims and collecting unpaid amounts (either ourselves or through a collection agency or attorney). "Health Care Operations" mean those administrative and managerial functions that we have to do to run our office. Examples of haw we use or disclose your health information for health care operations are: financial and billing audits internal quality assurance personal decisions participation in managed care plans defense of legal mattersbusiness planning and outside storage of our records. We routinely use your health information inside our office for these purposes without any special permission. If we need to disclose your health information outside our office for these reasons, we usually will not ask you for special written permission.
USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION In some limited situations, the law allows or requires us to use or disclose your health information without your permission. These examples are notmeant to be exhaustive, but to describe the types and uses that may be made by our office. Not all of these situations will apply to us some may never come up in our office at all. Such uses and disclosures are: * when a state or federal law mandates that that certain health information be reported for a specific purpose * for public health purposes, such a contagious disease reporting, investigation or surveillance and notices to and from Federal Food and Drug Administration regarding drugs and nedical devices * disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence * uses and disclosures for health oversight activities, such as for the licensing of doctors for audits by Medicare or Medicaid or for investigation of possible violations of health care laws * disclosure for judicial and administrative proceedings, such as in response to subpeonas or orders of courts or administrative agencies * disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime to provide information about a crime at our office or to report a crime that happened somewhere else * disclosure to a medical examiner to identify a dead person or to determine the cause of death or to funeral directors to aid in burial or to organizations that handle organ and tissue donations * uses and disclosures to prevent serious threat to health and safety * uses and disclosures for specialized governmental functions, such as for the protction of the president or high ranking government officials for lawful national intelligence activities for military purposes or for the evaluation and health of members of the foreign service * disclosures of de-identified information * disclosures related to worker's compensation programs * disclosures of a "limited data set" for research, public health, or health care operations * incidental disclosures that are an unavoidable by-product of premitted of permitted uses or disclosures * disclosures to "business associates" who perform health care operation to us and who commit to respect the privacy of you health information Unless you object, we will also share revelant information about your care with your family or friends who are helping you with your eye care.
APPOINTMENT REMINDERS We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We may also call or write to notify you of other treatments or services available at our office that might help you. Unless you tell us otherwise, we will mail you a notice that it is time to schedule a routine appointment. We will call you to remind you of a scheduled appointment, leaving a message for you at your home or at work, or with someone who answers the phone if you are not available.
OTHER USES AND DISCLOSURES We will not make any other uses or disclosures of your health information unless you sign a written "authorization form". The content of an "authorization |form" is determined by federal law. Sometimes, we may initiate the authorization process if the use or disclosure is our idea. Sometimes, you may initiate the authorization process if it's your idea for us to send your information to someone else. Typically in this situation you will give us a properly completed authorization form,or you can use one of ours. If we initiate the authorization process and ask you to sign an authorization form, you do not have to sign it. If you do not sign the authorization, we cannot make the use or disclosure. If you do sign it, you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be in writing. Send them to the office contact person at the address shown above at the end of this notice.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION The law gives you many rights regarding your health information. You can: * ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment and health operations. We do not have to agree to this, but if we agree, we must honor the restrictions that you want. To ask for a restriction, you can give us a properly completed request form, or you can use one of ours. You may send the request to the office contact person at he address shown at the end of this notice.
-ask us to communicate with you in a confidential way, such as phoning you at work rather than at home, by mailing health information to a different address, or by using Email to your personal Email address. We will accommodate these requests if they are resonable, and if you pay us for any extra cost. If you want to ask for confidential communtcations, you can send us a properly completed request form, available upon request, to the office contact person at the address shown at the end of this notice.
-ask to see or get photocopies of your health information. By law, there are a few limited situations whichwe can refuse to permit access or copying. For the most part, however, you will be able to review or have a copy of your health information within thirty (30) days of asking (or sixty (60) days if stored off-site. You may have to pay for photocopies in advance. If we deny your request, we will send you a written explanation, and instructions about how to get an impartial review of our denial if one is legally available. By law, we can have a thirty (30) day extension of time for us to give you access or photocopies if we send you a written notice if extension. If you want to review or get photocopies of your health information, you can sen us a properly completed request form, available upon request, to the office contact person at the address shown at the end of this notice.
-ask us to amend your health information if you think it is incomplete or inaccurate. If we agree, we will amend the information within sixty (60) days from when you ask us. We will send the corrected information to persons we know got the wrong information, and others you specify. If we do not agree, you can write a statement of your position, and we will include it with your health information along with any rebuttal statement we might write. Once your statement of postions and/or our rebuttalis included in your health information, we will send it along whenever we are permitted disclosure of you health information. By law, we can have one thirty (30) day extension of time to consider a request of amendment if we notify you of the extension. If you want to ask us to amend your health information, you can send us a properly completed request form, available upon request, to the office contact person at the address shown at the end of this notice. * get a list of disclosures that we have made of your health information since April 14, 2003. After April 14, 2009, the accounting will be provided for the past six (6) years (or a shorter period if you want). By law, the list will not include: disclosures for purposes or treatment, payment or health care operations disclosures with your authorization incidental disclosures disclosures required by law and some other limited disclosures. You are entitled to one such list per year without charge. If you want more frequent lists, you will have to pay for them in advance. We will usually respond to your request within 60 (sixty) days of receiving it, but by law we can have one thirty (30) day extension of time if we notify you of the extension in writing. If you want a list of disclosures, you can send us a properly completed request form, available upon request, to the office contact person at the address shown at the end of this notice. * to get additional paper copies of this notice upon request Send a written request to the office contact person listed at the end of this notice.
OUR NOTICE OF PRIVACY PRACTICES By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information we already have as well as to such information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our office, have copies available at our office, and post it on our Website.
COMPLAINTS If you think we have improperly respected the privacy of your health information, you are free to complain to us or to the U.S. Department of Health and Human Resources, Office of Civil Rights. We will not retaliate against you if you make a complaint. If you want to complain to us, send a written complaint to the office contact person listed at the end of this Notice. If you prefer, you can discuss your complaint in person or by telephone.
FOR MORE INFORMATION If you want more information about our privacy practices, call or visit our office.
We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give you a notice of our privacy pratices. This Notice describes how we protect your health information andd what rights you have regarding it.
TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS The most common reasons why we use or disclose your health information is for treatment, payment and health care operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you testing or examining your eyes prescribing glasses, contact lenses, or eye medications and faxing them to be filled showing you low vision aids referring you to another doctor or clinic for eye care or low vision aids or services or getting copies of your health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about your health or vision care plans, or other sources of payment preparing and sending bills or claims and collecting unpaid amounts (either ourselves or through a collection agency or attorney). "Health Care Operations" mean those administrative and managerial functions that we have to do to run our office. Examples of haw we use or disclose your health information for health care operations are: financial and billing audits internal quality assurance personal decisions participation in managed care plans defense of legal mattersbusiness planning and outside storage of our records. We routinely use your health information inside our office for these purposes without any special permission. If we need to disclose your health information outside our office for these reasons, we usually will not ask you for special written permission.
USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION In some limited situations, the law allows or requires us to use or disclose your health information without your permission. These examples are notmeant to be exhaustive, but to describe the types and uses that may be made by our office. Not all of these situations will apply to us some may never come up in our office at all. Such uses and disclosures are: * when a state or federal law mandates that that certain health information be reported for a specific purpose * for public health purposes, such a contagious disease reporting, investigation or surveillance and notices to and from Federal Food and Drug Administration regarding drugs and nedical devices * disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence * uses and disclosures for health oversight activities, such as for the licensing of doctors for audits by Medicare or Medicaid or for investigation of possible violations of health care laws * disclosure for judicial and administrative proceedings, such as in response to subpeonas or orders of courts or administrative agencies * disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime to provide information about a crime at our office or to report a crime that happened somewhere else * disclosure to a medical examiner to identify a dead person or to determine the cause of death or to funeral directors to aid in burial or to organizations that handle organ and tissue donations * uses and disclosures to prevent serious threat to health and safety * uses and disclosures for specialized governmental functions, such as for the protction of the president or high ranking government officials for lawful national intelligence activities for military purposes or for the evaluation and health of members of the foreign service * disclosures of de-identified information * disclosures related to worker's compensation programs * disclosures of a "limited data set" for research, public health, or health care operations * incidental disclosures that are an unavoidable by-product of premitted of permitted uses or disclosures * disclosures to "business associates" who perform health care operation to us and who commit to respect the privacy of you health information Unless you object, we will also share revelant information about your care with your family or friends who are helping you with your eye care.
APPOINTMENT REMINDERS We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We may also call or write to notify you of other treatments or services available at our office that might help you. Unless you tell us otherwise, we will mail you a notice that it is time to schedule a routine appointment. We will call you to remind you of a scheduled appointment, leaving a message for you at your home or at work, or with someone who answers the phone if you are not available.
OTHER USES AND DISCLOSURES We will not make any other uses or disclosures of your health information unless you sign a written "authorization form". The content of an "authorization |form" is determined by federal law. Sometimes, we may initiate the authorization process if the use or disclosure is our idea. Sometimes, you may initiate the authorization process if it's your idea for us to send your information to someone else. Typically in this situation you will give us a properly completed authorization form,or you can use one of ours. If we initiate the authorization process and ask you to sign an authorization form, you do not have to sign it. If you do not sign the authorization, we cannot make the use or disclosure. If you do sign it, you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be in writing. Send them to the office contact person at the address shown above at the end of this notice.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION The law gives you many rights regarding your health information. You can: * ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment and health operations. We do not have to agree to this, but if we agree, we must honor the restrictions that you want. To ask for a restriction, you can give us a properly completed request form, or you can use one of ours. You may send the request to the office contact person at he address shown at the end of this notice.
-ask us to communicate with you in a confidential way, such as phoning you at work rather than at home, by mailing health information to a different address, or by using Email to your personal Email address. We will accommodate these requests if they are resonable, and if you pay us for any extra cost. If you want to ask for confidential communtcations, you can send us a properly completed request form, available upon request, to the office contact person at the address shown at the end of this notice.
-ask to see or get photocopies of your health information. By law, there are a few limited situations whichwe can refuse to permit access or copying. For the most part, however, you will be able to review or have a copy of your health information within thirty (30) days of asking (or sixty (60) days if stored off-site. You may have to pay for photocopies in advance. If we deny your request, we will send you a written explanation, and instructions about how to get an impartial review of our denial if one is legally available. By law, we can have a thirty (30) day extension of time for us to give you access or photocopies if we send you a written notice if extension. If you want to review or get photocopies of your health information, you can sen us a properly completed request form, available upon request, to the office contact person at the address shown at the end of this notice.
-ask us to amend your health information if you think it is incomplete or inaccurate. If we agree, we will amend the information within sixty (60) days from when you ask us. We will send the corrected information to persons we know got the wrong information, and others you specify. If we do not agree, you can write a statement of your position, and we will include it with your health information along with any rebuttal statement we might write. Once your statement of postions and/or our rebuttalis included in your health information, we will send it along whenever we are permitted disclosure of you health information. By law, we can have one thirty (30) day extension of time to consider a request of amendment if we notify you of the extension. If you want to ask us to amend your health information, you can send us a properly completed request form, available upon request, to the office contact person at the address shown at the end of this notice. * get a list of disclosures that we have made of your health information since April 14, 2003. After April 14, 2009, the accounting will be provided for the past six (6) years (or a shorter period if you want). By law, the list will not include: disclosures for purposes or treatment, payment or health care operations disclosures with your authorization incidental disclosures disclosures required by law and some other limited disclosures. You are entitled to one such list per year without charge. If you want more frequent lists, you will have to pay for them in advance. We will usually respond to your request within 60 (sixty) days of receiving it, but by law we can have one thirty (30) day extension of time if we notify you of the extension in writing. If you want a list of disclosures, you can send us a properly completed request form, available upon request, to the office contact person at the address shown at the end of this notice. * to get additional paper copies of this notice upon request Send a written request to the office contact person listed at the end of this notice.
OUR NOTICE OF PRIVACY PRACTICES By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information we already have as well as to such information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our office, have copies available at our office, and post it on our Website.
COMPLAINTS If you think we have improperly respected the privacy of your health information, you are free to complain to us or to the U.S. Department of Health and Human Resources, Office of Civil Rights. We will not retaliate against you if you make a complaint. If you want to complain to us, send a written complaint to the office contact person listed at the end of this Notice. If you prefer, you can discuss your complaint in person or by telephone.
FOR MORE INFORMATION If you want more information about our privacy practices, call or visit our office.