|
NOTICE OF PRIVACY PRACTICES
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.
The Health Insurance Portability & Accountability
Act of 1996 (“HIPAA”) is a federal program that requires that all medical
records and other individually identifiable health information used or disclosed
by us in any form, whether electronically, on paper, or orally are kept properly
confidential. This Act gives you, the patient, significant new rights to
understand and control how your health information is used. “HIPAA” provides
penalties for covered entities that misuse personal health information.
As required by “HIPAA”, we have prepared this
explanation of how we are required to maintain the privacy of your health
information and how we may use and disclose your health information.
We may use and disclose your medical records only
for each of the following purposes: treatment, payment and health care
operations.
-
Treatment
means providing, coordinating, or managing health care and related services by
one or more health care providers. An example of this would include a
comprehensive eye examination.
-
Payment
means such activities as obtaining
reimbursement for services, confirming coverage, billing or collection
activities, and utilization review. An example of this would be sending a
bill for your visit to your insurance company for payment.
-
Health care operations
include the business aspects of running our
practice, such as conducting quality assessment and improvement activities,
auditing functions, cost-management analysis and customer service. An example
would be an internal quality assessment review.
We may also create and distribute de-identified
health information by removing all references to individually identifiable
information.
We may contact you to provide appointment
reminders or information about treatment alternatives or other health-related
benefits and services that may be of interest to you.
Any other uses and disclosures will be made only
with your written authorization. You may revoke such authorization in writing
and we are required to honor and abide by that written request, except to the
extent that we have already taken actions relying on your authorization.
You have the following rights with respect to
your protected health information, which you can exercise by presenting a
written request to our HIPAA Compliance Officer:
-
The right to request restrictions on certain
uses and disclosures of protected health information, including those related
to disclosures to family members, other relatives, close personal friends, or
any other person identified by you. We are, however, not required to agree to
a requested restriction. If we do agree to a restriction, we must abide by it
unless you agree in writing to remove it.
-
The right to reasonable requests to receive
confidential communications of protected health information from us by
alternative means or at alternative locations.
-
The right to inspect and copy your protected
health information
-
The right to amend your protected health
information.
-
The right to receive an accounting of
disclosures of protected health information.
-
The right to obtain a paper copy of this notice
from us upon request.
We are required by law to maintain the privacy of
your protected health information and to provide you with notice of our legal
duties and privacy practices with respect to protected health information.
This notice is effective as of January 1, 2003 as
we are required to abide by the terms of the Notice of Privacy Practices
currently in effect. We reserve the right to change the terms of our Notice of
Privacy Practices and to make the new notice provision effective for all
protected health information that we maintain. We will post and you may request
a written copy of a revised Notice of Privacy Practices from this office.
You have recourse if you feel that your privacy
protections have been violated. You have the right to file written complaint
with our office or with the Department of Health & Human Services, Office of
Civil Rights, about violations of the provision of this notice or the policies
and procedures of our office. We will not retaliate against you for filing a
complaint.
For more information about HIPAA or to file 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
Toll Free: 1-877-696-6775
|
