NOTICE OF PRIVACY PRACTICES
OUR PLEDGE REGARDING HEALTH INFORMATION
The privacy of your medical information is important to us. We understand that your medical information is personal and we are committed to protecting it. We create a record of the care and services you receive at our clinic. We need this record to provide you with quality care and to comply with certain legal requirements. This notice will tell you about the ways we may use and share medical information about you. We also describe your rights and certain duties we have regarding the use and disclosure of medical information.
OUR LEGAL DUTY
The Law Requires Us to:
- Keep your medical information private.
- Provide you with notice of our legal duties and privacy practices with respect to your health information.
- Follow the terms of the current notice.
We Have the Right to:
- Change our privacy practices and the terms of this notice at any time, provided the changes are permitted by law.
- Make the changes in our privacy practices and the new terms of our notice effective for all medical information that we keep, including information previously created or received before the changes.
USE AND DISCLOSURE OF YOUR MEDICAL INFORMATION
We may use and disclose your medical records only for each of the following purposes: treatment, payment and health care operations. We are not able to list every use or disclosure, however, we have listed all the different ways we are permitted to use and disclose medical information. We will not use or disclose your medical information for any purpose not listed below without your specific written authorization. Any specific written authorization you provide may be revoked at any time by writing to us. 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.
- Treatment means providing, coordinating, or managing health care and related services by one or more health care providers.
- Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review.
- Health Care Operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, getting the accreditation, certificates, licenses and credentials we need to serve you and customer service.
- The practice may also disclose your PHI for law enforcement and other legitimate reasons although we shall do our best to assure its continued confidentiality to the extent possible.
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, via an automated phone system or by mail. You may also be contacted regarding alternatives or other health-related benefits and services.
YOUR INDIVIDUAL RIGHTS
You have the following rights with respect to your protected health information, which you may exercise by presenting a written request to Ophthalmology Associates, L.L.P. – Southdale Eye Clinic.
- 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. There may be charges for copying and for postage if you want the copies mailed to you. Speak with our Billing Department about our fee structure.
- The right to amend your protected health information, with your physician's approval.
- The right to receive an accounting of disclosures of protected health information.
- The right to obtain and we have the obligation to provide to you a paper copy of this notice from us at your first service delivery date.
- The right to obtain and we are obligated to receive a written acknowledgement that you have received a copy of our Notice of Privacy Practices.
- The right to be advised if your unprotected PHI is intentionally or unintentionally disclosed.
You have recourse if you feel that your privacy protections have been violated. You have the right to file a formal, written complaint to our Clinic Manager, or with the Department of Health & Human Services, Office of Civil Rights, about violations of the provisions of this notice or the policies and the procedures of our clinic. We will not retaliate in any way if you choose to file a complaint.
Feel free to contact the Clinic Manager for more information, in person or in writing.