NOTICE OF PRIVACY PRACTICES
Effective Date: August 1, 2019
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 understand the importance of privacy and confidentiality and are committed to safeguarding any medical or individually identifiable health information created by or provided to us.
The Privacy Rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires us to:
- Maintain the privacy of protected health information (PHI)
- Provide notice of our legal duties and privacy practices
- Abide by the terms of this Notice
- Notify affected individuals following a breach of unsecured PHI
This Notice describes how we may use and disclose your PHI. It also outlines your rights and our legal obligations.
WHO WILL FOLLOW THIS NOTICE
This notice describes the practices of our employees and staff, as well as business associates that may include hospitals, physician organizations, health plans, and other entities that collectively provide health care services.
A listing of the OHCAs we participate in is available from the Privacy Officer.
This notice applies to all individuals, entities, sites, and locations involved in your care. These parties may share PHI for treatment, payment, and health care operations as described below.
INFORMATION COLLECTED ABOUT YOU
During the course of treatment and care, we may collect:
- Your name, address, email, and phone number
- Medical history information
- Insurance information and coverage details
- Information about your doctors or other providers
We also create and maintain a medical record of your care. This record is stored electronically. The medical record is the property of our ophthalmic practice, but the information belongs to you.
Information may also be provided by others in your “circle of care,” such as your primary care provider, referring physician, health plan, or family members.
HOW WE MAY USE AND DISCLOSE INFORMATION ABOUT YOU
Treatment
We may use PHI to provide medical care. For example:
- Assessing the health of your eyes
- Sharing information with other providers
- Providing prescriptions
- Ordering laboratory tests
Payment
We may use and disclose PHI to:
- Bill for services
- Collect payment
- Obtain prior authorization
- Determine insurance coverage
Health Care Operations
We may use PHI to:
- Improve our services
- Conduct audits
- Evaluate quality of care
- Share information within participating OHCAs
Required by Law
We will disclose PHI when required by law and limit disclosures to what is legally necessary.
Public Health
We may disclose PHI to:
- Prevent or control disease
- Report exposure risks
Abuse or Neglect
We may report suspected abuse, neglect, or domestic violence as required by law.
Food and Drug Administration
We may disclose PHI to report:
- Adverse events
- Product defects
- Recalls or replacements
Serious Threat
We may disclose PHI to prevent a serious threat to health or safety.
Health Oversight Activities
We may disclose PHI for:
- Audits
- Investigations
- Licensure or disciplinary actions
Judicial and Administrative Proceedings
We may disclose PHI:
- By court order
- In response to lawful subpoenas
Law Enforcement
We may disclose PHI to:
- Identify or locate individuals
- Comply with court orders
Coroners and Funeral Directors
We may disclose PHI to:
- Identify deceased persons
- Determine cause of death
Organ Donation
We may disclose PHI to organ procurement organizations.
Worker’s Compensation
We may disclose PHI as required for workers’ compensation claims.
Employers
We may disclose PHI when care is provided at the employer’s request for workplace evaluations.
Armed Forces
We may disclose PHI for military command purposes.
Correctional Institutions
If incarcerated, PHI may be disclosed for treatment and safety.
National Security
We may disclose PHI for national security or protective services.
Business Associates
We work with outside vendors (billing, IT, etc.). They are contractually required to protect your PHI.
Notification and Family Communication
We may disclose PHI to:
- Notify family or responsible persons
- Coordinate disaster relief
Facility Directories
We may include you in a facility directory unless you object.
Change of Ownership
If the practice is sold or merged, records transfer to the new owner. You retain rights to request record transfers.
Research
We may use PHI for research when approved by appropriate review boards.
De-Identified Information
We may remove identifying details and use health information in de-identified form.
Marketing
We will obtain written authorization before certain marketing communications where compensation is involved.
We may communicate without authorization:
- Appointment reminders
- Government program information
- Promotional gifts of nominal value
- Wellness communications
Appointment Reminders
We may contact you via:
- Phone
- Text
You may request your preferred communication method.
Sale of Health Information
We will not sell your health information without written authorization.
Psychotherapy Notes
Psychotherapy notes require written authorization except as allowed by law.
Immunization Records
We may provide proof of immunization to schools with proper authorization.
OTHER USES AND DISCLOSURES
We must obtain written authorization for uses not described above. You may revoke authorization in writing at any time.
INDIVIDUAL RIGHTS
To exercise your rights, contact our Privacy Officer in writing.
Restriction Requests
You may request limits on certain disclosures. We are not required to agree but will notify you of the outcome.
Restricted Disclosures to Health Plans
If you pay in full out-of-pocket, you may request we not disclose that information to your health plan.
Specific Communications
You may request communication by specific methods or locations.
Inspect and Copy
You may inspect and request copies of records. Reasonable fees may apply.
Amend or Supplement
You may request corrections to your record within 60 days. Certain limitations apply.
Accounting of Disclosures
You may request a list of certain disclosures made within the last six years.
Breach Notification
You have the right to be notified of breaches of unsecured PHI.
Copy of Notice
You may request a paper copy at any time.
CHANGES TO THIS NOTICE
We reserve the right to revise this Notice at any time. Updates will be posted on our website. You may request a copy of the revised notice.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, SW
Washington, DC 20201
Phone: (877) 696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/
You will not be retaliated against for filing a complaint.
CONTACT US
Contact our Privacy Officer:
Email: danielle.s@visionpointeye.com
Phone: 309-662-7700 ext. 1807
