Privacy Notice
NOTICE OF PRIVACY PRACTICES
FOR YOUR PROTECTION:
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
THIS NOTICE IS EFFECTIVE 4/14/03 PENDING ANY FUTURE UPDATES.
The Eye Doctor's Office, PA has always been committed to maintaining the security and confidentiality of the information we receive from our patients and customers. Whether it?s your medical information or identifiable information (such as your name, address, phone number, date of birth, or social security number), we maintain careful safeguards to protect you against unauthorized access and use.
How We Safeguard Your Health Information
Our privacy officer has the overall responsibility to implement and enforce privacy policies and procedures to protect your personal health information. You can be assured that every effort is taken to comply with federal and state laws ? physically, electronically, and procedurally ? to safeguard your information. The Eye Doctor?s Office, PA requires all of its employees, business associates (such as optical labs and insurance claim clearinghouses), providers, and vendors to adhere to our privacy policies and procedures under the strictest standards.
Right to Notice
As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPAA), The Eye Doctor?s Office, PA is permitted by law to use your protected health information without your authorization for the following purposes: Treatment, Payment, and Health Care Operations.
a) Treatment - We may use or disclose your health information to healthcare providers (doctors, surgeons, hospitals, and other caregivers) who request it to aid in your treatment.
b) Payment - We may use and disclose your health information to obtain payment for services and products we provide you.
c) Health Care Operations - We may use and disclose your health information in connection with our everyday health care operations. Health care operations may include quality assessment, improvement activities, outcome assessments, performance measurement, case management, care coordination competency, training, certification, credentialing activities, or licensing.
Service Reminders
We may contact you to remind you to obtain preventative or ongoing care services or to inform you of treatment alternatives and/or health-related benefits and services, which may be of interest or necessity.
Additional Uses and Disclosures
In certain other situations, the law permits us to use or disclose your personal health information without your authorization. These situations are inclusive of, at the least, the following:
REQUIRED BY LAW. We may use or disclose your personal health information, as we are required to do so by state or federal law, including disclosures to the US Dept. of Health & Human Services.
PUBLIC HEALTH ISSUES: We may disclose your health information to an authorized public health authority for public health activities in controlling disease, injury, or disability.
ABUSE OR NEGLECT: We may make disclosures to governmental authorities concerning abuse, neglect, or domestic violence as required by law.
HEALTH OVERSIGHT ACTIVITIES: We may disclose your health information to a government agency authorized to conduct health care system or governmental procedures such as audits, examinations, investigations, inspections, & licensure.
LEGAL PROCEEDINGS: We may disclose your health information in the course of any legal proceeding in response to a court order or administrative judge and, in certain cases, in response to subpoena, discovery request, or other lawful process.
CORONERS, MEDICAL EXAMINERS, ORGAN DONATIONS, AND FUNERAL DIRECTORS: We may disclose your health information in certain instances to medical examiners and coroners during their investigations. We may disclose personal health information to organizations that handle donations of eye tissues and transplantations. And we may disclose information to funeral directors so that they may carry out their duties.
RESEARCH: We may disclose your health information to researchers only if certain established measures are taken to protect your privacy.
TO PREVENT A SERIOUS THREAT TO HEALTH OR SAFETY: We may disclose your health information to the extent necessary to avoid a serious or imminent threat to your health or to the health or safety of others.
MILITARY ACTIVITY AND NATIONAL SECURITY: We may disclose your health information to armed forces personnel under certain circumstances, and to federal officials for national security and intelligence activities.
CORRECTIONAL INSTITUTIONS: We may disclose your health information to a correction-al facility should you become a resident of such a facility and if this information helps to provide you health care or to provide safety to you or others.
WORKERS COMPENSATION: We may disclose your health information as required by worker?s compensation laws.
OTHERS INVOLVED IN YOUR HEALTH CARE: We may disclose certain billing information to a family member on your behalf.
YOUR EMPLOYER: If your insurance coverage is through your employer and if we are in a contractual relationship with the insurer of concern, we may be required to release certain information to the employer for the purposes of reviews or audits. All personal identifiable information will be removed unless such identification is necessary.
Your Rights
The Eye Doctor?s Office, PA would like you to know that beginning on April 14, 2003 you have additional rights regarding your personal health information. Your additional rights are described below:
YOUR RIGHT TO CONFIDENTIAL COMMUNICATIONS: We will make every effort to accommodate reasonable requests to communicate with you about your health information at an alternative location. For our records, we will need this alternative address request in writing.
YOUR RIGHT TO ACCESS: You have the right to receive, by written request, a copy of your personal health information with some specified exceptions. There may be a fee for this service.
YOUR RIGHT TO REQUEST RESTRICTIONS: You have the right to request restrictions on the way we handle your personal health information for treatment, payment, or health care operations as described earlier in the permitted handling of health information section of this notice. The law, however, does not require us to agree to these restrictions. If we do agree, we will send you a written confirmation. If we do not agree, we will notify you of such a decision in writing.
YOUR RIGHT TO AMEND YOUR HEALTH INFORMATION: You have the right to request an amendment of any personal health information or record of yours for which we posses. In certain circumstances, we will notify you in writing that we are denying your request. You have a right to file a written statement of disagreement with The Eye Doctor?s Office, PA, and we have the right to rebut that statement.
YOUR RIGHT TO INFORMATION ABOUT CERTAIN DISCLOSURES: You have the right to request (in writing) information about the times we have disclosed your personal health information for purposes other than the following: Treatment, Payment, or Health Care Operations as described in the first section of this notice, disclosures that you or your personal representatives have authorized, and certain other disclosures. The requirement that we provide you with information about the times we have disclosed your personal health information applies for six years from the date of the disclosure. This applies only to disclosures after April 14, 2003.
Legal Requirements
Although, The Eye Doctors? Office, PA follows the privacy practices described in this notice, you should know that under certain circumstances these practices could change in the future. For example, if the privacy laws change, we will change our practices to comply with the law. Should this occur, we will send a new notice to you prior to making a significant change to our privacy practices. Further, the change will apply to all personal information we have in our posses-soon, including any information created or received before we change the notice.
We are required to abide by the terms of this notice as it is currently stated, and reserve the right to change this notice. The policies in any new notice will not be in effect until they are officially adopted and are made effective by the US Dept of Health and Human Services or any other federal agency responsible for this aspect of your health care. We will make every attempt to have any changes made to our privacy policy posted on our website in a timely manner.
For additional information, questions about this Notice of Privacy Practices, or if you want another written copy, please visit The Eye Doctor?s Office, PA?s website or contact our privacy officer, Stephanie Haenes at the phone number, fax number, or address listed below.
If you have complaints regarding the way your protected health information was handled, you may submit a complaint in writing to our office. Please be assured that we will not take any retaliatory action against you if you should feel compelled to file such a written complaint about our privacy practices.
Contact Information
For further information about The Eye Doctors Office PA's privacy policies, please contact Stephanie Haenes in any of the following communication methods:
Address: Art of Optiks
747 E. Lake Street
Wayzata, MN 55391
Phone: (952) 404-2020
Fax: (952) 404-0202
Internet: stephanie@artofoptiks.net
FOR YOUR PROTECTION:
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
THIS NOTICE IS EFFECTIVE 4/14/03 PENDING ANY FUTURE UPDATES.
The Eye Doctor's Office, PA has always been committed to maintaining the security and confidentiality of the information we receive from our patients and customers. Whether it?s your medical information or identifiable information (such as your name, address, phone number, date of birth, or social security number), we maintain careful safeguards to protect you against unauthorized access and use.
How We Safeguard Your Health Information
Our privacy officer has the overall responsibility to implement and enforce privacy policies and procedures to protect your personal health information. You can be assured that every effort is taken to comply with federal and state laws ? physically, electronically, and procedurally ? to safeguard your information. The Eye Doctor?s Office, PA requires all of its employees, business associates (such as optical labs and insurance claim clearinghouses), providers, and vendors to adhere to our privacy policies and procedures under the strictest standards.
Right to Notice
As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPAA), The Eye Doctor?s Office, PA is permitted by law to use your protected health information without your authorization for the following purposes: Treatment, Payment, and Health Care Operations.
a) Treatment - We may use or disclose your health information to healthcare providers (doctors, surgeons, hospitals, and other caregivers) who request it to aid in your treatment.
b) Payment - We may use and disclose your health information to obtain payment for services and products we provide you.
c) Health Care Operations - We may use and disclose your health information in connection with our everyday health care operations. Health care operations may include quality assessment, improvement activities, outcome assessments, performance measurement, case management, care coordination competency, training, certification, credentialing activities, or licensing.
Service Reminders
We may contact you to remind you to obtain preventative or ongoing care services or to inform you of treatment alternatives and/or health-related benefits and services, which may be of interest or necessity.
Additional Uses and Disclosures
In certain other situations, the law permits us to use or disclose your personal health information without your authorization. These situations are inclusive of, at the least, the following:
REQUIRED BY LAW. We may use or disclose your personal health information, as we are required to do so by state or federal law, including disclosures to the US Dept. of Health & Human Services.
PUBLIC HEALTH ISSUES: We may disclose your health information to an authorized public health authority for public health activities in controlling disease, injury, or disability.
ABUSE OR NEGLECT: We may make disclosures to governmental authorities concerning abuse, neglect, or domestic violence as required by law.
HEALTH OVERSIGHT ACTIVITIES: We may disclose your health information to a government agency authorized to conduct health care system or governmental procedures such as audits, examinations, investigations, inspections, & licensure.
LEGAL PROCEEDINGS: We may disclose your health information in the course of any legal proceeding in response to a court order or administrative judge and, in certain cases, in response to subpoena, discovery request, or other lawful process.
CORONERS, MEDICAL EXAMINERS, ORGAN DONATIONS, AND FUNERAL DIRECTORS: We may disclose your health information in certain instances to medical examiners and coroners during their investigations. We may disclose personal health information to organizations that handle donations of eye tissues and transplantations. And we may disclose information to funeral directors so that they may carry out their duties.
RESEARCH: We may disclose your health information to researchers only if certain established measures are taken to protect your privacy.
TO PREVENT A SERIOUS THREAT TO HEALTH OR SAFETY: We may disclose your health information to the extent necessary to avoid a serious or imminent threat to your health or to the health or safety of others.
MILITARY ACTIVITY AND NATIONAL SECURITY: We may disclose your health information to armed forces personnel under certain circumstances, and to federal officials for national security and intelligence activities.
CORRECTIONAL INSTITUTIONS: We may disclose your health information to a correction-al facility should you become a resident of such a facility and if this information helps to provide you health care or to provide safety to you or others.
WORKERS COMPENSATION: We may disclose your health information as required by worker?s compensation laws.
OTHERS INVOLVED IN YOUR HEALTH CARE: We may disclose certain billing information to a family member on your behalf.
YOUR EMPLOYER: If your insurance coverage is through your employer and if we are in a contractual relationship with the insurer of concern, we may be required to release certain information to the employer for the purposes of reviews or audits. All personal identifiable information will be removed unless such identification is necessary.
Your Rights
The Eye Doctor?s Office, PA would like you to know that beginning on April 14, 2003 you have additional rights regarding your personal health information. Your additional rights are described below:
YOUR RIGHT TO CONFIDENTIAL COMMUNICATIONS: We will make every effort to accommodate reasonable requests to communicate with you about your health information at an alternative location. For our records, we will need this alternative address request in writing.
YOUR RIGHT TO ACCESS: You have the right to receive, by written request, a copy of your personal health information with some specified exceptions. There may be a fee for this service.
YOUR RIGHT TO REQUEST RESTRICTIONS: You have the right to request restrictions on the way we handle your personal health information for treatment, payment, or health care operations as described earlier in the permitted handling of health information section of this notice. The law, however, does not require us to agree to these restrictions. If we do agree, we will send you a written confirmation. If we do not agree, we will notify you of such a decision in writing.
YOUR RIGHT TO AMEND YOUR HEALTH INFORMATION: You have the right to request an amendment of any personal health information or record of yours for which we posses. In certain circumstances, we will notify you in writing that we are denying your request. You have a right to file a written statement of disagreement with The Eye Doctor?s Office, PA, and we have the right to rebut that statement.
YOUR RIGHT TO INFORMATION ABOUT CERTAIN DISCLOSURES: You have the right to request (in writing) information about the times we have disclosed your personal health information for purposes other than the following: Treatment, Payment, or Health Care Operations as described in the first section of this notice, disclosures that you or your personal representatives have authorized, and certain other disclosures. The requirement that we provide you with information about the times we have disclosed your personal health information applies for six years from the date of the disclosure. This applies only to disclosures after April 14, 2003.
Legal Requirements
Although, The Eye Doctors? Office, PA follows the privacy practices described in this notice, you should know that under certain circumstances these practices could change in the future. For example, if the privacy laws change, we will change our practices to comply with the law. Should this occur, we will send a new notice to you prior to making a significant change to our privacy practices. Further, the change will apply to all personal information we have in our posses-soon, including any information created or received before we change the notice.
We are required to abide by the terms of this notice as it is currently stated, and reserve the right to change this notice. The policies in any new notice will not be in effect until they are officially adopted and are made effective by the US Dept of Health and Human Services or any other federal agency responsible for this aspect of your health care. We will make every attempt to have any changes made to our privacy policy posted on our website in a timely manner.
For additional information, questions about this Notice of Privacy Practices, or if you want another written copy, please visit The Eye Doctor?s Office, PA?s website or contact our privacy officer, Stephanie Haenes at the phone number, fax number, or address listed below.
If you have complaints regarding the way your protected health information was handled, you may submit a complaint in writing to our office. Please be assured that we will not take any retaliatory action against you if you should feel compelled to file such a written complaint about our privacy practices.
Contact Information
For further information about The Eye Doctors Office PA's privacy policies, please contact Stephanie Haenes in any of the following communication methods:
Address: Art of Optiks
747 E. Lake Street
Wayzata, MN 55391
Phone: (952) 404-2020
Fax: (952) 404-0202
Internet: stephanie@artofoptiks.net