GENERAL RULE

We respect our legal obligation to keep health information that identifies you private.  We are obligated by law to give you notice of our privacy practices.

Generally, we cannot use your health information in our office or disclose it outside of our office without your written permission.  Sometimes the written permission will be called a consent form, and sometimes it will be called an authorization form.  The type of permission form will depend upon the kinds of uses or disclosures that are involved.  In some limited situations, the law allows or requires us to disclose your health informaiton without either a written consent or authorization

USES OR DISCLOSURES WITH CONSENT

We will  ask you to sign a consent for m allowing us to use and disclose your health information for purposes of treatment, payment, and health care operations of this office.  We are allowed to refuse to treat you if you do not sign the consent form.

We use information for treatment purposes, when, for example, we set up an appointment for you, when our technician or doctor tests your eyes, when the doctor prescribes glasses or contact lenses, when the doctor prescribes medication, when our staff helps you select and order glasses or contact lenses, and when we show you  low vision aids.  We may disclose your health information outside of our office for treatment purposes if, for example, we refer you to another doctor or clinic for eye care or low vision aids or services, if we send a prescription for glasses or contacts to another to be filled, when we provide a prescription for medication to a pharmacist, ro when we phone to let you know that your glasses or contact lenses are ready to be picked up.  Sometimes we may ask for copies of your health information from another professional that you may have seen before us.

We use your health information for payment purposes when, for example, our staff asks you about health or vision care plans that you may belong to, or about other sources of payment for our services, when we prepare bills to send to you or your health or vision care plan, when we process payment by credit card, and when we try to collect unpaid amounts due.  We may disclose your health informaiton outside of our office for payment purposes when, for example, bills or claims for payment are mailed, faxed, ro sent by computer to you or your health or vision plan, or when we occasionally have to ask a collection agency or attorney to help us with unpaid amounts due.

We use and disclose your ehalth information  for health care operations in a number of ways.  Health care operations means those administrative and managerial functions that we have to do in order to run our office.  We may use or disclose your health informaiton, for example, for financial  or billing audits, for internal quality assurance, for personnel decisions, to enable our doctors to participate in managed care plans, for the defense of legal matters, to develop business plans, and for outside storage of our records.

USES AND DISCLOSURES WITHIOUT CONSENT OR AUTHORIZATION

In some limited situations, the law allows or requires us to use or disclose your health information without your permission.  Not all of these situations will apply to us; some may never come up at our office at all. 

Such uses or disclosures include:

1. when a state or federal law mandates that certain health information be reported for a specific purpose;
2. for public health purposes, such as contagious disease reporting, investigation or surveillance; and notices to and from the Food and Drug Administration regarding drugs or medical devices;
3. disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence;
4. 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;
5. disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies;
6. 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;
7. 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 or tissue donations;
8. uses or disclosures for health related research;
9. uses and disclosures to prevent a serious threat to health or safety;
10. uses or disclosures for specialized government functions, such as for the protection 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;
11. disclosures relating to worker’s compensation programs;
12. disclosures to business associates who perform health care operations for us and who agree to keep your health information private.

APPOINTMENT REMINDERS

We may call to remind you of scheduled appointments.  We may also call to notify you of other treatments or services available at our office that might help you.  We may remind you by mail and we may ask to pre-appoint you for your visit next time.

OTHER DISCLOSURES

We will not make any other uses or disclosures of your health information unless you sign a written authorization form.  You do not have to sign such a form.  If you do sign one, you may revoke it at any time unless we have already acted in reliance upon it.

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 or health care operations.  We do not have to agree to do this, but if we agree, we must honor the restrictions that you want.  To ask for a restriction, send a written request to the office manager at the address or fax shown at the beginning of this Notice.
• Ask us to communicate with you in a confidential way, such as by 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 reasonable, and if you pay us for any extra cost.  If you want to ask for confidential communications, send a written request to the office manager at the address, fax or e-mail shown at the beginning of this Notice
• Ask us to see or to get photocopies of your health information.  By law, there are a few limited situations in which we 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 30 days of asking us.  You may  have to pay for the photocopying 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 required.  By law, we can have one 30 day extension of the time for us to give you access or photocopies if we send you a written notice of the extension.  If you want to review or get photocopies of your health information, send a written request to the office manager at the address, fax or email shown at the benginning of this Notice.
• Ask us to amend your health information if you think that it is incorrect or incomplete.  If we agree, we will amend the information withinn 60 days from when you ask us.  We will send the corrected information to persons who we know go the wrong information, and others that 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 that we may write.  Once your statement of position and/or our rebuttal is included in your heatlh information, we will send it along whenever we make a permitted disclosure of your health informaiton.  By law, we can have one 30 day extension of time to sconsider a request for amendment if we notify you in writing of the extension.  IF you want to ask us to amend your heatlh information, send a written request, including your reasons for the amendment, to office manager at the address, fasx or email shown at the beginning of this Notice.