PLEASE REVIEW THIS CAREFULLY.
We are obligated by law to give you notice of our privacy practices. this notice describes how we protect your health information and what rights you have regarding it. the most common reason why we disclose your health information is for treatment, payment, or health care operations. We use your health information inside our offices for these purposes without any special permission. If we need to disclose your health information outside of our offices for these reasons, we usually will not ask you for special written permission. In some situations, the law allows us to use or disclose your health information without your permission. Unless you object, we will also share relevant information about your care with your family or friends who are helping you with your eye care.
We may call or email to remind you of scheduled appointments, or that it is time to make a routine appointment. Unless you tell us otherwise, we will mail you an appointment reminder on a postcard or send an electronic reminder, leave a message on your home answering machine or with someone who answers your phone if you are not home. We will not make any other uses or disclosures of your health information unless you sign a written "authorization form." The content of the "authorization form" is determined by federal law. If we initiate the process and ask you to sign an authorization form, you do not have to sign it. If you do not sign the authorization, we cannot make the use or disclosure. if you do sign one, you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be in writing. 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), payment, or health care operations. We do not have to agree to do this, but if we agree, we must honor the restrictions you want. To ask for a restriction, send a written request to the contact person of the office.
--Ask us to communicate with you in a confidential way, such as phoning you at work rather than home. We will accommodate these requests if they are reasonable, and if you pay us for any extra cost. Requests should be made in writing.
--Ask to see or to get photocopies of your health information. 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 photocopies in advance. 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 would like to review or get photocopies of your health information, send a written request to the contact person.
--Ask us to amend your health information if you think that it is incorrect or incomplete. If we agree we will amend the information within 60 days from when you ask us. We will send the corrected information to persons who we know received the wrong information, and others 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 you may write. By law, we can have a 30-day extension of time to consider a request for amendment if we notify you in writing.
--Get a list of the disclosures that we have made of your health information within the past 6 years. By law, the list will not include: disclosures for purposes of treatment, payment, or health care operations disclosures with your authorization incidental disclosures disclosures required by law, and some other limited disclosures. We usually respond to your request within 60 days of receiving it, but by law, we can have one 30-day extension of time if we notify you of the extension in writing.
--Get additional paper copies of this Notice of Privacy Practices upon request. If you want additional paper copies, send a written request to the contact person. By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. we reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to such information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our office and have copies available. If you think that we have not properly respected the privacy of your health information, you are free to complain to us or the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint. If you want more information about our privacy practices, call or visit the office and speak to the contact person.