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To make the most of your first visit, please try to bring with you the following items, if possible:

  • List of your current health conditions and medications
  • Any information regarding past eye treatments or surgeries
  • Name of your current primary doctor



NOTICE OF PRIVACY PRACTICES

 

(Described is how medical information about you (the patient) may be used and disclosed and how you can get access to this information.  Please read this carefully)

 

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) requires all health care records and other individually identifiable health information (protected health information) used or disclosed to us in any form, whether electronically, on paper, or orally, be kept confidential.  This federal law gives you, the patient, significant new rights to understand and control how your health information is used.  HIPAA provides penalties for covered entities that misuse personal health information.

 

Without specific written authorization, we are permitted to use and disclose your health care records for the purposes of treatment, payment, and health care operations.

 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.  An example of this would be billing your medical plan for your medical service.

 Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer services.  An example would include a periodic assessment of our documentation protocols, etc.

 

In addition, your confidential information may be used to remind you of an appointment (by phone or mail) or provide you with information about treatment options or other health-related services including release of information to legally authorized friends or family members that are directly involved in your care.  We will use and disclose your PROTECTED HEALTH INFORMATION when we are required to do so by the federal, state, or local law.  We may disclose your PROTECTED HEATH INFORMATION to public health authorities that are authorized by law to collect information, to a health oversight agency for activities authorized by law but not limited to: response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.  We will release your PROTECTED HEALTH INFORMATION if requested by a law enforcement official for any circumstance required by law.  We may release your PROTECTED HEALTH INFORMATION to organizations that handle organ, eye or tissue procurement or transplantation, including organ donation banks, as necessary to facilitate organ or tissue donation and transplantation if you are an organ donor.  We may use and disclose your PROTECTED HEALTH INFORMATION when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public.