Durrie Vision, PA
Notice of Privacy Practices
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.
UNDERSTANDING YOUR HEALTH RECORD/INFORMATION
Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examinations and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a basis for planning your care and treatment and serves as a means of communication among the health professionals who contribute to your care. Understanding what is in your record and how your health information is used helps you to ensure its accuracy and to make informed decisions when authorizing disclosure to others.
OUR DUTIES:
Durrie Vision, PA is required to maintain the privacy of your health information. In addition, we must provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you. Durrie must abide by the terms of this notice. We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. We will post any revisions to our notice and provide you a new notice at your request. If we maintain a Web site that provides information about our customer services or benefits, we will post our notice on that Web site. We will not use or disclose your health information without your authorization, except as described in the notice.
EXAMPLES OF DISCLOSURES FOR TREATMENT, PAYMENT, AND HEALTH OPERATIONS :
We will use your health information for treatment. For example: Information obtained by a healthcare practitioner will be recorded in your record and used to determine the course of treatment that should work best for you. By way of example, your physician will document in your record their expectations of the members of your healthcare team. Members of your healthcare team will then record their observations and course of action. We will also provide your other practitioners with copies of various reports that should assist them in treating you.
We will use your health information for payment. For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used. This information may be necessary for us to receive payment or for you to be reimbursed.
We will use your health information for regular health operations. For example: Members of the medical staff, the risk or quality improvement manager, or members of quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.
WAYS IN WHICH WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION:
Business Associates : There may be some services provided in our organization through contracts with Business Associates. Examples include certain lab tests, a copy service, and medical record retention services. When services are contracted, we may disclose some or all of your health information to our Business Associate so that they can perform the job we’ve asked them to do. To protect your health information, however, we require the Business Associate to appropriately safeguard your information in compliance with HIPAA and the HIPAA regulations.
Appointment and Patient Recall Reminders . We may ask that you sign in writing at the receptionists’ desk a "sign in" log on the day of your appointment with the practice. We may use and disclose medical information to contact you as a reminder that you have an appointment for medical care with the practice or that you are due to receive periodic care from the practice.
Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location and general condition.
Communication with family: Health professionals, using their best judgement, may disclose to a family member, other relatives, close personal friends or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.
Research: Under certain circumstances, we may use and disclose medical information about you for research purposes regarding medications, efficiency of treatment protocols and the like. All research projects are subject to an approval process, which evaluates a proposed research project and its use of medical information. Before we use or disclose medical information for research, the project will have been approved through this research approval process. We will obtain an Authorization form from you before using or disclosing your individually identifiable health information unless the authorization requirement has been waived. If possible, we will make the information non-identifiable to a specific patient. If the information has been sufficiently de-identified, an authorization for the use or disclosure is not required.
Coroners and funeral directors: We may disclose health information to a coroner to help determine the cause of death or to identify the deceased. We may disclose health information to funeral directors consistent with applicable law to carry out their duties.
Organ procurement organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
Marketing: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
Required by Law: We will disclose medical information about you when required to do so by federal, state or local law.
Workers compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
Correctional institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals. An inmate does not have the right to the Notice of Privacy Practices.
Investigation and Government Activities: We may disclose medical information to a local, state or federal agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure. These activities are necessary for the payer, the government and other regulatory agencies to monitor the health care system, government programs and compliance with civil rights laws.
Lawsuits and Disputes: If you are involved in a lawsuit or dispute, we may disclose medical information about you in response to a court or administrative order. This is particularly true if you make your health an issue. We may also disclose medical information about you in response to subpoena, discovery, request, or other lawful process by someone else involved in the dispute. We shall attempt in these cases to tell you about the request so that you may obtain an order protecting the information requested if you so desire. We may also use such information to defend ourselves or any member of our practice in any actual or threatened action.
Law enforcement: We may release medical information if asked to do so by a law enforcement official:
- In response to a court order, subpoena, warrant, summons or similar process
- To identify or locate a suspect, fugitive, material witness or missing person
- About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement
- About a death we believe may be the result of criminal conduct
- About criminal conduct of the Practice; and
- In emergency circumstances to report a crime: the location of the crime or victims or the identity, description or location of the person who committed the crime.
CHANGES IN THIS NOTICE
We reserve the right to change this notice at any time. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we may receive from you in the future. We will post a copy of the current notice in the practice. The notice will contain on the first page, top right- hand corner, the date of last revision and effective date. In addition, each time you visit the practice for treatment or health care services you may request a copy of the current notice in effect.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with the practice or the Secretary of the Department of Health and Human Services. To file a complaint with the practice, contact the Administrator, who will direct you on how to file an office complaint. All complaints shall be investigated, without repercussion to you.
The Administrator can be reached at this number 913-491-3737.
You will not be penalized for filing a complaint .
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written authorization, unless those uses can be reasonably inferred from the intended uses above. If you have provided us with your authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required to retain our records of the care that we provided to you.
PATIENT RIGHTS
THIS SECTION DESCRIBES YOUR RIGHTS AND THE OBLIGATIONS OF THIS PRACTICE REGARDING THE USE AND DISCLOSURE OF YOUR MEDICAL INFORMATION
You have the following rights regarding medical information we maintain about you:
- Right to Inspect and Copy.
You have the right to inspect and copy medical information that may be used to make decisions about your care. This includes your own medical and billing records, but does not include psychotherapy notes .
To inspect and copy your medical record, you must submit your request in writing to our Compliance Officer. Ask the front desk person for the name of the Compliance Officer. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies (tapes, disks, etc.) associated with your request .
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that our Compliance Committee review the denial. Another licensed health care professional chosen by the practice will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome and recommendations from that review.
- Right to Amend.
If you feel that the medical information we have about you in your record is incorrect or incomplete, then you may ask us to amend the information, following the procedure below. You have the right to request an amendment for as long as the practice maintains your medical record.
To request an amendment, your request must be submitted in writing, along with your intended amendment and a reason that supports your request to amend. The amendment must be dated and signed by you and notarized.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment
- Is not part of the medical information kept by or for the practice
- Is not part of the information which you would be permitted to inspect and copy; or
- Is inaccurate and incomplete.
- Right to an Accounting of Disclosures.
You have the right to request an "accounting of disclosures". This is a list of certain disclosures we made of medical information about you, to others.
To request this list, you must submit your request in writing. Your request must state a time period not longer than six- (6) years back and may not include dates before April 14, 2003 (or the actual implementation date of the HIPAA Privacy Regulations). Your request should indicate in what form you want the list (for example, on paper, electronically). The first accounting you request within a 12 month period is free. For additional accountings we may charge you for costs of providing the accounting. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
- Right to Request Restrictions.
You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care (a family member or friend). For example, you could ask that we not use or disclose information about a particular treatment you received.
We are not required to agree to your request and we may not be able to comply with your request. If we do agree, we will comply with your request except that we shall not comply, even with a written request, if the information is exempt from the consent requirement or we are otherwise required to disclose the information by law.
To request restrictions, you must make your request in writing. In your request, you indicate:
- What information you want to limit
- Whether you want to limit our use, disclosure or both; and
- To whom you want the limits to apply, (e.g. disclosures to your children, parents, spouse, etc.)
- Right to Request Confidential Communications.
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail, that we not leave voice mail or e-mail, or the like.
To request confidential communications, you must make your request in writing. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish us to contact you.
- Right to a Paper Copy of this Notice.
You have the right to paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice .
Click here to view our web site privacy policy.
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