Privacy Notice
LONDON EYE CARE
NOTICE OF PRIVACY PRACTICES
Effective February 1, 2013
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. This notice is effective until further notice.
We will post the current notice in the office with its effective date. Upon request, we will provide a revised notice to you. You may request a paper copy of this notice at any time. It is also available on our website: www.londoneyecare.net.
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), LONDON EYECARE can use your protected health information for treatment, payment of your medical bills and health care operations
a) Treatment We may use or disclose your health information to a physician or other healthcare provider to treat you, to coordinate or manage your health care and related services, or to consult about your condition. We will disclose your glasses or contact lens prescription without your written request to an optical or laboratory requiring this information to fill your order.
b) Payment We may use and disclose your medical information to obtain payment for services we provide you, determine eligibility, process claims or make payment for covered services you receive under your benefit plan. We may disclose your information to a health care provider or another health plan for that provider or plan to obtain payment or engage in other payment activities.
c) Health care operations We may use and disclose your protected health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, general administrative activities, evaluating staff performance, cost-management analysis, conducting training programs, accreditation, certification, licensing or credentialing activities.
Unless you notify us in writing, we may contact you by mail, or at any phone number that you provide to us, leaving messages on voice mail or with someone that answers your phone. While we will not leave any sensitive information, we might remind you of an appointment or notify you that you have glasses or contacts to pick up, or ask you to return our call. With your permission, we may text or email.
You have the right to request in writing that we communicate with you in a certain way or at a certain location. For example, you can ask that we only contact you by mail, or only at work. We will not require you to tell us why you are asking for the confidential communication, but we will require an alternate address or other method to contact you.
Your Authorization Most uses and disclosures that do not fall under treatment, payment, or health care operations will require your written authorization. Upon signing, you may revoke your authorization (in writing) through our practice at any time.
You may give us written authorization to use your medical information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosure permitted by your authorization while it was in effect.
Unless you object, we may disclose your medical information to a family member, friend or any other person you involve in your health care or payment for your health care. We will disclose only the medical information that is relevant to the person's involvement, and at all times, we will only disclose the minimum necessary information. Inviting someone into the exam room with you involves them in your health care.
Appointment Reminders We send appointment reminders via phone, e-mail, text or mail.
Minors If there are family members or other people to whom you do not want us to disclose information about you or your child, notify our privacy officer in writing. Information will be released to the child's representative, that is, the person accompanying the child to our office.
Others involved in your care Unless you object in writing, we may disclose your PHI that directly relates to a person's involvement in your health care, e.g., your caregiver.
School or workplace Vision and health reports required for school entrance or for work will be completed in full and returned to the patient, his representative, or directly to the entity.
Emergency Situations In the event of your incapacity or an emergency situation, we will disclose health information to a family member, or another person responsible for your care, using our professional judgment. We will only disclose health information that is directly relevant to the person's involvement in your healthcare.
Education We may use your medical information to communicate with you about health-related products, benefits and services, payment for those products, benefits and services, and treatment alternatives that may be of interest to you.
Disclosures made without your authoization or opportunity to object We may use or disclose your name, location and general condition to notify, or to assist an appropriate public or private agency to locate and notify a person responsible for your health care in appropriate situations, such as a medical emergency or during disaster relief efforts.We may use and disclose your medical information, when required by law, and when authorized by law for the following kinds of public health and interest activities, judicial and administrative proceedings, law enforcement, research and other public benefit functions: for public health, including to report disease and vital statistics, suspected child and adult abuse, neglect or domestic violence to avert a serious and imminent threat to health or safety for health care oversight, such as activities of state insurance commissioners, licensing and peer review authorities and fraud prevention enforcement agencies for research to report adverse events or track recalls in response to court and administrative orders and other lawful process to law enforcement officials with regard to crime victims, crimes on our premises, crime reporting in emergencies and identifying or locating suspects or other persons to coroners, medical examiners, funeral directors, and organ procurement organizations to the military, federal officials for lawful intelligence, counterintelligence and national security activities, and correctional institutions and law enforcement regarding persons in lawful custody and as authorized by state worker's compensation laws.
Your Rights as a Patient
You have the right to request that we restrict our use or disclosure of your medical information for treatment, payment or health care operations, or with family, friends or others you identify. We are not required to agree to your request. If we do agree, we will abide by our agreement, except in a medical emergency or as required or authorized by law. You must make a written request to the contact at the end of this notice.
You have the right to request that we communicate with you about your medical information in confidence by alternative means or to alternative locations that you specify. You must make a written request to the contact at the end of this notice and your request must represent that the information could endanger you if it is not communicated in confidence as you request. We will accommodate your request if it is reasonable and specifies the alternative means or location for confidential communication.
You have the right to inspect and copy your protected health information. We will respond to your written request within 10 days of receipt.
You have the right to request that we amend your protected health information if you believe the information is incorrect or incomplete. We may deny your request if you do not provide a reason to support the request, if we did not create the file, or if our information is accurate and complete. We will act on your written request writing thirty days after receipt. If we deny your request, we will provide you a written explanation if we grant your request, we will make the appropriate amendment to the medical information by appending or otherwise providing a link to the amendment. The original record cannot be changed.
You have the right to receive an account of disclosures of your protected health information, which must state a specific time period not to exceed six years. We will respond to this request within 30 days. You may be charged for the costs of providing this.
You have the right to a paper copy of this notice of privacy practices.
Our Legal Duty LONDON EYECARE uses many methods to protect your oral, written and electronic medical information from illegal use or disclosure. We are required by law to maintain the privacy of your protected health information, and we take that obligation seriously. We are required to abide by the terms of this notice as it is currently stated, but we reserve the right to change this notice as allowed by law. The policies in any new notice will not be in effect until they are posted to this site, and are available within our office.
Complaints If you have concerns regarding the way your protected health information was handled, you may submit a complaint in writing to our office or with the Office of Civil Rights in the Department of Health and Human Services. You will not be retaliated against in any manner for a complaint.
Contact Information For further information about LONDON EYECARE's privacy policies, please contact Dr. Debra Croley PO BOX 310 London, KY 40743 or call (606) 878-2012.
NOTICE OF PRIVACY PRACTICES
Effective February 1, 2013
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. This notice is effective until further notice.
We will post the current notice in the office with its effective date. Upon request, we will provide a revised notice to you. You may request a paper copy of this notice at any time. It is also available on our website: www.londoneyecare.net.
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), LONDON EYECARE can use your protected health information for treatment, payment of your medical bills and health care operations
a) Treatment We may use or disclose your health information to a physician or other healthcare provider to treat you, to coordinate or manage your health care and related services, or to consult about your condition. We will disclose your glasses or contact lens prescription without your written request to an optical or laboratory requiring this information to fill your order.
b) Payment We may use and disclose your medical information to obtain payment for services we provide you, determine eligibility, process claims or make payment for covered services you receive under your benefit plan. We may disclose your information to a health care provider or another health plan for that provider or plan to obtain payment or engage in other payment activities.
c) Health care operations We may use and disclose your protected health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, general administrative activities, evaluating staff performance, cost-management analysis, conducting training programs, accreditation, certification, licensing or credentialing activities.
Unless you notify us in writing, we may contact you by mail, or at any phone number that you provide to us, leaving messages on voice mail or with someone that answers your phone. While we will not leave any sensitive information, we might remind you of an appointment or notify you that you have glasses or contacts to pick up, or ask you to return our call. With your permission, we may text or email.
You have the right to request in writing that we communicate with you in a certain way or at a certain location. For example, you can ask that we only contact you by mail, or only at work. We will not require you to tell us why you are asking for the confidential communication, but we will require an alternate address or other method to contact you.
Your Authorization Most uses and disclosures that do not fall under treatment, payment, or health care operations will require your written authorization. Upon signing, you may revoke your authorization (in writing) through our practice at any time.
You may give us written authorization to use your medical information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosure permitted by your authorization while it was in effect.
Unless you object, we may disclose your medical information to a family member, friend or any other person you involve in your health care or payment for your health care. We will disclose only the medical information that is relevant to the person's involvement, and at all times, we will only disclose the minimum necessary information. Inviting someone into the exam room with you involves them in your health care.
Appointment Reminders We send appointment reminders via phone, e-mail, text or mail.
Minors If there are family members or other people to whom you do not want us to disclose information about you or your child, notify our privacy officer in writing. Information will be released to the child's representative, that is, the person accompanying the child to our office.
Others involved in your care Unless you object in writing, we may disclose your PHI that directly relates to a person's involvement in your health care, e.g., your caregiver.
School or workplace Vision and health reports required for school entrance or for work will be completed in full and returned to the patient, his representative, or directly to the entity.
Emergency Situations In the event of your incapacity or an emergency situation, we will disclose health information to a family member, or another person responsible for your care, using our professional judgment. We will only disclose health information that is directly relevant to the person's involvement in your healthcare.
Education We may use your medical information to communicate with you about health-related products, benefits and services, payment for those products, benefits and services, and treatment alternatives that may be of interest to you.
Disclosures made without your authoization or opportunity to object We may use or disclose your name, location and general condition to notify, or to assist an appropriate public or private agency to locate and notify a person responsible for your health care in appropriate situations, such as a medical emergency or during disaster relief efforts.We may use and disclose your medical information, when required by law, and when authorized by law for the following kinds of public health and interest activities, judicial and administrative proceedings, law enforcement, research and other public benefit functions: for public health, including to report disease and vital statistics, suspected child and adult abuse, neglect or domestic violence to avert a serious and imminent threat to health or safety for health care oversight, such as activities of state insurance commissioners, licensing and peer review authorities and fraud prevention enforcement agencies for research to report adverse events or track recalls in response to court and administrative orders and other lawful process to law enforcement officials with regard to crime victims, crimes on our premises, crime reporting in emergencies and identifying or locating suspects or other persons to coroners, medical examiners, funeral directors, and organ procurement organizations to the military, federal officials for lawful intelligence, counterintelligence and national security activities, and correctional institutions and law enforcement regarding persons in lawful custody and as authorized by state worker's compensation laws.
Your Rights as a Patient
You have the right to request that we restrict our use or disclosure of your medical information for treatment, payment or health care operations, or with family, friends or others you identify. We are not required to agree to your request. If we do agree, we will abide by our agreement, except in a medical emergency or as required or authorized by law. You must make a written request to the contact at the end of this notice.
You have the right to request that we communicate with you about your medical information in confidence by alternative means or to alternative locations that you specify. You must make a written request to the contact at the end of this notice and your request must represent that the information could endanger you if it is not communicated in confidence as you request. We will accommodate your request if it is reasonable and specifies the alternative means or location for confidential communication.
You have the right to inspect and copy your protected health information. We will respond to your written request within 10 days of receipt.
You have the right to request that we amend your protected health information if you believe the information is incorrect or incomplete. We may deny your request if you do not provide a reason to support the request, if we did not create the file, or if our information is accurate and complete. We will act on your written request writing thirty days after receipt. If we deny your request, we will provide you a written explanation if we grant your request, we will make the appropriate amendment to the medical information by appending or otherwise providing a link to the amendment. The original record cannot be changed.
You have the right to receive an account of disclosures of your protected health information, which must state a specific time period not to exceed six years. We will respond to this request within 30 days. You may be charged for the costs of providing this.
You have the right to a paper copy of this notice of privacy practices.
Our Legal Duty LONDON EYECARE uses many methods to protect your oral, written and electronic medical information from illegal use or disclosure. We are required by law to maintain the privacy of your protected health information, and we take that obligation seriously. We are required to abide by the terms of this notice as it is currently stated, but we reserve the right to change this notice as allowed by law. The policies in any new notice will not be in effect until they are posted to this site, and are available within our office.
Complaints If you have concerns regarding the way your protected health information was handled, you may submit a complaint in writing to our office or with the Office of Civil Rights in the Department of Health and Human Services. You will not be retaliated against in any manner for a complaint.
Contact Information For further information about LONDON EYECARE's privacy policies, please contact Dr. Debra Croley PO BOX 310 London, KY 40743 or call (606) 878-2012.