Privacy Notice
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED. IT ALSO DESCRIBES HOW YOU MAY GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice is effective01/01//2013 until further notice.
Patients have the right to adequate notice of the uses and disclosures of their protected health information. Under the Health Insurance Portability and Accessibility Act(HIPAA) Dennis O'Bryan. O.D. dba Pleasant View Eye Wear & Eye Care,can use your protected health information for treatment,payment and health
care operations, as outlined below:
TREATMENT: We may disclose your health information to a physician or other health care provider providing treatment to you.
PAYMENT: We may use and disclose your health information to obtain payment for services we provide you.
HEALTH CARE OPERATIONS: We may disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment,improvement activities,reviewing the competency or qualifications of healthcare providers professionals, evaluating provider performance, conducting training programs, cooperating with organizations which evaluate, accredit. accredit,certify,license or credential, our providers and staff.
Most uses and disclosures that are not for treatment,payment or healthcare operations,
will require your written authorization. Signed authorizations for disclosure may be revoked upon your written signed request at any time.
Emergency Situations: In the event of your incapacity or an emergency situation, we will disclose health information to a family member or another responsible person, using our professional judgement. Only health information directly relevant to that person's involvement in your care will be disclosed.
Marketing: We will not use health information for marketing communications without your written consent.
REQUIRED BY LAW
If required by federal, state or local law, we will disclose your health information limited to the requirements of the law.
ABUSE or NEGLECT: We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect or domestic violence, or the victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to you or others' health or safety.
NATIONAL SECURITY: We may disclose health information of Armed Forces personnel to military authorities under certain circumstances.We may disclose health information to authorized federal officials for lawful inteligence and national security activities. Health information for inmates may be disclosed to appropriate authorities under certain circumstances.
APPOINTMENT REMINDERS: We may disclose health information to provide you with appointment reminders by, phone, e-mail, postcard, or letters.
YOUR RIGHTS as a Patient: You have the right to restrict disclosure of your protected health information (in writing). The request may be denied if the information is required for treatment, payment,or health care operations. You have the right to request that you receive "confidential communications" regarding your protected health information.
You have the right to request an opportunity to inspect and receive a copy of PHI about you, for a for certain records.If you request a copy of PHI about you , we may charge you a reasomnble fee for copying, postage, labor & supplies used to meet your request.
RIGHT TO AMEND: You have a right to request that we amend your PHI as long as the information is kept by our office. Requests must be made in writing, with a reason for the request.
RIGHT TO SEE LIST OF DISCLOSURES made sfter April 14, 2003.
You have a right to receive a paper copy of this notice of privacy practices.
PVEW&EC, the practice of Dennis O'Bryan, O.D,
is required by law to maintain the privacy of your protected health information. We must
abide by this notice as currently stated, and reserve the right to chang the notice. New policies will not be in effect until they are posted to the web site or are available in the office.
COMPLAINTS: You may submit a complaint to us, in writing, about the way your health information was handled. There will be no retaliation against you by us for filing a complaint.
CONTACT INFORMATION:
Dennis O'Bryan, O.D.
Pleasant View Eye Wear & Eye Care
8422- M-119 Harbor Plaza
Harbor Springs, MI 49740
This notice is effective01/01//2013 until further notice.
Patients have the right to adequate notice of the uses and disclosures of their protected health information. Under the Health Insurance Portability and Accessibility Act(HIPAA) Dennis O'Bryan. O.D. dba Pleasant View Eye Wear & Eye Care,can use your protected health information for treatment,payment and health
care operations, as outlined below:
TREATMENT: We may disclose your health information to a physician or other health care provider providing treatment to you.
PAYMENT: We may use and disclose your health information to obtain payment for services we provide you.
HEALTH CARE OPERATIONS: We may disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment,improvement activities,reviewing the competency or qualifications of healthcare providers professionals, evaluating provider performance, conducting training programs, cooperating with organizations which evaluate, accredit. accredit,certify,license or credential, our providers and staff.
Most uses and disclosures that are not for treatment,payment or healthcare operations,
will require your written authorization. Signed authorizations for disclosure may be revoked upon your written signed request at any time.
Emergency Situations: In the event of your incapacity or an emergency situation, we will disclose health information to a family member or another responsible person, using our professional judgement. Only health information directly relevant to that person's involvement in your care will be disclosed.
Marketing: We will not use health information for marketing communications without your written consent.
REQUIRED BY LAW
If required by federal, state or local law, we will disclose your health information limited to the requirements of the law.
ABUSE or NEGLECT: We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect or domestic violence, or the victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to you or others' health or safety.
NATIONAL SECURITY: We may disclose health information of Armed Forces personnel to military authorities under certain circumstances.We may disclose health information to authorized federal officials for lawful inteligence and national security activities. Health information for inmates may be disclosed to appropriate authorities under certain circumstances.
APPOINTMENT REMINDERS: We may disclose health information to provide you with appointment reminders by, phone, e-mail, postcard, or letters.
YOUR RIGHTS as a Patient: You have the right to restrict disclosure of your protected health information (in writing). The request may be denied if the information is required for treatment, payment,or health care operations. You have the right to request that you receive "confidential communications" regarding your protected health information.
You have the right to request an opportunity to inspect and receive a copy of PHI about you, for a for certain records.If you request a copy of PHI about you , we may charge you a reasomnble fee for copying, postage, labor & supplies used to meet your request.
RIGHT TO AMEND: You have a right to request that we amend your PHI as long as the information is kept by our office. Requests must be made in writing, with a reason for the request.
RIGHT TO SEE LIST OF DISCLOSURES made sfter April 14, 2003.
You have a right to receive a paper copy of this notice of privacy practices.
PVEW&EC, the practice of Dennis O'Bryan, O.D,
is required by law to maintain the privacy of your protected health information. We must
abide by this notice as currently stated, and reserve the right to chang the notice. New policies will not be in effect until they are posted to the web site or are available in the office.
COMPLAINTS: You may submit a complaint to us, in writing, about the way your health information was handled. There will be no retaliation against you by us for filing a complaint.
CONTACT INFORMATION:
Dennis O'Bryan, O.D.
Pleasant View Eye Wear & Eye Care
8422- M-119 Harbor Plaza
Harbor Springs, MI 49740
