Privacy Policy
EYEMAX, PLLC
NOTICE OF PRIVACY PRACTICES
This Notice of Privacy Practices describes how health information about you may be used and disclosed, and how you may obtain access to this health information.
***Please Review Carefully***
We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while this Notice is in effect. This notice takes effect April 14, 2003, and will remain in effect until we replace it.
We reserve the right to change our privacy practices and the terms of this Notice at any time, provided that such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before we made the change. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available on request.
You may request a copy of our Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact our office at 859-272-1422.
USES AND DISCLOSURES OF HEALTH/OPTOMETRIC INFORMATION
We use and disclose information about you for treatment, payment and healthcare operations.
Treatment – We may use and disclose your health information to a physician or other healthcare provider providing treatment to you.
Payment – We may use and disclose your health information to obtain payment for services we provide to you.
Appointment Reminders – We may use and disclose your health information to provide you with appointment reminders such as voicemail messages, postcards or letters.
Your Authorization – You may give us written authorization to use your health information or to disclose it to anyone for any purpose, such as allowing a person to pick up prescriptions, medical supplies, x-rays, charts or other similar forms of health information. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in this Notice.
Your Family And Friends – We must disclose your health information to you, as described in the “Patient Rights” sections of this Notice. We may disclose your health information to a family member, friend or other person to the extent necessary to help with your healthcare or with payment for your healthcare, but only if you agree that we may do so.
Persons Involved in Care – We may use and disclose health information to notify, or assist in the notification OF a family member, your personal representative or another person responsible for your care, of your locations, or your general condition in the event of an emergency. We will disclose health information using our professional judgment disclosing only information that is directly relevant to the person’s involvement in your healthcare.
Marketing – We will not use your health information for marketing communication without your written authorization.
Required By Law – We may use and disclose your health information when we are required to do so by 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 possible victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.
National Security – We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful national security activities. We may disclose health information to correctional institution or law enforcement officials having lawful custody of a protected inmate or patient in certain circumstances.
PATIENT RIGHTS
Access – You have the right to look at or get copies of your health information, with limited exceptions. Your request must be in writing. We will charge you a reasonable cost-based fee for copying expenses.
Disclosure Accounting – You have the right to receive a list of instances in which we or our business associates disclose your health information for purposes other than treatment, and payment for the last six years. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.
Restrictions – You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement except in an emergency.
Alternative Communication – You have the right to request that we communicate with you about your health information by alternative means or to alternative locations. You must make your request in writing. Your request must specify the alternative means or location, and provide satisfactory explanation how payments will be handled under your request. We are not required to agree to this request.
Amendment – You have the right to request that we amend your health information. Your request must be in writing and explain why the information should be amended. We may deny your request under certain circumstances.
QUESTIONS AND COMPLAINTS
If you want more information about our privacy policy or have questions or concerns, please contact us.
If you are concerned that we may have violated your privacy rights, or you disagree with a decision concerning your health information, you may complain to us by contacting our office. You may also submit a written complaint to the U.S. Department of Health and Human Services. We will, on request, provide you with the address to file your complaint.
We support your right to privacy of your health information.