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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 THIS INFORMATION CAREFULLY
Note: If you have questions about this notice,
please contact Michael A. Snell to answer questions.
WHO WILL FOLLOW THIS NOTICE?
This notice describes the privacy practices of American Eyecare.
All of our physicians and staff may have access to information
in your chart for treatment, payment and health care operations,
which are described below, and may use and disclose information
as described in this Notice. This Notice also applies to any volunteer
or trainee we allow to help you while seeking services from us.
OUR PLEDGE REGARDING THE PRIVACY OF YOUR MEDICAL INFORMATION:
Your medical information includes information about your physical
and mental health. We understand that information about your physical
and mental health is personal. We are committed to protecting
medical information about you. We create a record of the care
and services you receive from us. We need this record to provide
you with quality care and to comply with certain legal requirements.
This notice applies to any and all of the records of your care
generated by us.
This notice will tell you about the ways in which we may use and
disclose medical information about you. We also describe your
rights and certain obligations we have regarding the use and disclosure
of medical information.
We reserve the right to revise or amend our notice of privacy
practices without additional notice to you. Any revision or amendment
to this notice will be effective for all of your records our practice
has created or maintained in the past, and for any of your records
we may create or maintain in the future. We will post a copy of
our current notice in our offices in a prominent place and will
post the notice on our website.
OUR OBLIGATIONS TO YOU
We are required by law to:
Make sure that medical information that identifies you is kept
private except as otherwise provided by state or federal law
Give you this notice of our legal duties and privacy practices
with respect to medical information about you and
Follow the terms of the notice that is currently in effect.
HOW
WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU:
The following categories describe different ways that we may use
and disclose medical information. For each category of uses or
disclosures we will explain what we mean and try to give some
examples. Not every use or disclosure in a category will be listed.
This notice covers treatment, payment, and what are called health
care operations, as discussed below. It also covers other uses
and disclosures for which a consent or authorization are not necessary.
Where Iowa law is more protective of your medical information,
we will follow state law, as explained below.
For Treatment: We may use medical information
about you to provide you with medical treatment or services without
consent or authorization unless otherwise required by applicable
state law. We may disclose medical information about you to doctors,
nurses, medical students, pharmacists, laboratories, or other
health care providers who are involved in taking care of you whether
or not they are affiliated with us. For example, we may disclose
medical information concerning you to (hospitals, family practice
groups, dispensaries, pharmacies, and/or other providers you may
share information with; these may be designated either by name
or by classification, e.g., (” family practitioners”)as
well as to any other entity that has provided or will provide
care to you. We will disclose any mental information, including
psychotherapy notes, AIDS or HIV-related information, or drug
treatment information, that we may have about you only with written
authorization as required by Iowa law, HIPAA and other federal
regulations.
During the course of your treatment, we may refer you to other
health care providers such as independent laboratories with which
you may not have direct patient contact. These providers are called
“indirect treatment providers.” “Indirect treatment
providers” are required to comply with the privacy requirements
of state and federal law to keep your medical information confidential.
For Payment: We may use and disclose medical
information about you without consent or authorization so that
the treatment and services you receive from us may be billed to
and payment may be collected from you, an insurance company or
a third party. For example, we may need to give your health plan
information about treatment received so your health plan will
pay us or reimburse you for the treatment. We may also tell your
health plan or insurance company about a treatment you are going
to receive to obtain prior approval or to determine whether it
will cover the treatment
For Health Care Operations: We may use and disclose
medical information about you without consent or authorization
for “health care operations”. These uses and disclosures
are necessary to operate our practice and make sure that all of
our patients receive quality care. For example, we may use medical
information or mental health treatment information to review your
treatment and services and to evaluate the performance of our
staff in caring for you. We may also disclose your protected health
information to doctors, nurses, medical students and other employees
or consultants for review and learning purposes.
Appointment Reminders: We may use and disclose
medical information to contact you by mail or phone to remind
you that you have an appointment for treatment, unless you tell
us otherwise in writing.
Treatment Alternatives: We may use and disclose
medical information to tell you about or recommend possible treatment
options or alternatives that may be of interest to you. However,
we will not use or disclose medical information to market other
products and services, either ours or those of third parties,
without your authorization.
Health-Related Benefits and Services: We may
use and disclose medical information to tell you about health-related
benefits or services that may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care: We
may release medical information (including mental health information),
about you to a family member who is involved in your medical care
without consent or authorization. We may also give medical information,
including prescription information or information concerning your
appointments to friends who are involved in your care. We may
also give such information to someone who helps pay for your care.
In addition, we may disclose medical information about you to
an entity assisting in a disaster relief effort so that your family
can be notified about your condition, status and location.
As Required By Law: We will disclose medical
information about you when required to do so by federal, state
or local law without your consent or authorization.
To Avert a Serious Threat to Health or Safety: We may disclose
medical information about you when necessary to prevent a serious
threat to your health and safety or the health and safety of the
public or another person. Any disclosure, however, would only
be someone able to help prevent the threat.
To Business Associates: American Eyecare from
time to time will hire consultants called “business associates”,
who render services to us. We may disclose your medical information
to such business associates without your consent or authorization.
Business associates are required to maintain and comply with the
privacy requirements of state and federal law and keep your medical
information confidential. Examples of “business associates”
are accounting firms that we hire to perform audits of billing
and payment information, and computer software vendors who assist
us in maintaining and processing medical information.
For Research: From time to time we participate
in research studies with entities such as drug companies. Before
we use or disclose medical information for research, the project
will have been approved through a research approval process required
by law. We may disclose medical information about you to people
preparing to conduct a research project, for example, to help
them look for patients with specific medical needs as permitted
by federal law. We will almost always ask for your specific permission
if the researcher will have access to your name, address or other
information that reveals who you are. We will also comply with
all other requirements under federal law to seek your written
authorization to disclose protected health information in connection
with research studies.
Military and Veteran: If you are a member of
the armed forces, we may release medical information about you
as required by military command authorities. We may also release
medical information about foreign military personnel to the appropriate
foreign military authority.
Worker’s Compensation: We may release medical
information about you for worker’s compensation or similar
programs without consent or authorization. These programs provide
benefits for work-related injuries or illnesses. For example,
if you are injured on the job, we may release information regarding
that specific injury.
Public Health Risks: We may disclose medical
information about you for public health activities without your
consent or authorization. These activities generally include the
following:
To prevent or control disease, injury or disability
To Report reactions to medications or problems with products
To notify people of recalls of products they may be using
To notify a person who may have been exposed to a disease or may
be at risk for contracting or spreading a disease or condition
To notify the appropriate government authority if we believe a
patient has been the victim of abuse, neglect or domestic violence.
We will only make this disclosure if you agree or when required
or authorized by law.
Health Oversight Activities: We may disclose
medical information to a health oversight agency, such as the
Department of Health and Human Services, for activities authorized
by law. These oversight activities include, for example, audits,
investigations, inspections, and licensure. These activities are
necessary for the government to monitor the health care system,
government programs, and compliance with civil rights laws.
Lawsuits and Administrative Proceedings: If you
are involved in a lawsuit or dispute as a party, we may disclose
medical information about you in response to a court or administrative
order. We may also disclose medical information about you in response
to a subpoena, discovery request, or other lawful process by someone
else involved in the dispute. Similarly we may disclose medical
information about you in proceedings where you are not a party,
but only if efforts have been made to tell you or your attorney
about the request or to obtain an order protecting the information
requested. In addition, we may disclose medical information, including
mental health treatment information, to the opposing party in
any lawsuit or administrative proceeding where you have put your
physical or mental condition at issue.
Law Enforcement: We may release medical information
if asked to do so by a law enforcement official:
1. 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 at Medical Associates Clinic; 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.
Coroners, Medical Examiners and Funeral Directors:
We may release medical information including mental health information
to a coroner or medical examiner. This may be necessary, for example,
to identify a deceased person or determine the cause of death.
National Security and Intelligence Activities: We may release
medical information about you to authorized federal officials
for intelligence, counterintelligence, and other national security
activities authorized by law.
Protective Services for the President and Others:
We may disclose medical information about you to authorized federal
officials so they may provide protection to the President, other
authorized persons or foreign heads of state or conduct special
investigations.
Inmates: If you are an inmate of a correctional
institution or under the custody of a law enforcement official,
we may release medical information about you to the correctional
institution or law enforcement official. This release would be
necessary (1) for the institution to provide you with health care:
(2) to protect your health and safety or the health and safety
of others; or (3) for the safety and security of the correctional
institution.
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