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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 Viewmont Eye Associates, a record is made. Typically, this record contains your
symptoms, exam and test results, diagnoses, treatment, and a plan for future care and/or treatment. This information,
generally referred to as your health or medical record, serves as the basis for the following:
- planning your care and treatment
- a means by which you or a third-party payer can verify that services billed were actually rendered
- a tool with which we can assess and continually work to improve the care we provide and the results we achieve.
Understanding what is in your record and how your health information is used helps you to insure its accuracy and to
better understand who, what, when, where, and why others may access it. It will also help you to make more informed
decisions when authorizing disclosure to others.
Your Health Information Rights:
Although your health record is the physical property of Viewmont Eye Associates, the information
belongs to you. You have the right to inspect and obtain a copy of your health record. You have the right to
request a restriction on certain uses and disclosures of your health information, to request an amendment of your
health record, to request communications of your health record by alternative means or to alternate locations,
and to revoke your authorization to use or disclose health information except to the extent that action has already
been taken (or if the authorization was obtained as a condition of obtaining insurance coverage. All requests
should be made in writing to Viewmont Eye Associates.
Our Responsibilities
This organization is required to maintain the privacy of your health information. We must also provide
you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain
about you, to abide by the terms of this notice, to notifiy you if we are unable to agree to a requested restriction,
and to accommodate reasonable requests you may have to communicate health information by alternative means or to alternate
locations. We reserve the right to change our practices and to make the new provisions effective for all protected
health information that we maintain. Upon your request, we will provide you with any revised Notice of Privacy
Practices either by directing you to our website at http://www.viewmonteye.com , by sending a revised copy to you in the
mail, or by providing a printed copy at the time of your next visit. We will post a copy in our office in a prominent
location.
For More Information
If you have questions and would like more information, you may contact our privacy officer here at
828.322.4973. If you believe that your privacy rights have been violated, you may file a complaint with our privacy
officer or with the Department of Health and Human Services. There will be no retaliation for filing a complaint.
Examples of Disclosures for Treatment, Payment, and Health Operations:
We will use your health information for treatment. For example, information obtained by a nurse,
physician, or other healthcare team will be recorded and used to determine the course of treatment recommended for you.
Your physician will document in your record the actions that they took and their observations. In that way, the physician
will know how you are responding to treatment.
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 identfies you, as well as your diagnosis,
procedures, and supplies used.
We will use your information for regular health operations. We will share your protected health information
with third-party "business associates" that perform various activities for the practice. For example, our accountants
audit our financial records quarterly. Whenever an arrangement between our business office and business associate
involves the use or disclosure of your protected health information, we will have a written record that contains terms
will protect the privacy of your health information.
Marketing: We will 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.
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: Our staff, using their best judgement, may disclose to a family member, other
relative, close personal friend, or any other person that you identify, health information relavant to that person's
involvement in your care or payment related to your care.
Workers Compensation: We may disclose health information to the extent necessary to comply with laws related
worker's compensation or other similar programs established by law.
Public Health: As required by law, we may disclose your health information to public health or legal authorities
charged with preventing or controlling disease, injury, or disability.
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.
Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in
response to a valid subpoena.
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