Privacy Notice
Effective date of notice: January 1, 2003
NOTICE OF PRIVACY PRACTICES
Don E. Stoken, O.D.
ADAMS CUMBERLAND VISION CARE
3375 Carlisle Road, Suite C Gardners, PA 17324
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU
MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO
THIS INFORMATION. PLEASE READ AND REVIEW THIS CAREFULLY.
We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give you notice of our privacy practices. This Notice describes how we protect your health information and what rights you have regarding it.
Treatment, Payment, and Health Care Operations
The most common reason why we use or disclose your health information is for treatment, payment or health care operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you testing or examining your eyes prescribing glasses, contact lenses, or eye medications and faxing them to be filled showing you low vision aids referring you to another doctor or clinic for eye care or low vision aids or services or getting copies of your health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about your health or vision care plans, or other sources of payment preparing and sending bills or claims and collecting unpaid amounts (either ourselves or through a collections agency or attorney). Health care operations mean those administrative and managerial functions that we have to do in order to run our office. Examples of how we use or disclose your health information for health care operations are: financial or billing audits internal quality assurance personnel decisions participation in managed care plans defense of legal matters business planning and outside storage of our records. We routinely use your health information inside our office for these purposes without any special permission. If we need to disclose your health information outside of our office for these reasons, we usually will not ask you for special written permission.
Uses and Disclosures for Other Reasons Without Permission
In some limited situations, the law allows or requires us to use or disclose your health information without your permission. Not all of these situations will apply to us some may never come up at our office at all. Such uses or disclosures are:
- when a state or federal law mandates that certain health information be reported for a specific purpose
- for public health purposes, such as contagious disease reporting, investigation or surveillance and notices to and from the federal Food and Drug Administration regarding drugs or medical devices
- disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence
- uses and disclosures for health oversight activities, such as for the licensing of doctors for audits by Medicare or Medicaid or for investigation of possible violations of health care laws
- disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies
- disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime to provide information about a crime at our office or to report a crime that happened somewhere else
- disclosure to a medical examiner to identify a deceased person or to determine the cause of death or to funeral directors to aid in burial or to organizations that handle organ or tissue donations
- uses or disclosures for health related research
- uses and disclosures to prevent a serious threat to health or safety
- uses or disclosures for specialized government functions, such as for the protection of the president or high ranking government officials for lawful national intelligence activities for military purposes or for the evaluation and health of members of the foreign service
- disclosures of de-identified information
- disclosures relating to workers compensation programs
- disclosures of a limited data set for research, public health, or health care operations
- incidental disclosures that are an unavoidable by-product of permitted uses or disclosures
- disclosures to business associates who perform health care operations for us and who commit to respect the privacy of your health information.
Unless you object, we will also share relevant information about your care with your family or friends who are helping you with your eye care.
Appointment Reminders
We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We may also call or write to notify you of other treatments or services available at our office that might help you.
Our Notice of Privacy Practices
By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to such information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our office, and have copies available to you upon request.
NOTICE OF PRIVACY PRACTICES
Don E. Stoken, O.D.
ADAMS CUMBERLAND VISION CARE
3375 Carlisle Road, Suite C Gardners, PA 17324
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU
MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO
THIS INFORMATION. PLEASE READ AND REVIEW THIS CAREFULLY.
We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give you notice of our privacy practices. This Notice describes how we protect your health information and what rights you have regarding it.
Treatment, Payment, and Health Care Operations
The most common reason why we use or disclose your health information is for treatment, payment or health care operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you testing or examining your eyes prescribing glasses, contact lenses, or eye medications and faxing them to be filled showing you low vision aids referring you to another doctor or clinic for eye care or low vision aids or services or getting copies of your health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about your health or vision care plans, or other sources of payment preparing and sending bills or claims and collecting unpaid amounts (either ourselves or through a collections agency or attorney). Health care operations mean those administrative and managerial functions that we have to do in order to run our office. Examples of how we use or disclose your health information for health care operations are: financial or billing audits internal quality assurance personnel decisions participation in managed care plans defense of legal matters business planning and outside storage of our records. We routinely use your health information inside our office for these purposes without any special permission. If we need to disclose your health information outside of our office for these reasons, we usually will not ask you for special written permission.
Uses and Disclosures for Other Reasons Without Permission
In some limited situations, the law allows or requires us to use or disclose your health information without your permission. Not all of these situations will apply to us some may never come up at our office at all. Such uses or disclosures are:
- when a state or federal law mandates that certain health information be reported for a specific purpose
- for public health purposes, such as contagious disease reporting, investigation or surveillance and notices to and from the federal Food and Drug Administration regarding drugs or medical devices
- disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence
- uses and disclosures for health oversight activities, such as for the licensing of doctors for audits by Medicare or Medicaid or for investigation of possible violations of health care laws
- disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies
- disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime to provide information about a crime at our office or to report a crime that happened somewhere else
- disclosure to a medical examiner to identify a deceased person or to determine the cause of death or to funeral directors to aid in burial or to organizations that handle organ or tissue donations
- uses or disclosures for health related research
- uses and disclosures to prevent a serious threat to health or safety
- uses or disclosures for specialized government functions, such as for the protection of the president or high ranking government officials for lawful national intelligence activities for military purposes or for the evaluation and health of members of the foreign service
- disclosures of de-identified information
- disclosures relating to workers compensation programs
- disclosures of a limited data set for research, public health, or health care operations
- incidental disclosures that are an unavoidable by-product of permitted uses or disclosures
- disclosures to business associates who perform health care operations for us and who commit to respect the privacy of your health information.
Unless you object, we will also share relevant information about your care with your family or friends who are helping you with your eye care.
Appointment Reminders
We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We may also call or write to notify you of other treatments or services available at our office that might help you.
Our Notice of Privacy Practices
By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to such information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our office, and have copies available to you upon request.