Eye Consultants of St. Louis - Notice of Privacy Practices

EYE CONSULTANTS 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.

Eye Consultants and its staff must maintain the privacy of your personal health information (PHI) and give you notice that describes our legal duties and privacy practices concerning your PHI. In general, when we release your health information, we must release only the information we need to achieve the purpose of the use or disclosure. However, all of your personal health information that you designate will be available for release if you sign an authorization form, if you request the information for yourself, to a provider regarding your treatment, or due to legal requirement. We must follow the privacy practices described in this notice.

However, we reserve the right to change the privacy practices described in this notice, in accordance with the law. Changes to our privacy practices would apply to all health information we maintain. In the vent there is a change to this notice, the revised notice will be posted. In addition, you may request a copy of the revised notice at any time.

Without written authorization, we can use your health information for the following purposes:

Medical Treatment (such as sending your medical information about you to another provider, facility, or specialist.)

To Obtain Payment for Treatment (such as sending billing information to your insurance company or Medicare.)

Health Care Operations (such as comparing patient data to improve the quality or cost of care.)

Public Policy (when required by federal, state or local law, or to respond to a court order.)

Public Health Activities (when required in connection with certain public reporting activities)

In addition, we may want to use your health information to contact you as a reminder that you have an appointment or that you should schedule an appointment.

We may also have to report to your employer certain work related illnesses and injuries.

We may disclose your PHI in order to tell you about or recommend possible treatment options, alternatives or health-related services that may be of interest to you.

Under certain circumstances, we may use and disclose medical information about you for research purposes regarding medications, efficiency of treatment protocols and the like.

Other uses of Medical Information

Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide is with your permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission and that we are required to retain our records of the care that we provided to you.

Your Health Information Rights

You have he following rights regarding medical information we maintain about you:

Right to Inspect and Copy

With a few exceptions you have the right inspect and obtain a copy of your health information. However this right does not apply to psychotherapy notes or information gathered for judicial proceedings, for example. Upon proof of an appropriate legal relationship, records of others related to you or under your care may also be disclosed. In addition we may charge you a reasonable fee if you want a copy of your health information.

To inspect and copy your medical record, you must submit your request in writing to our Compliance Officer. Ask the front desk person for the name of the Compliance Officer.

We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that our Compliance Committee review the denial.

Request to Correct Your Health Information

If you believe that medical information we have about you in your incorrect or incomplete, then you may ask us to amend the information. You have the right to request an amendment for as long as the Practice maintains your medical record. Your request for an amendment must be submitted in writing, along with your intended amendment and a reason that supports your request to amend. We may deny your request for an amendment if it is not in writing, does not include a reason to support the request, or if we disagree with you and believe your information is correct.

Right to an Accounting of Disclosure

You have a right to request an "accounting of disclosures". This is a list of the disclosures we made of medical information about you, to others. You must submit your request in writing. Your request must state a time period no longer than the previous six years and may not include dates prior to April 14, 2003.

Right to Request Restrictions

You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment of your care (a family member or friend). However we are not required to agree to all circumstances to your requested restriction.

Right to Request Confidential Communications

You have the right to request that we communicate with you about medical records matters in a certain way or at a certain location. You can ask that we only contact you at work or by mail, that we not leave voice mail, or e-mail or the like. We will accommodate all reasonable requests. Your request must be in writing and specify how or where you wish us to contact you.

Right to a Paper copy of this Notice

You have a right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the Practice or the Secretary of the Department of Health and Human Services. To file a complaint with the Practice, contact our Business Manager, who will direct you on how to file an office complaint. All complaints must be submitted in writing, and all complaints shall be investigated, without repercussion to you.