Oviedo Vision Center

NOTICE OF PRIVACY PRACTICES

OVIEDO VISION CENTER

Gary D. McDonald, O.D.

875 Clark Street, Oviedo, Florida 32765

Phone: 407.366.7655
Fax: 407.366.4129
Email: OviedoVision@cfl.rr.com

Contact: Dr. Gary D. McDonald

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT 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 statements or claims; and collection unpaid amounts (either ourselves or through a collection agency or attorney). In our health care operations we may use and disclose information about you for the general operation of our business. For example, we sometimes arrange for accreditation organizations, auditors or other consultants to review our practice , evaluate our operations and tell us how to improve our services.

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 other than for these reasons, we will 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 may be:

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 dead 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 worker’s 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

We may also share relevant information about your care with your family or friends who are helping you with your eye care, unless you do not want us to.

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. Unless you tell us otherwise, we may mail you an appointment reminder on a post card and/or leave a reminder message on your home answering machine or with someone who answers your phone if you are not home.

OTHER USES AND DISCLOSURES

If you have been referred to our office by another of our patients and you inform us, unless you tell us not to do so we send them a “thank you” gift which will reveal that you have had an appointment with our office.

We will not make any other uses or disclosures of your health information unless you sign a written “authorization form.” The content of an “authorization form” is determined by federal law. Sometimes we may initiate the authorization process if the use or disclosure is our idea. Sometimes you may initiate the process if it is your idea for us to send your information to someone else. Typically, in this situation, you will give us a properly completed “authorization form”, or you can use one of ours.

If we initiate the process and ask you to sign an “authorization form” you do not have to sign it. If you do not sign the “authorization form”, we cannot make use of or disclosure your information. If you do sign such a form you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be made in writing and include the patient’s or patient guardian’s or patient health care surrogate’s signature. Send a revocation of authorization to the office contact person named at the beginning of this Notice.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

The law gives you many rights regarding your health information. You can:

ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment or health care operations. We do not have to agree to do this, but if we agree we must honor the restrictions that you request. To ask for a restriction send a written, signed request tot he office contact person at the address shown at the beginning of this Notice;
ask us to communicate with you in a confidential way, such as by phoning you at work rather than at home, by mailing health information to a different address or by using e-mail to your personal e-mail address. We will accommodate these request if they are reasonable and if you pay us for any extra cost. If you want to ask for confidential communications send a written request to the office contact person at the address, fax or e-mail address shown at the beginning of this Notice;
ask to see or to get photocopies of your health information. By law, there are a few limited situations in which we can refuse to permit access or copying. For the most part, however, you will be able to review or have a copy of your health information within 30 days of asking us (or sixty day if the information is stored off-site). You may have to pay for photocopies in advance. If we deny your request we will send you a written explanation and instructions about how to get an impartial review of our denial if one is legally available. By law, we can have one 30 day extension of the time for us to give you access or photocopies if we send you written notice of the extension. If you want to review or get photocopies of your health information send a written request to the office contact person at the address, fax or e-mail address shown at the beginning of this Notice;
get a list of the disclosures that we have made of your health information within the past six years (or a shorter period if you want). By law, the list will not include: disclosures for purposes of treatment, payment or health care operations; disclosures with your authorization; incidental disclosures; disclosures required by law; and some other limited disclosures. You are entitled to one such list per year without charge. If you want more frequent lists, you will have to pay for them in advance. We will usually respond to your request within 60 days of receiving it, but by law we can have one 30 day extension of time if we notify you of the extension in writing. If you want a list, send a written request to the office contact person at the address, fax or E-mail shown at the beginning of this Notice.
get additional paper copies of this Notice of Privacy Practices upon request. It does not matter whether you got one electronically or in paper form already. If you want additional paper copies, send a written request to the office contact person at the address, fax or e-mail shown at the beginning of this Notice.

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, have copies available in our office, and post it on our Website.

COMPLAINTS

If you think that we have not properly respected the privacy of your health information, you are free to complain to us or the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint. If you want to complain to us, send a written complaint to the office contact person at the address, fax or E-mail shown at the beginning of this Notice. If you prefer, you can discuss your complaint in person or by phone.

FOR MORE INFORMATION

If you want more information about our privacy practices, call or visit the office contact person at the address or phone number shown at the beginning of this Notice.