NOTICE OF
PRIVACY PRACTICE
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.THIS NOTICE IS EFFECTIVE 12/12/02 UNTIL FURTHER
NOTICE.
Right
to Notice
As a
patient, you have the right to adequate notice of the uses and
disclosures of your protected health information. Under the Health
Insurance Portability and Accessibility Act (HIPAA). The Santa
Clarita Vision Center can use your protected health information for
treatment, payment and health care operations.
a) Treatment - We may use or disclose your health information to a
physician or other healthcare provider providing treatment to you.
b) Payment - We may use and disclose your health information to
obtain payment for services we provide you.
c) Health care operations - We may use and disclose your health
information in connection with our healthcare operations. Healthcare
operations include quality assessment and improvement activities,
reviewing the competency or qualifications of healthcare
professionals, evaluating provider performance, conducting training
programs, accreditation, certification, licensing or credentialing
activities.
Your
Authorization
Most
uses and disclosures that do not fall under treatment, payment,
health care operations will require your written authorization. Upon
signing, you may revoke your authorization (in writing) through our
practice at any time.
Emergency
Situations
In the
event of your incapacity or an emergency situation, we will disclose
health information to a family member, or another person responsible
for your care, using our professional judgment. We will only
disclose health information that is directly relevant to the
person's involvement in your healthcare.
Marketing
We
will not use your health information for marketing communications
without your written authorization.
Required by Law
We may
also use or disclose your health information when we are required to
do so by law.
Abuse or Neglect
We may
disclose your health information to appropriate authorities if we
reasonably believe that you are a possible victim of abuse, neglect,
or domestic violence or the victim of other crimes. We may disclose
your health information to the extent necessary to avert a serious
threat to your or other people's health or safety.
National Security
We may
disclose the health information of Armed Forces personnel to
military authorities under certain circumstances. We may disclose
health information to authorized federal officials required for
lawful intelligence, counterintelligence and other national security
activities. We may disclose health information of inmates or
patients to the appropriate authorities under certain circumstances.
Appointment
Reminders
We may
use or disclose your health information to provide you with
appointment reminders via phone, e-mail or letter.
Your Rights as a
Patient
You
have the right to restrict the disclosure of your protected health
information (in writing). The request for restriction may be denied
if the information is required for treatment, payment or health care
operations.
-You have the right to receive confidential communications regarding
your protected health information.
-You have the right to inspect and copy your protected health
information.
-You have the right to amend your protected health information.
-You have the right to receive an account of disclosures of your
protected health information.
-You have the right to a paper copy of this notice of privacy
practices.
Legal
Requirements
The Sylmar Vision Center is required by law to maintain
the privacy of your protected health information. We are required to
abide by the terms of this notice as it is currently stated, and
reserve the right to change this notice. The policies in any new
notice will not be in effect until they are posted to this site, or
are available within our office.
Complaints
If you
have complaints regarding the way your protected health information
was handled, you may submit a complaint in writing to our office.
You will not be retaliated against in any manner for a complaint.
Contact
Information
For
further information about Santa Clarita Center's privacy policies,
please contact
Santa Clarita
Vision Center 26506 Bouquet Canyon Road,
Saugus, CA 91350
(661) 297-2020
Dr. Leonard Forbes, Optometrist