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.
Effective April 14, 2003:
The privacy of your medical information is important to us. You may be aware that the US government regulators established privacy rule (“HIPPA”) governing protected health information. This notice tells you about how it may be used, and about certain rights that you have.
Your Rights: Although the records containing your medical information are the physical property of New York Vision, the information belongs to you. By law, you have the right to:
- Inspect and obtain a copy of your medical information. Generally, we will respond to your request within 30 days but, under certain circumstances, we may deny your request.
- Request a restriction on certain uses and disclosures of your medical information; however, we are not required to agree to a requested restriction.
- Request an amendment of your medical information, if you believe it is inaccurate; however, we may deny your request for amendment if we believe your medical information is accurate.
- Request an accounting of certain disclosures we have made, if any, of your medical information.
- Revoke any authorization you have provided to use or disclose your medical information except to the extent that action has already been taken in reliance on such authorization.
Our Duties: We are required by law to:
- Maintain the privacy of your medical information.
- Provide you with a copy of our Notice of Privacy Practices.
How We May Use and Disclose Your Medical Information:
The following are the examples of the types of uses and disclosures of your medical information that are permitted:
Treatment: We may use and disclose your medical information to provide, coordinate or manage your health care and any related services. For example, we may disclose your medical information to the doctors or technicians that care for you, even if the doctors or technicians are not affiliated with NEW YORK VISION.
Payment: Your medical information may be disclosed, as needed, to obtain payment from your insurance company or other person/party responsible for payment for services we provide to you. For example, we may disclose your medical information to your health plan to determine your eligibility or coverage for insurance benefits.
Health Care Operations: We may use or disclose your medical information for our internal operations, which include activities necessary to operate the sites or programs from which you receive services. For example, we may use your medical information for quality improvement services to evaluate the care or other services provided to you. We may also use your medical information to evaluate the skills and qualifications of our health care providers, or to resolve grievances within our organization.
Appointment Reminders and Treatment Alternatives: We may use and disclose your medical information to provide a reminder to you about an appointment you have with us for treatment or medical care. We may also use or disclose your medical information to tell you about or recommend possible treatment options or alternatives, or inform you of other health-related benefits and services that may be of