HIPAA
Compliance.
Virdi Eye Clinic, P.C. · Effective Date: April 14, 2003
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. Please review it carefully.
The Health Insurance Portability & Accountability Act of 1996 (HIPAA) requires all health care records and other individually identifiable health information (protected health information) used or disclosed to us in any form, whether electronically, on paper, or orally, be kept confidential. This federal law gives you, the patient, significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information.
Without specific written authorization, we are permitted to use and disclose your health care records for the purposes of treatment, payment and health care operations.
Permitted Uses & Disclosures
Treatment
Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. Examples of treatment would include eyeglass prescriptions, a-scans, and eye care services.
Payment
Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be billing your insurance company for our services.
Health Care Operations
Health Care Operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost management analysis, and customer service. An example would include a periodic assessment of our documentation protocols.
Additional Permitted Disclosures
Your confidential information may also be used to remind you of an appointment (by phone or mail) or provide you with information about treatment options or other health-related services, including release of information to friends and family members directly involved in your care.
We will use and disclose your protected information when required by federal, state or local law — including disclosures to public health authorities, health oversight agencies, law enforcement officials, medical examiners, coroners, organ procurement organizations, and in situations involving serious threats to health and safety, military or national security activities, workers' compensation programs, or court orders.
Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor that request, except to the extent that we have already taken actions relying on your authorization.
Your Rights
You have certain rights regarding your protected health information, which you can exercise by presenting a written request to our Privacy Officer at the practice address.
- ✓The right to request restriction on certain uses and disclosures of protected information, including those related to disclosures to family members, other relatives, close personal friends, or any other individual identified by you.
- ✓The right to request to receive confidential communications of protected health information from us by alternative means or at alternative locations.
- ✓The right to access, inspect, and copy your protected health information. There is a charge for copying your records of 10 cents per copy sheet. Original copies of your protected health information cannot leave the medical office.
- ✓The right to request an amendment to your protected health information.
- ✓The right to receive an accounting of disclosures of protected health information outside of treatment, payment and health care operations.
- ✓The right to obtain a paper copy of this notice from us upon request.
Our Duties
We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices. We are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy Practices and to make new notice provisions effective for all protected health information that we maintain. Revisions will be posted on the effective date and you may request a written copy of the revised notice from this office.
You have the right to file a formal, written complaint with us at the main clinic office in Rock Island, IL, or with the Department of Health and Human Services, Office of Civil Rights, if you feel your privacy rights have been violated. We will not retaliate against you for filing a complaint.
Privacy Officer Contact
Jessey Hullon, Privacy Official
Virdi Eye Clinic, P.C.
4600 30th St.
Rock Island, IL 61201
File a Complaint with HHS
U.S. Department of Health & Human Services
Office of Civil Rights
200 Independence Avenue SW
Washington, D.C. 20201