Privacy Policy

Privacy Notice

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. THE PRIVACY OF YOUR HEALTH INFORMATION IS IMPORTANT TO US.

OVERVIEW: We are required by law to: Maintain the privacy of protected health information. Give you notice of our legal duties and privacy practices regarding health information about you. Follow the terms of our notice that is currently in effect. USES AND DISCLOSURES OF HEALTH INFORMATION: Under the Health Insurance Portability and Accessibility Act (HIPAA), Eyetopia Eyecare can use your protected health information for treatment, payment and health care operations. TREATMENT: We may use and disclose your health information to another health care provider providing treatment to you. PAYMENT: We may use and disclose your health information to obtain payment for services or goods we provide for you. HEALTH CARE OPERATIONS: We may use and disclose your health information in connection with our health care operations. Health care 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. We may also use and disclose health information for the following: To business associates we have contracted with to perform the agreed upon services and billing for those services To remind you that you have an appointment with the office To assess your satisfaction with our services To tell you about benefits of treatment or product updates For research relating to improvement of healthcare or reducing healthcare costs For conducting training programs or reviewing competence of healthcare professionals When disclosing information, appointment reminders and billing/collection efforts, we may leave messages on your answering machine/voicemail or email BUSINESS ASSOCIATES: There are some services provided by our office through contracts with business associates. An example would be a laboratory test or special imaging test. When these services are contracted, we may disclose your health information to our business associate so that they can perform the duty we have asked them to do and bill you, your insurance company or a third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.

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. FUTURE COMMUNICATIONS: We may communicate to you via newsletters, mailouts, or other means regarding treatment options, health related information, disease management programs, wellness programs, or other community based initiatives or activities our office is participating in. 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 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'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 correctional institutions or law enforcement officials under certain circumstances. APPOINTMENT REMINDERS: We may use or disclose your health information to provide you with appointment reminders via phone, email, letter, or postcard.

YOUR RIGHTS: Your have the right to restrict the disclosure of your protected health information (in writing). We are not required to agree with your request. 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: Eyetopia Eyecare 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 and available within our office.

QUESTIONS OR COMPLAINTS: If you want more information about our privacy practices or have questions or concerns, please contact us. If you are concerned that we may have violated your privacy rights, you may complain to us or to the Secretary of the U.S. Department of Health and Human Services. You may file a question or complaint (in writing) with us by notifying our Privacy Officer. We support your right to protect the privacy of your health information. We will not retaliate in any way if you choose to file a complaint.

CONTACT INFORMATION: For further information about Eyetopia Eyecare's privacy policies, please contact Dr. Deborah Roos, our practice privacy officer at:

Eyetopia Eyecare 9325 Dorchester St., Suite 124 Highlands Ranch, CO 80129 303-471-2015

Notice of PRIVACY PRACTICES

Effective Date: September 12, 2006

Health Insurance Portability and Accountability Act (HIPAA)

9325 Dorchester St. Suite 124 Highlands Ranch, CO 80129 303-471-2015