Eye Care

Oklahoma Eye Center and 
Oklahoma Eye Center Optical

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.
Our goal is to take appropriate steps to attempt to safeguard any medical or other personal information that is provided to us.  The Privacy Rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires us to : (1) maintain the privacy of medical information provided to us; (2) provide notice of our legal duties and privacy practices, and (3) abide by the terms of our Notice of Privacy Practices currently in effect.
WHO WILL FOLLOW THIS NOTICE

This notice describes the practices of our employees and staff as well as other health care professionals, physicians and insurance companies, or any other entity that would be in contact with your private health information.   This notice applies to each of these individuals, entities, as well as those involved with our satellite office located in Henryetta, Oklahoma.   In addition, these individuals, entities, sites and locations may share medical information with each other for treatment, payment or hospital operation purposes described in this notice.
INFORMATION COLLECTED ABOUT YOU

In the ordinary course of receiving treatment and health care services from us, you will be providing us with personal information such as:
    1.  Your name, address and phone number and social security number.
    2.  Information relating to your medical history.
    3.  Your insurance information and coverage.
    4.  Information concerning your doctor, nurse or other medical providers.
In addition, we will gather certain medical information about you and will create a record of the care provided to you.  Some information also may be provided to us by other individuals or organizations that are part of your "circle of care" -- such as the referring physician, your other doctors, your health plan, family members and close friends.
HOW WE MAY USE AND DISCLOSE INFORMATION ABOUT YOU

We may use and disclose personal and identifiable health information about you for a variety of purposes.  All of the types of uses and disclosures of information are described below, but not every use or disclosure in a category is listed.
Required Disclosures.  We are required to disclose health information about you to the Secretary of Health and Human Service, upon request, to determine our compliance with HIPAA and to you, in accordance with your right to access and right to receive an accounting of disclosures, as described below.
For Treatment.  We may use health information about you in your treatment.  For example, we may use your medical history, such as any presence or absence of diabetes, to access the health of your eyes.
For Payment.  We may use and disclose health information about you to bill for our services and to collect payment from you or your insurance company.  For example, we may need to give payer information about your current medical condition so that it will pay for the eye examinations or other services that we have furnished to you.  We may also need to inform your payer of the treatment you are going to receive in order to obtain prior approval or to determine whether services are covered.
For Health Care Operations.  We may use and disclose information about you for the general operation of our business.  For example, we sometime arrange for auditors or other consultants to review our practices and evaluate our operations, and review with us ways to improve our services.  Or, for example, we may use and disclose your health information to review the quality of services provided to you.
Public Policy Use and Disclosures.  There are a number of public policy reasons why we may disclose information about you which is described below:
  1. We may disclose health information about you when we are required to do so by federal, state, or local law.
  2. We may disclose protected health information (PHI) about you in connection with certain public health reporting activities.  For instance, we may disclose such information to a public health authority which has authorized to collect or receive personal health information (PHI) for the purpose of preventing or controlling disease, injury or disability, or at the direction of a public health authority, to an official of a foreign government that is acting collaboration with a public health authority.  Public health authorities include state health department, the Center for Disease Control, the Food and Drug Administration, the Occupational Safety and Health Administration and the Environmental Protection Agency, to name a few.
  3. We are also permitted to disclose protected health information (PHI) to a public health authority or other government agency authorized by law to receive reports of child abuse or neglect.  Additionally we may disclose protected health information (PHI) to a person subject to the Food and Drug Administration's power for the following activities: to report adverse events, product defects or problems, or geological product deviations, to tract products, to enable product recalls, repairs or replacements; or to conduct post marketing surveillance.  We may also disclose a patient's health information to a person who may have been exposed to a communicable disease or to an employer to conduct an evaluation relating to medical surveillance of the workplace or to evaluate whether an individual has a work-related illness or injury.
  4. We may disclose a patient's health information where we reasonably believe a patient is a victim of abuse, neglect or domestic violence and the patient authorized the disclosure or it is required or authorized by law.
  5. We may disclose health information about you in the connection with certain health oversight activities of licensing and other health oversight agencies which are authorized by law.  Health oversight activities include audit investigation, inspection, licensure or disciplinary actions, and civil, criminal, or administrative proceedings or action or any other activity necessary of the oversight of:
  •   the health care system,
  •   governmental benefit programs for which information is relevant to determining beneficial eligibility,
  •   entities subject to governmental regulatory programs for which health information is necessary for determining   compliance with program standards, or
  •   entities subject to civil rights laws for which health information is necessary for determining compliance.

   6.  We may disclose your health information as required by law, including in response to a warrant, subpoena, or other order of a court or administrative hearing body or to assist law enforcement to identify or locate a suspect, fugitive, material witness or missing person .  Disclosures for law enforcement purposes also permit us to make disclosures about victims of crimes and the death of an individual, among others.

   7.  We may release a patient's health information to:

  •   a coroner or medical examiner to identify a deceased person or determine the cause of death,
  •   funeral directors.
  •   an organ procurement organization, transplant center, and eye or tissue bank if you are on organ donor.

    8.  We may release your health information to worker's compensation or similar programs which provide benefits for work related injuries, or illness with out regard to fault.
    9.  Health information about you also may be disclosed when necessary to prevent a serious threat to your health and safety or the health and safety of others.
  10.  If you are a member of the Armed Forces, we may release health information about you for your activities deemed necessary by military command authorities. We also may release health information about foreign military personnel to their appropriate foreign military authority.
  11.  We may disclose your protected health information (PHI) for legal or administrative proceedings that involve you.  We may release such information upon order of a court or administrative tribunal.
  12.  We may also release protected health information (PHI) in the absence of such an order in response to a discovery or other lawful request, if efforts have been made to notify you or secure a protective order.
  13.  If you are an inmate, we may release protected health information (PHI) about you to a correctional institution where you are incarcerated or to law enforcement officials in certain situations such as where the information is necessary for your treatment, health or safety, or the health or safety of others.
  14.  Finally, we may disclose protected health information (PHI) for national security and intelligence activities and for the provision of protective services to the President of the United States and other officials or foreign heads of state.
Our Business Associates.  We sometimes work with outside individuals and businesses that help us operate our business successfully.  We may disclose your health information to these business associates so that they can perform the tasks that we hire them to do.  Our business associates must promise that they will respect the confidentiality of your personal and identifiable health information.
Disclosures to Persons Assisting in Your Care or Payment for Your Care.  We may disclose information to individuals involved in your care or in the payment for your care.  This includes people and organizations that you are part of "your circle of care" -- such as your spouse, your parents, your siblings, other doctors involved with your care, or an aide who may be providing services to you.  We may also use and disclose health information about a patient to disaster relief efforts and to notify persons responsible for a patent's care about a patient's location, general condition, or death.  Generally, we will obtain your verbal agreement before using or disclosing health information in this way.  However, under certain circumstances, such as in an emergency situation, we may make these uses and disclosures without your agreement.
Appointment Reminders.  We may use and disclose medical information to contact you as reminder that you have an appointment or to remind to schedule an appointment.
Treatment Alternatives.  We may use and disclose your personal health information in order to inform you about or recommend to you possible treatment options, alternatives, or health-related services that may be of interest to you.

OTHER USES AND DISCLOSURES OF A PERSONAL INFORMATION

We are required to obtain written authorization from you for any other uses and disclosures of medical information other than those described above.  If you provide us with such permission you may revoke that permission, in writing, at any time.  If you revoke your permission, we will no longer use or disclose personal information about you for the reasons covered by your written authorization except to the extent we have already relied on your original permission.

INDIVIDUAL RIGHTS.  You have the right to ask for restrictions on the ways we use and disclose your health information for treatment, payment and health care operation purposes.  You may also request that we limit your disclosures to persons assisting your care or payment for your care.  We will consider your request, but we are not required to accept it.

You have the right to request that you receive communications containing your protected health information from us by alternative means or at alternative locations.  For example, you may ask that we only contact you at home or by mail.

Except under certain circumstances, you have the right to inspect and copy medical, billing and other records used to make decisions about you.  If you ask for copies of this information, we may charge you a fee for copying and mailing.

If you believe that information in you records is incorrect or incomplete, you have the right to ask us to correct the existing information or add missing information.  Under certain circumstances, we may deny your request, such as when the information is accurate and complete.

You have a right to receive a list of certain instances when we have used or disclosed your medical information.  We are not required to include in the list uses and disclosures for you treatment, payment for services furnished to you, our health care operations, disclosures to you, disclosures you give us authorization to make and uses and disclosures before April 14, 2003, among others.  If you ask for this information from us more than once every twelve (12) months, we may charge a fee.

You have the right to a copy of this notice in paper form.  You may ask us for a copy any time.  You may also obtain a copy of this form at our web site at: www.okeye.com

When making a request for an amendment to your records, you must date your request and state a reason for making this request.  If you have any complaints concerning our privacy practices, please contact us or you may e-file your complaint with HIPAA Complaint, 7500 Security Blvd., C5-24-04, Baltimore, MD, 21244 or (e-mail address of: ocmail@hhs.gov).
YOU WILL NOT BE RETALIATED AGAINST OR PENALIZED 
BY US FOR FILING A COMPLAINT.

This notice is effective as of: January 1, 2003.

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