NOTICE OF HEALTH INFORMATION PRACTICES

This notice describes how health information about you may be used and disclosed and how you can get access to this health information.  Please read it carefully and ask any questions.

WHAT IS HEALTH INFORMATION:

Each time that a service is rendered or a procedure is done, even as simple as a routine blood pressure check, data and information are collected.  This is health information or what is commonly referred to as information for or in the medical record or the patient record.  Accurate, credible, and timely data and information are used by this facility as the basis for planning your care, as a means of having multiple healthcare providers know about your current health status, as a health legal document, as a record for billing purposes, as a source of data for research, planning, and marketing, as a source of required information for public health officials, and as a means to continue to improve the care that we provide.   At this facility, we have always, and will continue to protect the privacy of your health information and the dignity of you as an individual.  On July 6, 2001, the U.S. Federal Government passed compliance regulations that mandate all healthcare facilities to protect health information and inform consumers of the healthcare information practices of the facility.

THE CONSUMER'S HEALTH INFORMATION RIGHTS:

This facility maintains a medical record for you containing medical information concerning you.  With this in mind, you have the right to:

·          Request a restriction on use and disclosure of health information, although the facility is not required to comply (45 CFR 164.522)

·          Obtain a copy of this notice

·          Inspect and receive a copy of your medical record (45 CFR 164.524)

·          Amend your medical record (45 CFR 164.528)

·          Obtain an accounting of disclosures of your medical record (45 CFR 164.528)

·          Request your medical record by alternative means or location

·          Revoke your authorization to use or disclose your health information except to the extent that action has already been taken.

THIS FACILITY'S RESPONSIBILITIES:

This facility's mission of quality service and respect of the individual has always taken into account protecting health information privacy.  Our responsibilities are to:

·          Maintain the privacy of your health information

·          Provide you this notice of health information practices

·          Notify you if we are unable to satisfy a request

·          Accommodate all reasonable requests while maintaining quality care and respect for you

·          Make you aware of all health information practice policy changes

·          We will not use or disclose your health information without your approval except as stated in this notice.

TO REQUEST FURTHER INFORMATION OR ASK QUESTIONS:

If you would like further information or have questions, this facility, Retina Vitreous Consultants, employs a Compliance Officer who can be reached at 412-683-5327 ext 219.

If you believe that your privacy rights have been violated, you can file a complaint with the Compliance Officer or with the Secretary of Health and Human Services.  There will be no penalty or retaliation for filing a complaint.

Examples of Permitted Types of Uses and Disclosures of Health Information:

This facility may use or be required to use your health information without your authorization or consent for normal business activities as follows:

For Care and Treatment:  Health information obtained by a healthcare practitioner such as a physician, nurse, or therapist, will be entered into your medical record and used to determine a plan of care.  For example, healthcare members will write and read what others have written such that your care can be coordinated and everyone is aware of how you are responding to your treatment plan.  When you are discharged from this facility, your health information may go with you such that future healthcare providers will have a record of your care.  Your health insurer may disclose health information to the sponsor of the plan.  Information regarding your care will be provided to your referring physician and/or you primary care physician for coordination of care.

For Billing and Payment:  Health information on a bill sent to an insurer may include health information.  This health information is restricted to that which is needed for the financial transactions.  At times, the insurance company may require records sent with the bill for payment. 

For Healthcare Operations:  In order to provide quality care, healthcare providers at this facility may use your health information, for example, to analyze the care, treatment, and outcomes of your medical case and of others.  This health information will be used to continually improve the care of the services that we provide to you.