Continuous Wear - Eye Care Center

Privacy Policy: EYE CARE CENTER OF COLORADO SPRINGS

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.

USES AND DISCLOSURES

Treatment

Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions and providing treatment. For example, diagnostic tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.

Payment

Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated. Also, the information on your prescription may be sent to a lab to fill your prescription whether it is glasses or contacts.

Health care operations

Your health information may be used as necessary to support the day-to-day activities and management of Eye Care Center of Colorado Springs. For example, information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.

Law enforcement

Your health information may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government-mandated reporting.

Public health reporting

Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state's public health department.

Other uses and disclosures require your authorization. Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occured before you notified us or your decision to revoke your authorization.

Additional Uses of Information

Appointment reminders. Your health information will be used by our staff to send you appointment reminders by mail, e-mail, telephone, answering service, or voice mai. E-mail addresses may be used to help you purchase your contact lenses through our company web-site.

Treatment Information

We may at times send information regarding new technology or treatment options that may improve your visual clarity.

Right to Revise Privacy Practices

As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practices will be applied to all protected health information we maintain.

Requests to Inspect Protected Health Information

You may generally inspect the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect protected health information be submitted in writing. You may obtain a form to request access to your records by contacting Mindi Barajas. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request. Photocopies: a photocopy of your medical record will be provided to you upon your request. There is a nominal processing fee required for photocopies. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.

Comments

If you would like to submit a comment about our privacy practices, you can do so by sending a letter outlining your concerns to:

Mindi Barajas.
Eye Care Center of Colorado Springs
1805 E. Cheyenne Mt. Blvd.
Colorado Springs, Colorado 80906

If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the same address.

Effective Date

This notice is effective on or after April 5, 2003