HIPPA: NOTICE OF PRIVACY POLICIES AND PRACTICES

Effective Date: Sept. 1, 2002

Tri-County Eye Physicians & Surgeons, PC is committed to protecting our patients’ privacy. The confidentiality of our patients has always been of greatest concern to our physicians and employees alike. This notice details how our practice collects, handles and protects personal information about our patients. This policy will be distributed to all patients. We will review this policy on an annual basis and monitor our compliance with this policy. Should it be necessary to revise this policy more often, due to circumstances, we will do so in a timely fashion.

Information we collect and maintain:

We collect nonpublic personal information with regards to:

• Past medical and ocular history
• Review of systems
• History of the present illness/complaint
• Family and social history
• Medications and allergies
• Insurance and billing information
• Patient demographics

How we protect our information:

Our staff is trained to adhere to the following privacy measures with regards to Protected Health Information (PHI):

• There are only three (3) reasons why an employee needs to have access to a patient’s chart or computer information

1. Treatment or care of a patient(to include surgery scheduling and back to work certification)
2. Process billing for services
3. Medical records request

• Our patient medical charts are located in a staff business area, out of the patient flow area. Patients do not have access to this area. Charts are not to be left lying about at the tech stations nor other unsecured areas.
• Computer display terminals are to be exited out to a menu when the operator leaves the station. Entry into the system is password protected. Passwords are not to be shared.
• Confidential patient information is not placed anywhere but in the patients’ charts.
• Appointment schedules are not posted in the exam rooms, rather in the physicians’ private offices.
• Employees will not discuss any patient in a public area. We will not make curious inquiries or pull a chart of a friend or relative, out of curiosity unless we have the permission of the patient.
• Information we may disclose and the purpose: No PHI will be released without the proper written consent from the patient or parent or guardian of the minor patient, unless the request is during an emergency. Occasions for release of PHI are the following:
• Workman’s Compensation – the patient signs a record release at the time of the visit, as the chart notes must accompany the insurance billing.
• Legal pursuit:

1. Attorney request (to also include medical record service)
2. Subpoena

• Patient request:

1. Moving
2. Transfer records to another physician

• Disability documentation
• Auto accident
• Insurance company chart audit
• Driver’s form
• Insurance claim adjudication

Patients’ Rights:

• Our patients have the right to privacy and respect regarding their personal information.
• The patient has the right to access and copy health records with reasonable notice.
• The patient has the right to request amendment or correction.
• The patient has the right to an accounting of disclosures.
• The patient has the right to specify how confidential information is communicated.
• The patient has the right to request a restriction on how health information is disclosed or used.
• The patient has the right to file a complaint if they believe that our safeguards and procedures have not been followed. Any privacy issue complaints should be directed to the Privacy Officer of Tri-County Eye Physicians & Surgeons, PC or to any manager. If satisfaction is not received, the patient may notify the Department of Health & Human Services.