HIPAA: NOTICE OF PRIVACY POLICIES AND PRACTICES

Effective Date: Sept. 1, 2002, Revised September 1, 2010

Tri-County Eye Physicians & Surgeons, PC is committed to protecting our patient’s privacy. This notice details how our practice collects, handles and protects personal information about our patients. This policy will be distributed to all patients and will also be available for viewing at our web site: www.tricountyeye.com.

Information we collect and maintain:

We collect nonpublic personal information with regards to:

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

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 medical or account information:

1. Treatment or care of a patient (including scheduling)
2. Process billing for services
3. Medical records requests

• Patient records are stored in a secure Electronic Health Records (EHR) database. PHI is protected in accordance with the HIPAA Security Rule.
• Staff will not discuss any patient in a public area.

Permitted Uses and Disclosures of PHI:

PHI will only be released with the proper written consent from the patient or parent/guardian of the minor patient, unless the request is during an emergency. Occasions for release of PHI are the following:

• Treatment, Payment and Operations (Disclosure without authorization is permitted for the following: as required by law, for public health activities, for victims of abuse, neglect, or domestic violence, for health oversight activities, for judicial and administrative proceedings, for law enforcement purposes, for decedents, for cadaveric organ, eye, and tissue donation purposes, for research purposes, to avert a serious threat to health or safety, for specialized government functions, for disability documentation, and for worker’s compensation.)
• Patient request
• Legal pursuit
• Insurance company audit / claim adjudication

Patients’ Rights:

• Our patients have the right to privacy and respect regarding their personal information.
• The patient has a right to inspect 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 a 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.