757.425.5550 • 1201 First Colonial Road • Virginia Beach, VA 23454

Privacy Policy

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Beach Eye Care

Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW PROTECTED MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

• Beach Eye Care is permitted to make uses and disclosures of protected health information for treatment, payment and health care operations, as described in the following examples:
• For treatment – Use in acquisition of referrals from PCP offices.
• For payment – Use in collection of payments.
• For health care operations – Use in keeping scheduling books.
• Beach Eye Care is permitted or required, under specific circumstances, to use or disclose protected health information without the individual’s written authorization.
• Other uses and disclosures will be made only with the Individual's written authorization, and the individual may revoke such authorization.
• Beach Eye Care intends to engage in (n)one or more of the following activities:
• Beach Eye Care may contact the individual to provide appointment reminders or information about treatment alternatives or other heath-related benefits and services that may be of interest to the individual or patient.
• Beach Eye Care may contact the individual/Patient to raise funds for Beach Eye Care; or
• A group health plan, or a health insurance issuer or HMO with respect to a group health plan, may disclose protected health information to the sponsor of the plan.
• The Individual has the following rights regarding protected health information:
• The right to request restrictions on certain uses and disclosures of protected health information. Beach Eye Care is not required to agree to a requested restriction, however.
• The right to receive confidential communications of protected health information, as applicable.
• The right to inspect and copy protected health information, as provided in the Privacy Regulation.
• The right to amend protected health information, as provided in the Privacy Regulation.
• The right to receive an accounting of disclosures of protected health information.
• The right to obtain a paper copy of the Notice from the covered entity upon request. This right extends to an individual who has agreed to receive the Notice electronically.
• Beach Eye Care is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and Privacy practices with respect to protected health information.
• Beach Eye Care is required to abide by the terms of the Notice currently in effect.
• Beach Eye Care reserves the right to change the terms of this Notice. The new Notice provisions will be effective for all protected health information that it maintains.
• Beach Eye Care will provide individuals or patients with a revised Notice upon their next visit to our office at time of check in.
• Individuals may complain to Beach Eye Care and to the Secretary of the Department of Health and Human Services, without fear of retaliation by the organization, if they believe their privacy rights have been violated. A brief description of how the individual may file a complaint follows:

Patient will fill out the patient complaint form provided to them and the form will then go to the Administrator .

• Beach Eye Care’s contact person for matters relating to complaints is:
• Jonathan West, Administrator
• (757) 425-5550
• 1201 First Colonial Road, Virginia Beach, VA 23454
• This Notice is first in effect on March 19 th, 2003.
• Beach Eye Care elects to limit the uses or disclosures that it is permitted to make, as follows: Currently, there are no limitations.

 

©2007 Medical Consulting Group LLC
Privacy Policy