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Notice of Privacy Practices for Protected Health Information
Effective Date: September 5, 2019
Eye Style of America Ltd. “Befitting”
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
If you have any questions or concerns about this notice, please contact: Befitting Privacy Officer at 10700 Montgomery Rd, Suite 221, Cincinnati, OH 45242
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 and its related rules and regulations dictate the privacy practices that health care organizations and their partners are obligated to follow with respect to health information about you. The law requires us to: (1) keep health information about you confidential, as provided for by state and federal law; (2) notify you of our legal duties and privacy practices with respect to health information about you; (3) abide by the terms of our most current version of this notice; and (4) notify you if there has been a security breach that compromises your PHI.
Uses and Disclosures of Health Information about You:
The following is a list of ways in which we may use and disclose health information about you. We may:
- use your health information to provide you with treatment or services, such as to fill your order and confirm your glasses prescription.
- We also may use health information about you for purposes of contacting you, for appointment reminders, possible treatment options and alternatives, care settings, health-related benefits or services, and provider networks that may be of interest to you. However, if we receive compensation for making a communication concerning another entity’s products or services (other than payment for treatment), the communication is “marketing” and will require that we obtain your prior written authorization.
- use your health information to receive payment for the services we provide, such as to bill and collect payment from you, your insurance company, or a third-party payer.
- use your health information to support our operational activities such as comparing patient data to improve our operations or assessing the care and outcomes in your case and others like it.
- use health information about you to interact with our business associates that we have contracted with to perform specific functions for us and help us do our jobs. Our partners are required by contract and by law to protect health information about you in the same manner as we do.
- disclose health information about you to other organizations, subject to certain requirements, without prior authorization, for public health purposes, research studies, organ donation, emergencies, abuse or neglect reporting, funeral arrangements, workers’ compensation purposes, and health oversight audits or inspections.
- disclose health information about you when required to do so by law, such as in response to requests from law enforcement agencies in specific circumstances; valid judicial or administrative orders; the government, if you are in the military or a veteran; national security and intelligence activities; and protective services for the President and others.
- disclose health information about you to a friend or family member who is involved in your health care, someone who helps pay for your care, or disaster relief authorities to notify your family of your location and condition. We may disclose health information about you to a person legally authorized to act on your behalfs, such as a parent, legal guardian, administrator, or executor of your estate, or other individual authorized under applicable law.
In any other situation not covered by this notice, we will ask for your written authorization before using or disclosing your health information. If you chose to authorize use or disclosure you can later revoke that authorization by notifying us in writing of your decision. We will never sell your health information without your prior authorization. However, we, or our business associate, may receive compensation (directly or indirectly) related to an exchange of your health information for the following purposes: (a) public health activities; (b) research purposes (if the price charged reflects the cost of preparation and transmittal of the information); (c) payment or compensation for your treatment; (d) health care operations related to the sale, merger or consolidation of all or part of our business; (c) performance of services by a business associate on our behalf; (f) providing you with a copy of your health information; or (g) other reasons determined necessary or appropriate by applicable laws or regulations.
Some states have separate privacy laws that may apply additional legal requirements regarding the uses and disclosures of health information about you. If the state privacy laws are more stringent than federal privacy laws, the state law preempts the federal law.
To exercise these rights, contact our Privacy Officer to obtain a form or submit a written request to 10700 Montgomery Rd, Suite 221, Cincinnati, OH 45242. You have the right to:
- inspect and obtain a copy of the health information that may be used to make decisions about your care. We may deny your request to inspect and copy in certain circumstances. If you are denied access to health information about you, you may request that the denial be reviewed. We may charge you for the cost of the request.
- request that we amend the information kept by us if you believe it is incorrect or incomplete. You must provide a reason that supports your request. We may deny your request for an amendment and if this occurs, you will be notified of the reason for the denial and permitted to provide a statement of disagreement that will be attached to your health record.
- request an accounting of disclosures. This is a list of certain disclosures we make of health information about you for purposes other than treatment, payment, or health care operations when authorization was not required. Your request must specify a time period, which may not be longer than six years. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests. With respect to disclosures made by our business associates, we may choose to provide you with a list of business associates acting on our behalf, along with their contact information, who must provide you with the accounting upon a request made directly by you to such entities.
- request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations and to limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request, except in the case of disclosure to a health plan if it is for payment or certain care operations and relates to an item or service for which you have paid out of pocket in full. If we agree, we will comply with your request except in certain emergency situations or as required by law.
- request that we communicate with you about health matters in a certain way or at a certain location. For example, you may ask that we contact you at work instead of home or vice versa. We will grant reasonable requests.
- a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
Changes to this Notice:
We reserve the right to change this notice at any time, and the revised or changed notice will be effective for information we already have about you as well as any information we may receive in the future. The current notice will be posted on our website www.befitting.com or upon request.
You have to file a complaint if you believe your privacy rights have been violated. You may register complaints with our Privacy Officer at the location above, who will evaluate the complaints and take appropriate action consistent with our mitigation and disciplinary policies. You will not be retaliated against for filing a complaint. You also have the right to contact the Office for Civil Rights (OCR), who is the federal agency that enforces HIPAA rules and regulations. Information on filing a complaint with OCR is available at http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html. You must file a complaint with OCR within 180 days (6 months) after the occurrence of the act or omission giving rise to your complaint.
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