HIPAA
NOTICE
Matthew Blondin, O.D., F.A.A.O.
Health Insurance Portability & Accessibility Act
August 1, 2008
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.
THIS NOTICE IS EFFECTIVE 4/15/03 UNTIL FURTHER NOTICE.
Right to Notice
As a patient, you have the right to adequate notice of the uses and
disclosures of your protected health information. Under the Health
Insurance Portability and Accessibility Act (HIPAA), Dr. Blondin can
use your protected health information for treatment, payment and health
care operations.
a) Treatment - We may use or disclose your health information to a
physician or other healthcare provider providing treatment to you.
b) Payment - We may use and disclose your health information to obtain
payment for services we provide you.
c) Health care operations - We may use and disclose your health information
in connection with our healthcare operations. Healthcare operations
include quality assessment and improvement activities, reviewing the
competency or qualifications of healthcare professionals, evaluating
provider performance, conducting training programs, accreditation,
certification, licensing or credentialing activities.
Your
Authorization
Most uses and disclosures that do not fall under treatment, payment,
health care operations will require your written authorization.
Upon signing, you may revoke your authorization (in writing) through
our practice at any time.
Emergency
Situations
In the event of your incapacity or an emergency situation, we will
disclose health information to a family member, or another person
responsible for your care, using our professional judgment. We will
only disclose health information that is directly relevant to the
person's involvement in your healthcare.
Marketing
We will not use your health information for marketing communications
without your written authorization.
Required
by Law
We may also use or disclose your health information when we are
required to do so by law.
Abuse
or Neglect
We may disclose your health information to appropriate authorities
if we reasonably believe that you are a possible victim of abuse,
neglect, or domestic violence or the victim of other crimes. We
may disclose your health information to the extent necessary to
avert a serious threat to your or other people's health or safety.
National
Security
We may disclose the health information of Armed Forces personnel
to military authorities under certain circumstances. We may disclose
health information to authorized federal officials required for
lawful intelligence, counterintelligence and other national security
activities. We may disclose health information of inmates or patients
to the appropriate authorities under certain circumstances.
Appointment
Reminders
We may use or disclose your health information to provide you with
appointment reminders via phone, e-mail or letter.
Your
Rights as a Patient
You have the right to restrict the disclosure of your protected
health information (in writing). The request for restriction may
be denied if the information is required for treatment, payment
or health care operations.
-You have the right to receive confidential communications regarding
your protected health information.
-You have the right to inspect and copy your protected health information.
-You have the right to amend your protected health information.
-You have the right to receive an account of disclosures of your
protected health information.
-You have the right to a paper copy of this notice of privacy practices.
Legal
Requirements
Dr. Blondin is required by law to maintain the privacy of your protected
health information. We are required to abide by the terms of this
notice as it is currently stated, and reserve the right to change
this notice. The policies in any new notice will not be in effect
until they are posted to this site, or are available within our
office.
Complaints
If you have complaints regarding the way your protected health information
was handled, you may submit a complaint in writing to our office.
You will not be retaliated against in any manner for a complaint.
Contact
Information
For further information about Dr. Blondin's privacy policies, please
contact Dr. Blondin at the following address or phone number:
Dr. Blondin
379 Prospect Street, Suite B
Torrington, CT 06790
860.489.2781
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