Privacy Notice
NOTICE OF PRIVACY PRACTICES
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.
WE RESPECT OUR LEGAL OBLIGATION TO KEEP HEALTH INFORMATION THAT IDENTIFIES YOU PRIVATE. WE ARE OBLIGATED BY LAW TO GIVE YOU NOTICE OF OUR PRIVACY PRACTICES. THIS NOTICE DESCRIBES HOW WE PROTECT YOUR HEALTH INFORMATION AND WHAT RIGHTS YOU HAVE REGARDING IT.
Right to Notice
As a patient, you have the right to notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPAA), Doctor M.A. Topolewski can use your protected health information for treatment, payment and health care operations.
We routinely use your health information inside our office for these purposes without any special permission. If we need to disclose your health information outside of our office for these reasons we will ask you for special written permission. In some cases, the law requires us to use or disclose your health information without your permission. These may include contagious disease, audits by Medicare, subpoenas or orders from court, to prevent serious threat, for law enforcement purposes, military purposes, to business associates who perform health care operations for us and who commit to respect the privacy of your health information,
In Emergency Situations
In the event of an emergency situation, unless you object, we will share relevant information about your eye care with your family or friends who are helping you with your care.
Appointment Reminders
We call or write to remind you of scheduled appointments, or that it is time to make your appointment for your exam, to notify you of other treatments or services available at our office that may help you. Unless you tell us otherwise, we will mail you an appointment reminder on a post card, and/or leave you a reminder message on your home answering machine or with someone who answers your phone if you are not home.
As a Patient
Our Notice of Privacy Practices
By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. We reserve the right to change this notice at any time allowed by the law.
If we change our Notice of Privacy Practices we will post the new notice in our office, have copies available in our office and post it on our web site.
Complaints
If you think that we have not properly respected the privacy of your health information, you are free to complain to us. If you want to complain to us , send a written complaint to the office contact person.
For More Information
If you want more information about our privacy practices, call or visit the office contact person at the address or phone number shown below.
EYE CARE SPECIALISTS
4868 Lapeer Road
Kimball, MI 48074
Phone: 810-982-3937
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.
WE RESPECT OUR LEGAL OBLIGATION TO KEEP HEALTH INFORMATION THAT IDENTIFIES YOU PRIVATE. WE ARE OBLIGATED BY LAW TO GIVE YOU NOTICE OF OUR PRIVACY PRACTICES. THIS NOTICE DESCRIBES HOW WE PROTECT YOUR HEALTH INFORMATION AND WHAT RIGHTS YOU HAVE REGARDING IT.
Right to Notice
As a patient, you have the right to notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPAA), Doctor M.A. Topolewski can use your protected health information for treatment, payment and health care operations.
- For Treatment - We may use or disclose your health information to a physician or other healthcare provider providing treatment to you.
- For Payment - We may use and disclose your health information to obtain payment for services we provide you.
- For Health care operations - We may use and disclose your health information in connection with our healthcare operations.
We routinely use your health information inside our office for these purposes without any special permission. If we need to disclose your health information outside of our office for these reasons we will ask you for special written permission. In some cases, the law requires us to use or disclose your health information without your permission. These may include contagious disease, audits by Medicare, subpoenas or orders from court, to prevent serious threat, for law enforcement purposes, military purposes, to business associates who perform health care operations for us and who commit to respect the privacy of your health information,
In Emergency Situations
In the event of an emergency situation, unless you object, we will share relevant information about your eye care with your family or friends who are helping you with your care.
Appointment Reminders
We call or write to remind you of scheduled appointments, or that it is time to make your appointment for your exam, to notify you of other treatments or services available at our office that may help you. Unless you tell us otherwise, we will mail you an appointment reminder on a post card, and/or leave you a reminder message on your home answering machine or with someone who answers your phone if you are not home.
As a Patient
- You may ask us to restrict our uses and disclosures for purposes of treatment. To do so you must send a written request to the office contact person.
- You may ask us to communicate with you in a confidential way - such as phoning you at work, using e-mail. To do this please submit a written request to the office
- You may get photocopies of your health information - You may have to pay for photocopies of your information and we have up to 30 days to provide you with the information requested.
- You may ask us to amend your health information if you think it is incorrect or incomplete.
- You may get additional paper copies of this Notice of Privacy Practices.
Our Notice of Privacy Practices
By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. We reserve the right to change this notice at any time allowed by the law.
If we change our Notice of Privacy Practices we will post the new notice in our office, have copies available in our office and post it on our web site.
Complaints
If you think that we have not properly respected the privacy of your health information, you are free to complain to us. If you want to complain to us , send a written complaint to the office contact person.
For More Information
If you want more information about our privacy practices, call or visit the office contact person at the address or phone number shown below.
EYE CARE SPECIALISTS
4868 Lapeer Road
Kimball, MI 48074
Phone: 810-982-3937