NOTICE OF PRIVACY PRACTICES

(Effective date of Notice:  September 23, 2013)

Dr. Louise F. Lee, O.D. and Associates

46228 Warm Springs Blvd., Suite 460, Fremont, CA  94539

510-668-0877  eyecareDrLee@gmail.com

 

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

 

We respect the importance of keeping your health information private.  We are legally bound to give you notices of our privacy practice.  This Notice of Privacy Practices describes how we protect your health information and what rights you have relating to it.  We can use your health information in our office or outside our office without your written permission only for the purposes of treatment, payment or health care operations.  In most other situations we will not use nor disclose your health information unless you sign a written consent form.  In limited situations, the law allows or requires us to disclose your health information without written consent.

 

Purposes for Disclosure of Health Information

The most common reason why we use or disclose your health information is for treatment, payment and health care operations.  Examples of how we use or disclose information for treatment purposes are:  setting up or confirming an appointment for you; testing and examining your eyes or eye related conditions; prescribing glasses, contact lenses, or eye medication and faxing them to be filled; showing you low vision aids; referring you to another doctor or clinic eye care or low vision aids or services; or getting copies of your health information from another professional that you may have seen before us.  Examples of how we disclose your health information for payment purposes are:  asking you about your health or vision care plans, or other sources of payment; preparing or sending bills or claims; and collecting unpaid amounts or balances (either ourselves or through a collection agency or attorney).  Health care operations mean those administrative and managerial functions that we have to do in order to run our office.  Examples of how we use or disclose your health information for health care operations are:  financial and billing audits; internal quality assurance; personnel decisions; participation in managed care plans; defense of legal matters; business planning; and outside and backup storage of our records.  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 our offices for these reasons, we usually will not ask you for special permission.

 

Uses and Disclosures of Health Information Without Authorization

In some limited situations, the law allows or requires us to use or disclose your health information without your permission.  These may include:  Disclosures when state or federal law mandates certain health information be reported for a specific purpose;  Disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence;  Disclosures for judicial or administrative proceedings, such as subpoenas or orders of courts or administrative agencies;  Disclosures for public health purposes, such as contagious disease reporting, investigation or surveillance and notices to and from the federal Food and Drug Administration regarding drugs or medical devices;  Disclosures for health oversight activities, such as for the licensing of doctors, audits for Medicare or Medical, or for investigation of possible violation of health care laws;  Disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected of being a victim of a crime; to provide information about a crime at our office; or to report a crime that happened somewhere else;  Disclosures to a medical examiner to identify a dead person or to determine the cause of death, or to funeral directors to aid in burial, or to organizations that handle organ and tissue donations;  Uses or disclosures for health related research;  Uses and disclosures to prevent a serious threat to health and safety;  Uses or disclosures for specialized government functions, such as for the protection of the president or high ranking government officials, for lawful national intelligence activities, for military purposes, or for the evaluation and health of the members of the foreign service;  Disclosures relating to worker's compensation programs;  Disclosures of a limited data set for research, public health or health care operations;  Incidental disclosures that are an unavoidable by-product of permitted uses or disclosures;  Disclosures to business associates who perform health care operations for us and who agree to respect the privacy of your health information;  Unless you object, we may also share relevant information about your care with your family or friends who are helping you with your eye care.

 

Your Rights Regarding Your Health Information

The law gives you many rights regarding your health information.

*You can ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment or health care operations.  We do not have to agree to do this, but if we agree, we must honor the restrictions that you want.  To ask for a restriction, send a written request to the address or fax shown at the beginning of this Notice.

*You can ask us to communicate with you in a confidential way, such as by phoning you at work rather than at home, by mailing health information to a different address, or by using email to your personal email address.  We will accommodate these requests if they are reasonable, and if you pay us for any extra cost.  If you want to ask for confidential communications, send a written request to the address or fax shown at the beginning of this Notice.

*You can ask to see or get photocopies of your health information.  By law, there are a few limited situations in which we can refuse to permit access or copying.  For the most part, however, you will be able to review your health information within 30 days of asking us.  You will be able to obtain a copy of your health information within 30 days of asking us.  You may have to pay for photocopies in advance and state law specifies that we may charge up to 25 cents per page.  If we deny your request, we will send you a written explanation, and instructions about how to get an impartial review of our denial if one is legally required.  By law, we can have one 30-day extension of the time for us to give you access or photocopies if we send you a written notice of the extension.  If you want to review or get photocopies of your health information, send a written request to the address or fax at the beginning of this Notice.

*You can ask us to amend your health information if you think it is incorrect or incomplete.  If we agree, we will amend the information within 60 days from when you ask us.  If we do not agree, you can still write a statement of you position, and we will include it with your health information along with any rebuttal statement that we may write.  Once your statement of position and/or our rebuttal is included in your health information, we will send it along whenever we make a permitted disclosure of your health information.  By law, we can have one 30-day extension of time to consider a request for amendment if we notify you in writing of the extension.  I you want to ask us to amend your health information, send a written request, including your reasons for the amendment, to the office address or fax at the beginning of this Notice.

*You can get a list of disclosures that we have made of your health information within the past six years (or a shorter period if you want).  By law, this list will not include:  disclosures for purposes of treatment, payment, or health care operations; disclosures with your authorization; and some other limited disclosures.  You are entitled to one such list per year without charge.  If you want more frequent lists, payment in advance is required.  We will usually respond to your request within 60 days of receiving it, but by law we can have one 30-day extension of time if we notify you of the extension in writing.  If you want a list, send a written request to the office address or fax at the beginning of this Notice. 

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 as allowed by law.  If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to any such information that we may generate in the future.  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 or to the U.S. Department of Health and Human Services, Office for Civil Rights.  We will not retaliate against you if you make a complaint.  If you want to complain to us, send a written complaint to our address or fax shown at the beginning of this Notice.  If you prefer, you can discuss your complaint in person or by phone.

For More Information

If you want more information about our privacy practices, contact our office at the address or phone number shown at the beginning of this Notice.

Website specific Privacy Guidelines

Whether you're purchasing online or just browsing, your privacy is important to us. Please take the time to review our policy for handling your customer information. By visiting the our website, you are accepting the practices described in this Notice of Privacy Practices . Our Notice of Privacy Practices may change from time to time, so please revisit this page and review it regularly. If you have any questions regarding our Notice of Privacy Practices , please contact us at the address, phone, or email at the beginning of this notice or on the home page of this website. We appreciate your comments and suggestions.

 

We may use the information to improve the content of our website, to make our future marketing efforts more efficient, to notify you about current products, special offers, services and events, and for other purposes. The information we collect may be combined with other personally identifiable information available from our records and other sources, such as purchase history and demographic information.

 

Your trust and privacy are very important to us! Therefore, we ask only for the information we need to process your requests:

 

Phone Number:
We ask for your phone number on the order form in the event we need to contact you regarding your order. We will not otherwise call you, and we will not share your phone number with any other companies.

 

Credit Card Information:
To purchase from the our website, you will need to give us a credit card number. This information is kept encrypted to ensure secure purchases.  This is secure information and cannot be accessed by anyone other than the account holder.

 

E-Mail Address:
We will use the e-mail address you provide on your order to send you an order receipt and to communicate about your order.  We may also use it to contact you about future website or product updates. Please be assured that the e-mail address you provide to us is for internal use only.  If you decide you would like to be removed from this service, you may follow the instructions on the messages you are sent.

 

Questions and Comments:
We want to hear from you.   Please call or email us with your comments, suggestions or questions. Every message is read and a response sent as quickly as possible if requested. The information you send us will be used to respond to your questions and comments only.

 

Cookies:
We may also use "cookies" or other means to passively collect information about your use of our website. A cookie is a piece of data stored on your computer that lets your web browser talk with our web server. It saves you from retyping your user name and password every time you use our secure checkout. If you are shopping on our site and are having difficulty completing your order, please check the privacy settings in your browser. If you have your settings set to not accept cookies, you will not be able to purchase from our site.

 

Children:
Our website is intended only for those aged 13 and older. If you are under 13, you may not register or submit personally identifiable information on, to or through the site. We do not collect personally identifiable information from any person we know to be under 13.

 

Opting Out:
If you do not wish to receive mailed or emailed promotional material for marketing purposes, please contact us.

 

Security:
We take care to protect the security of your personal information, including your credit card information, from loss, misuse, unauthorized access or disclosure. However, transmissions to the website may be intercepted and read by others and we cannot be responsible for any such interception.

 

We use Secure Sockets Layer (SSL) technology to protect the security of your personal on-line order information. To check the security of your connection to our website, look in the lower right-hand corner of your browser window after entering our checkout section. If you see an unbroken key or a closed lock (depending on your browser), then SSL is active.  On newer versions of some browsing software it may be located in the upper address bar. You can also double-check you are in a secure shopping environment by looking at the URL line of your browser. When you are using a secure server, the first characters of the site address will change from "http" to "https." If you cannot access the secure server for any reason, please call and place your order by phone.

 

Dr. Louise F. Lee and Associates is required by law to:

  • Maintain the privacy of your protected health information;
  • Give you this notice of our duties and privacy practices regarding health information about you;
  • Follow the terms of our notice that is currently in effect.

HOW Dr. Louise F. Lee and Associates MAY USE AND DISCLOSE YOUR HEALTH INFORMATION:

Described as follows are the ways Dr. Louise F. Lee and Associates may use and disclose health information that identifies you (Health Information, or PHI). Except for the following purposes, we will use and disclose Health Information only with your written permission. You may revoke such permission at any time by writing to us and stating that you wish to revoke permission you previously gave us.

Treatment. Dr. Louise F. Lee and Associates may use and disclose Health Information for your treatment and to provide you with treatment-related health care services. For example, we may disclose Health Information to doctors, nurses, technicians, or other personnel, including people outside our office, who are involved in your medical care and need the information to provide you with medical care.

Payment. Dr. Louise F. Lee and Associates may use and disclose Health Information so that we may bill and receive payment from you, an insurance company, or a third party for the treatment and services you received. For example, we may give your health plan information so that they will pay for your treatment. However, if you pay for your services yourself (e.g. out-of-pocket and without any third party contribution or billing), we will not disclose Health Information to a health plan if you instruct us to not do so.

Health Care Operations. Dr. Louise F. Lee and Associates may use and disclose Health Information for health care operation purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care and to operate and manage our office. For example, we may use and disclose information to make sure the care you receive is of the highest quality. Subject to the exception above if you pay for your care yourself, we also may share information with other entities that have a relationship with you (for example, your health plan) for their health care operations.

Appointment Reminders, Treatment Alternatives and Health Related Benefits and Services. Dr. Louise F. Lee and Associates may use and disclose Health Information to contact you and to remind you that you have an appointment with us. We also may use and disclose Health Information to tell you about treatment alternatives or health-related benefits and services that may be of interest to you. We will not, however, send you communications about health-related or non-health-related products or services that are subsidized by a third party without your authorization.

Individuals Involved in Your Care or Payment for Your Care. When appropriate, Dr. Louise F. Lee and Associates may share Health Information with a person who is involved in your medical care or payment for your care, such as your family or a close friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort.

Research. Under certain circumstances, Dr. Louise F. Lee and Associates may use and disclose Health Information for research. For example, a research project may involve comparing the health of patients who received one treatment to those who received another, for the same condition. Before we use or disclose Health Information for research, the project will go through an approval process. Even without approval, we may permit researchers to look at records to help them identify patients who may be included in their research project or for other similar purposes, as long as they do not remove or take a copy of any Health Information.

Fundraising and Marketing. Health Information may be used for fundraising communications, but you have the right to opt-out of receiving such communications. Except for the exceptions detailed above, uses and disclosures of Health Information for marketing purposes, as well as disclosures that constitute a sale of Health Information, require your authorization if we receive any financial remuneration from a third party in exchange for making the communication, and we must advise you that we are receiving remuneration.

Other Uses. Other uses and disclosures of Health Information not contained in this Notice may be made only with your authorization.

 

SPECIAL SITUATIONS:

As Required by Law. Dr. Louise F. Lee and Associates will disclose Health Information when required to do so by federal, state or local law.

To Avert a Serious Threat to Health or Safety. We may use and disclose Health Information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Disclosures, however, will be made only to someone who may help prevent the threat.

Business Associates. We may disclose Health Information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.

Organ and Tissue Donation. If you are an organ donor, we may use or release Health Information to organizations that handle organ procurement or other entities engaged in procurement; banking or transportation of organs, eyes, or tissues to facilitate organ, eye or tissue donation; and transplantation.

Military and Veterans. If you are a member of the armed forces, we may release Health Information as required by military command authorities.

We also may release Health Information to the appropriate foreign military authority if you are a member of a foreign military.

Workers' Compensation. We may release Health Information for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Risks. We may disclose Health Information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.


Health Oversight Activities. We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits. If you are involved in a lawsuit or a dispute, we may disclose Health Information in response to a court or administrative order. We also may disclose Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement. We may release Health Information if asked by a law enforcement official if the information is: (1) in response to a court order, subpoena, warrant, summons or similar process; (2) limited information to identify or locate a suspect, fugitive, material witness, or missing person; (3) about the victim of a crime even if, under certain very limited circumstances, we are unable to obtain the person's agreement; (4) about a death we believe may be the result of criminal conduct; (5) about criminal conduct on our premises; and (6) in an emergency to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.

Coroners, Medical Examiners and Funeral Directors. We may release Health Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We also may release Health Information to funeral directors as necessary for their duties.

National Security and Intelligence Activities. We may release Health Information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.

Protective Services for the President and Others. We may disclose Health Information to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or to conduct special investigations.

Inmates or Individuals in Custody. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release Health Information to the correctional institution or law enforcement official. This release would be if necessary: (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) the safety and security of the correctional institution.

 

YOUR RIGHTS:

You have the following rights regarding Health Information Dr. Louise F. Lee and Associates have about you:

Right to Inspect and Copy. You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records, other than psychotherapy notes. To inspect and copy this Health Information, you must make your request, in writing, to our office.

Right to Amend. If you feel that Health Information we have is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, you must make your request, in writing, to our office.

Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment and health care operations or for which you provided written authorization. To request an accounting of disclosures, you must make your request, in writing, to our office.

Right to Request Restrictions. You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the Health Information we disclose to someone involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about a particular diagnosis or treatment with your spouse. To request a restriction, you must make your request, in writing, to our office. We are not required to agree to all such requests. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

Right to Request Confidential Communication. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by mail or at work. To request confidential communication, you must make your request, in writing, to our office. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice. You have the right to 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. You may obtain a copy of this notice at our web site, www.EyeCareDrLee.com. To obtain a paper copy of this notice please request it in writing.

Right to Electronic Records. You have the right to receive a copy of your electronic health records in electronic form.

Right to Breach Notification. You have the right to be notified if there is a Breach of privacy such that your Health Information is disclosed or used improperly or in an unsecured way.

 

CHANGES TO THIS NOTICE:

Dr. Louise F. Lee and Associates reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a copy of our current notice at our office. The notice will contain the effective date on the first page, in the top right-hand corner.

 

COMPLAINTS:

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. All complaints must be made in writing. You will not be penalized for filing a complaint.