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 APPLIES TO ALL OF THE RECORDS OF YOUR CARE GENERATED BY THE PRACTICE, WHETHER MADE BY THE PRACTICE OR AN ASSOCIATED FACILITY.

 

This notice describes our policies, which extend to:

  Any health care professional authorized to enter information into your chart (including physicians, PAs, RNs, technicians, etc.);

  All areas of the Practice (front desk, administration, billing and collection, etc.);

  All employees, staff and other personnel that work for or with our Practice;

  Our business associates (including an answering service, or facilities to which we refer patients).

Cochise Eye and Laser is providing this Notice to comply with the Privacy Regulations issued by the Department of Health and Human Services in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).






OUR THOUGHTS ABOUT YOUR PROTECTED HEALTH INFORMATION:
We understand that your medical information is personal to you, and we are committed to protecting the information about you.  As our patient, we create paper and electronic medical records about your health, our care for you, and the services and/or items we provide to you as our patient.  We need this record to provide for your care and to comply with certain legal requirements.

We are required by law to:

      Make sure that the protected health information about you is kept private;

  Provide you with a Notice of our Privacy Practices and your legal rights with respect to protected health information about you; and

  Follow the conditions of the Notice that is currently in effect.

HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU.
The following categories describe different ways that we use and disclose protected health information that we have and share with others.  Each category of uses or disclosures provides a general explanation and provides some examples of uses.  Not every use or disclosure in a category is either listed or actually in place.  The explanation is provided for your general information only.
 

    Medical Treatment.  We use previously given medical information about you to provide you with current or prospective medical treatment or services.  Therefore we may, and most likely will, disclose medical information about you to doctors, nurses, technicians, medical students, or hospital personnel who are involved in taking care of you.  For example, a doctor to whom we refer you for ongoing or further care may need your medical record.  Different areas of the practice also may share medical information about you including your record(s), prescriptions, requests of lab work and x-rays.  We may also discuss your medical information with you to recommend possible treatment options or alternatives that may be of interest to you.  When purchasing glasses and/or contacts from our optical office, we may discuss your medical information with you in an open optical setting to explain your visual options.  We also may disclose medical information about you to people outside the practice who may be involved in your medical care after you leave the practice; this may include your family members, or other personal representatives authorized by you or by a legal mandate (a guardian or other person who has been named to handle your medical decisions, should you become incompetent).

    Payment.  We may use and disclose medical information about you for services and procedures so they may be billed and collected from you, an insurance company, or any other third party.  For example, we may need to give your health care information, about treatment you received at Cochise Eye and Laser, to obtain payment or reimbursement for the care.  We may also tell your health plan and/or referring physician about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment, to facilitate payment of a referring physician, or the like.

    Health Care Operations.  We may use and disclose medical information about you so that we can run our practice more efficiently and make sure that all of our patients receive quality care.  These uses may include reviewing our treatment and services to evaluate the performance of our staff, deciding what additional services to offer and where, deciding what services are not needed, and whether certain new treatments are effective.  We may also disclose information to doctors, nurses, technicians, medical students, and other personnel for review and learning purposes.  We may also combine the medical information we have with medical information from other practices to compare how we are doing and see where we can make improvements in the care and services we offer.  We may remove information that identifies you from this set of medical information so others may use it to study health care and health care delivery without learning who the specific patients are.

We may also use or disclose information about you for internal or external utilization review and/or quality assurance, to business associates for purposes of helping us to comply with our legal requirements, to auditors to verify our records, to billing companies to aid us in this process and the like.  We shall endeavor, at all times when business associates are used, to advise them of their continued obligation to maintain the privacy of your medical records.

  Appointment and Patient Recall Reminders.  We may use and disclose medical information to contact you as a reminder that you have an appointment for medical care with Cochise Eye and Laser or that you are due to receive periodic care from the practice.  This contact may be by phone, in writing, e-mail, or otherwise and may involve leaving a message on an answering machine, which could (potentially) be received or intercepted by others.
 

  Emergency Situations.  We may disclose medical information about you to an organization assisting in a disaster relief effort or in an emergency situation so that your family can be notified about your condition, status and location.

  Research.  Under certain circumstances, we may use and disclose medical information about you for research purposes regarding medications, efficiency or treatment protocols and the like.  All research projects are subject to an approval process, which evaluates a proposed research project and its use of medical information.  Before we use or disclose medical information for research, the project will have been approved through this research approval process.  We will obtain an authorization from you before using or disclosing your individually identifiable health information unless the authorization requirement has been waived.  If possible, we will make the information non-identifiable to a specific patient.  If the information has been sufficiently de-identified, an authorization for the use or disclosure is not required.

  Required by Law.  We will disclose medical information about you 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 medical information about you when necessary to prevent a serious threat either to your specific health and safety or the health and safety of the public or another person.  Any disclosure, however, would only be to someone able to help prevent the threat.

  Organ and Tissue Donation.  If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

  Workers’ Compensation.  We may release medical information about you for workers’ compensation or similar programs.  These programs provide benefits for work-related injuries or illness.

  Public Health Risks.  Law or public policy may require us to disclose medical information about you for public health activities.  These activities generally include the following: 

        to prevent or control disease, injury or disability;

        to report births and deaths;

        to report child abuse or neglect;

        to report reactions to medications or problems with products;

        to notify people of recalls of products they may be using;

        to notify a person who may have been exposed to a disease or may be at
      risk for contracting or spreading a disease or condition;

        to notify 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.

  Investigation and Government Activities.  We may disclose medical information to a local, state or federal agency for activities authorized by law.  These oversight activities include, for example, audits, investigations, inspections, and licensure.  These activities are necessary for the payor, the government and other regulatory agencies to monitor the health care system, government programs, and compliance with civil rights laws.

 

  Lawsuits and Disputes.  If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order.  This is particularly true if you make your health an issue.  We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute.  We shall attempt in these cases to tell you about the request so that you may obtain an order protecting the information requested if you so desire.  We may also use such information to defend ourselves or any member of our practice in any actual, or threatened, action.

  Law Enforcement.  We may release medical information if asked to do so by a law enforcement official:

        In response to a court order, subpoena, warrant, summons or similar
      process;

        To identify or locate a suspect, fugitive, material witness, or missing
      person;

        About the victim of a crime if, under certain limited circumstances, we are
      unable to obtain the person’s agreement;

        About a death we believe may be the result of criminal conduct;

        About criminal conduct at Cochise Eye and Laser; and

        In emergency circumstances 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 medical 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 may also release medical information about patients of Cochise Eye and Laser to funeral directors as necessary to carry out their duties.

 

  Inmates.  If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official.  This release would be 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; (3) for the safety and security of the correctional institution.

CHANGES TO THIS NOTICE 
We reserve the right to change this notice at any time.  We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we may receive from you in the future.  We will have a copy of the current notice available in the lobby of our offices.  The notice will contain on the first page, in the top right-hand corner, the date of the last revision and effective date.  In addition, each time you visit our offices for treatment or health care services, you may request a copy of the current notice in effect.

COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with Cochise Eye and Laser or with the Secretary of the Department of Health and Human Services.  To file a complaint with our office, contact our Office Administrator, who will direct you on how to file an office complaint.  All complaints must be submitted in writing, and all complaints shall be investigated, without repercussion to you.

The Office Administrator can be reached at 520-458-8131.
You will not be penalized for filing a complaint.

OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission, unless those uses can be reasonably inferred from the intended uses above.  If you have provided us with your permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time.  If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization.  You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.


PATIENT RIGHTS
THIS SECTION DESCRIBES YOUR RIGHTS AND THE OBLIGATIONS OF THIS PRACTICE REGARDING THE USE AND DISCLOSURE OF YOUR MEDICAL INFORMATION.

You have the following rights regarding medical information we maintain about you:

  Right to Inspect and Copy.  You have the right to inspect and copy medical information that may be used to make decisions about your care.  This includes your own medical and billing records, but does not include psychotherapy notes.  Upon proof of an appropriate legal relationship, records of others related to you or under your care (guardian or custodial) may also be disclosed.
 

To inspect and copy your medical record, you must submit your request in writing to our Compliance Officer.  Ask the front desk person for the name of the Compliance Officer.  If you request a copy of the information, we may charge a fee of fifteen (15) cents per page for the costs of copying, mailing or other supplies (tapes, disks, etc.) associated with your request.

We may deny your request to inspect and copy in certain very limited circumstances.  If you are denied access to medical information, you may request that our Compliance Committee review the denial.  Another licensed health care professional chosen by our office will review your request and the denial.  The person conducting the review will not be the person who denied your request.  We will comply with the outcome and recommendations from that review.

  Right to Amend.  If you feel that the medical information we have about you in your record is incorrect or incomplete, then you may ask us to amend the information, following the procedure below.  You have the right to request an amendment for as long as Cochise Eye and Laser maintains your medical record.

To request an amendment, your request must be submitted in writing to the Compliance Officer, along with your intended amendment and a reason that supports your request to amend.  The amendment must be dated and signed by you and notarized.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request.  In addition, we may deny your request if you ask us to amend information that:

  Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;

  Is not part of the medical information kept by or for Cochise Eye and Laser;

  Is not part of the information which you would be permitted to inspect and copy; or

  Right to an Accounting of Disclosures.  You have the right to request an “accounting of disclosures.”  This is a list of the disclosures we made of medical information about you to others.

To request this list, you must submit your request in writing to the Compliance Officer.  Your request must state a time period not longer than six (6) years back and may not include dates before April 14, 2003 (or the actual implementation date of the HIPAA Privacy Regulations).  Your request should indicate in what form you want the list (for example, on paper, electronically).  We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

  Right to Request Restrictions.  You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations.  You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care (a family member or friend).  For example, you could ask that we not use or disclose information about a particular treatment you received.

We are not required to agree to your request and we may not be able to comply with your request.  If we do agree, we will comply with your request except that we shall not comply, even with a written request, if the information is excepted from the consent requirement or we are otherwise required to disclose the information by law.

To request restrictions, you must make your request in writing to the Compliance Officer.  In your request, you must indicate:

     What information you want to limit;

  Whether you want to limit our use, disclosure or both; and

  To whom you want the limits to apply, (e.g., disclosures to your children, parents, spouse, etc.)

  Right to Request Confidential Communications.  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 at work or by mail, that we not leave voice mail or e-mail, or the like.

To request confidential communications, you must make your request in writing to the Compliance Officer.  We will not ask you the reason for your request.  We will accommodate all reasonable requests.  Your request must specify how or where you wish us to contact you.

  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.

JOB DESCRIPTION - PRIVACY OFFICER
 

            A. Oversee Compliance Efforts

 

  oversee and monitor the development and implementation of the Compliance Program;

  establish methods and periodically audit the Practice to ensure its efficiency and quality and to reduce vulnerability to exposure areas;

  coordinate compliance efforts with Compliance Personnel and Practice department managers as needed; and

  prepare and present regular reports to the Board of Directors and the Practice as a whole, on Practice compliance.



 

            B. Review and Update the Compliance Plan as Necessary

  receive all mailings, educational materials, etc. on HIPAA and/or state law privacy related material;

  cull through, organize and disseminate plan updates.

 

            C. Develop Training/Education Programs

  develop and implement training and education programs for all Practice employees (staff and providers);

  ensure that independent contractors, business associates and others who furnish services to the Practice are aware of the requirements of the Practice's Compliance Plan;

  develop mechanisms to receive and investigate reports of non-compliance; and

  develop policies and programs that encourage employees to report non-compliance without fear of retaliation.

D. Implement the Compliance Plan

   maintain current and effective Privacy policies and procedures;

   conduct periodic audits in the following areas:

   staff compliance with privacy policies and procedures;

   accounting for disclosures;

   patient access to information;

   Business Associate compliance;

   other areas as deemed appropriate.

   conduct ongoing educational programs;

    review and update Business Associate Agreements;

   circulate all HIPAA compliance updates" lfo9? level1 margin-left:1.25in;text-indent:-.25in;mso-list:l0 margin-top:0in;margin-right:0in;margin-bottom:12.0pt;>    investigate all complaints regarding breach of privacy policies or procedures;

   take prompt corrective actions where necessary;

   respond to compliance related inquiries; and

   act as liaison with legal counsel.

 

            E. Documentation

  maintain all logs regarding compliance efforts, investigations and the like in a secure location.

  maintain log for all staff training sessions, etc.

  conduct and maintain a record of all exit interviews with employees leaving the Practice's employ;

  maintain log for all Business Associates’ contracts.

JOB DESCRIPTION - SECURITY OFFICER 

            A. Oversee Compliance Efforts

 

   oversee and monitor the development and implementation of the Security
 Compliance Program;

   ensure compliance with the HIPAA Electronic Transactions Standards;

   ensure proper back-up systems for all data stored, received and transmitted;

   oversee the development of and manage the Disaster Plan;

   establish methods and periodically audit the Practice to ensure its efficiency
 and quality and to reduce vulnerability to exposure areas;

   coordinate compliance efforts with Compliance Personnel and Practice
 department managers as needed; and

   prepare and present regular reports to the Board of Directors and the
 Practice as a whole, on Practice compliance.

 

            C. Develop Training/Education Programs

  develop and implement training and education programs for all Practice employees (staff and providers) in the area of security and integrity of protected health information;

  ensure that independent contractors and investigators who furnish services to the Practice are aware of the requirements of the Practice's Compliance Plan;

  develop mechanisms to receive and investigate reports of non-compliance;

  take corrective actions to resolve non-compliance; and

  develop policies and programs that encourage employees to report non-compliance without fear of retaliation.

 

D. Implement the Compliance Plan

   maintain current and effective security policies and procedures;

   conduct periodic audits in the following areas:

   staff compliance with security policies and procedures;

   log of transmissions emanating from the Practice;

   password access systems;

   other areas as deemed appropriate.

   conduct ongoing educational programs;

   circulate all HIPAA security updates;

   maintain Chain of Trust Agreements;

   investigate all breaches of security and complaints of alleged breaches;

   take prompt corrective actions where necessary;

   respond to compliance related inquiries;

   act as liaison with information system hardware and software vendors; and

   act as liaison with legal counsel.

 

            E. Documentation

  maintain all logs regarding compliance efforts, investigations and the like in a secure location;

  maintain logs of staff training efforts;

  conduct and maintain record of all exit interviews with employees leaving the Practice's employ; and

  maintain log of all Chain of Trust Agreements.