Privacy Policy

NOTICE OF PRIVACY PRACTICES
ASSOCIATED OPTICAL
4050 HEALTHWAY DRIVE SUITE 100
AURORA, IL 60504
630-820-1303

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW
YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE
REVIEW 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 your rights are.

TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS
    The most common reason for us to disclose your health information is for treatment, payment or health care operations.  Examples of how we use or disclose information for treatment purposes are: scheduling appointments, examining your eyes, prescribing glasses, contact lenses or eye medication, and faxing prescription to be filled, referring you to another profession, or obtaining copies of your health information from another professional.  Examples of how we use or disclose your health information for payment purposes are: asking you about your health or vision insurance, preparing and sending bills or claims, and collecting unpaid amounts.  Health care operations include those administrative and managerial functions in running our office.  Examples of how we use or disclose your health information for health care operations are: financial or billing audits, internal quality assurance, personnel decisions, participation in managed care plans, defense of legal matters, business planning and storage of records.  We routinely use your information inside our office for these purposes without special permission.  If we need to disclose you information outside of our office fore these reasons, we will usually not ask you for written permission.

USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION
    In some limited situations, the law allows or requires us to use or disclose you health information without your permission.  Not all of these situation apply to us and some may never occur at our office.  Such disclosures are:
•    When a state or federal law mandates that health information be reported for a specific purpose
•    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 to governmental authorities about victims of suspected abuse, neglect, or domestic violence
•    Uses and disclosures for health oversight activities such as for the licensing of doctors, for audits by Medicare or Medicaid, or for investigation of possible violations of health care laws
•    Disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies
•    Disclosures for law enforcement purposes, such as to provide information about someone who is suspected to be a victim of crime, to provide information about a crime at our office, or to report a crime elsewhere
•    Disclosure to a medical examiner to identify a dead person or to determine cause of death, or to funeral directors to aid in burial or to organizations that handle organ or tissue donation.
•    Uses or disclosures for health related research
•    Uses and disclosures to prevent a serious threat to health or 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 members of the foreign service.
•    Disclosures of de-identified information
•    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 commit to respect the privacy of you health information

Unless you object, we will also share relevant  information about you care with your family or friends who are helping you with your eye care.

APPOINTMENT REMINDERS
    We may call or write to remind you of your scheduled appointments, or to remind you that it is time to schedule a routine exam.  We may also call or write to notify you of other treatments or services available at our office that may help you.  Unless you request otherwise, we well mail you appointment reminders on a post card and/or leave a message on your answering machine or with someone who answers the phone.

OTHER USES AND DISCLOSURES
    We will not make any other uses or disclosures of your health information unless you sign a written authorization form.   The content of the form is determined by federal law.  If we initiate the process and ask you to sign an authorization form, you do not have to sign it.  If you do not sign, we can not use or disclose information.  If you do, you may revoke the authorization if it has not been acted on.  Revocations must be in writing.

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 you request in writing, we will honor the restrictions you request
•    Ask us to communicate with you in confidence, such as by phoning you at a phone number other than the home number or by mailing health information to another address. 
•    Ask us to see or to obtain photocopies of your health information.  By law, there are a few limited situations in which we can refuse to permit access.  Copies will be provided with in 30 days of the request.
•    Ask us to amend your health information if you feel that it is incorrect or incomplete.  If we agree, we will amend the information with 60 days of the request.
•    Get a list of disclosures we have made of your health  information within the past six years for a shorter period.  By law, the list will not include disclosures for purposes of treatment, payment or health operations, disclosures with your authorization, incidental disclosures, disclosures required by law and some other limited disclosures.  You are entitled to one such list per year without charge.  If you want more frequent lists, you will have to pay for them in advance.  We will respond to your request with in 60days, but by law we can request a 30day extension.
•    Get additional paper copies of this Notice of Privacy Practices upon request.  If you would like additional copies, contact the office.

OUR NOTICE OF PRIVACY PRACTICES
    By law, we must abide by the terms of this Notice of Privacy Practices until there is a change.  We reserve the right to change this notice 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 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 and have copies available.
COMPLAINTS
    If you feel that we have not properly respected the privacy of your health information, you are free to issue a complaint either to us or to the U.S. Department of Health and Human Services, Office for Civil Rights. 

FOR MORE INFORMATION
    If you would like more information about our privacy practices, please call or visit the office.  Thank you.