HIPAA Notice of Privacy Practices
Thomas S Hong, O.D., LLC
9650 West Broad Street
Glen Allen, VA 23060
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
Uses and disclosures of your health care information by Thomas Hong, O.D.,LLC (TSH)
Treatment: Your health information may be used by staff members of Thomas S Hong, O.D., LLC or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical condition, and providing treatment. For example, results of procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members. This would include but not be limited to things like sending information about you to a specialist as part of a referral or providing information to another healthcare provider in the case of an emergency.
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Payment: Your health information such as, dates of service, the services provided, and the medical condition being treated may be requested and received by your health plan.
Healthcare and related operations: Your health information may be used as necessary to support the day-to-day activities and operations of TSH. For example, information on the services you received may be used to support budgeting and financial reporting to support activities to evaluate and promote quality or research. This includes things like employee quality review activities, training of office staff.
Legal, governmental and public health: Your health information may be disclosed to law enforcement investigations, and to comply with government mandated reporting. It may also be disclosed to health over sight agencies. It may be used to notify a family member, personal representative, or another person responsible for the patients care, or shared with a correctional institution if a person is or becomes an inmate at an institution. It may also be shared with a governmental authority if TSH believes the patient to be a victim of abuse, neglect, or domestic violence or if TSH believes it is necessary to prevent harm to the patient or to someone else or the public. Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the states public heath department. It may be shared with the Department of Health and Human Services.
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Additional Uses of Information
Appointment reminders: Your health information will be used by our staff to contact you regarding your appointments, test results or other related communications. We may call you by name in the waiting room.
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Information about treatment: Your health information may be used to send you information that you may find useful on the treatment and management of your medical condition.
Other uses and disclosures require your authorization: Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information, you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision to revoke your authorization.
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Individual Rights
You have certain rights under the federal privacy standards. These include:
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The right to request restrictions on the use and disclosure of your protected health information.
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The right to inspect and copy of your protected health information.
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The right to amend or submit corrections to your protected health information.
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The right to receive an accounting of how and to whom your health information has been disclosed.
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The right to receive a printed copy of this notice.
Thomas s. Hong, O.D.,LLC. Duties
We are required by law to maintain the privacy of your protected health information and to provide you with this notice.
We are also required to abide by the privacy policies that are outlined in this notice.
Right to Revise Privacy Practices
As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by chances in federal and state laws and regulations. Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practices will be applied to all protected health information we maintain
Request to Inspect Protected Health Information
You may generally inspect or copy the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. Your request will be reviewed and generally be approved unless there are legal or medical reasons to deny the request.
Complaints
If you would like to submit a comment or complaint about our privacy policies, you can do so by submitting a letter outlining your concerns to: Thomas S. Hong, O.D., 9650 West Broad Street Glen
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Allen, VA 23060.
Effective Date
This notice is effective October 25, 2009.