Notice of Privacy Practices
This notice explains how medical information about you may be used or disclosed, how you can obtain access to it, and the privacy responsibilities of Melamed Eye Care Optometry.
Your Rights
Obtain a copy of your medical record
You may ask to inspect or receive an electronic or paper copy of your medical record and other health information we maintain about you. We generally provide access within the time required by law and may charge a reasonable, legally permitted cost-based fee.
Request a correction
You may ask us to amend health information you believe is inaccurate or incomplete. We may deny a request in circumstances permitted by law, but if we do, we will explain the decision in writing.
Request confidential communications
You may ask us to contact you in a particular way or at a particular address. We will accommodate reasonable requests as required by law.
Ask us to limit certain uses or disclosures
You may ask us not to use or disclose certain health information for treatment, payment, or healthcare operations. We are not always required to agree. If you pay in full out of pocket for a service, you may ask us not to disclose information about that service to your health plan for payment or healthcare operations, and we will honor that request unless disclosure is required by law.
Receive an accounting of certain disclosures
You may ask for a list of certain disclosures of your health information made during the period allowed by law. The accounting does not include every type of disclosure, such as many disclosures made for treatment, payment, or healthcare operations.
Receive a copy of this notice
You may request a paper copy of this notice at any time, even if you previously agreed to receive it electronically.
Choose a personal representative
If a person has legal authority to act for you, such as through a valid healthcare power of attorney or guardianship, that person may exercise your privacy rights after we verify the authority.
File a privacy complaint
You may complain to us if you believe your privacy rights have been violated. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
Your Choices
In certain situations, you may tell us your preference regarding disclosure of information to family members, close friends, or other people involved in your care or payment for your care. If you cannot tell us your preference, we may share information when permitted by law and when we reasonably believe doing so is in your best interest or is necessary to reduce a serious and imminent threat.
We will obtain your written authorization before using or disclosing your health information for purposes that require authorization under HIPAA, including most uses of psychotherapy notes, the sale of protected health information, and certain marketing activities. You may revoke an authorization in writing, subject to actions already taken in reliance on it.
How We May Use and Disclose Your Health Information
Treatment
We may use and share your health information with optometrists, ophthalmologists, physicians, pharmacies, laboratories, and other healthcare professionals involved in your care.
Payment
We may use and disclose information to bill for services, obtain payment, determine benefits, or communicate with health plans and other payers when applicable.
Healthcare operations
We may use and disclose health information to operate the practice, coordinate care, conduct quality review, train staff, perform compliance activities, manage records, and improve our services.
Appointment reminders and care communications
We may contact you about appointments, follow-up care, treatment alternatives, products or services related to your care, and other healthcare communications permitted by law.
Public health and safety
We may disclose health information when permitted or required for activities such as disease prevention, product recalls, reporting adverse events, reporting suspected abuse or neglect, or preventing a serious threat to health or safety.
Health oversight and legal requirements
We may disclose information to health oversight agencies, licensing boards, government authorities, or others when required or permitted by law.
Workers' compensation and law enforcement
We may disclose health information for workers' compensation matters, lawful law-enforcement requests, and certain government functions as permitted by law.
Legal proceedings
We may disclose health information in response to a valid court or administrative order, subpoena, or other lawful process when the applicable legal requirements are satisfied.
Research
We may use or disclose health information for research only when the requirements of applicable privacy law are met.
Decedents, organ donation, and related purposes
When applicable, we may disclose health information to coroners, medical examiners, funeral directors, or organ-procurement organizations as permitted by law.
Substance Use Disorder Records
To the extent we maintain substance use disorder patient records protected by 42 CFR Part 2, those records receive additional federal protections. Such records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a court order and subpoena meeting applicable legal requirements.
Additional California Protections
California law may provide additional confidentiality protections for certain categories of medical information. When California law is more protective than federal law, we follow the applicable California requirements.
Our Responsibilities
- We are required by law to maintain the privacy and security of protected health information.
- We will notify affected individuals as required by law if a breach occurs that compromises the privacy or security of their information.
- We must follow the privacy practices described in the notice currently in effect.
- We will not use or disclose your information for purposes not described in this notice unless you authorize us in writing or another law permits or requires the use or disclosure.
Changes to This Notice
We may change the terms of this notice. A revised notice may apply to health information we already maintain as well as information received in the future. The current notice will be available at our office, upon request, and on our website.
Privacy Contact
Privacy Officer
Melamed Eye Care Optometry
8213 Beverly Blvd
Los Angeles, CA 90048
Phone/Text: (323) 655-6582
Email: [email protected]
To file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, visit HHS.gov or contact HHS at 1-877-696-6775.