Dean A. Wright, O.D. - Privacy Notice

Privacy Notice

Medical Privacy Act
Dr. Dean A. Wright, O.D. and Dr. Cheryl T. Bloom, O.D.

THIS NOTICE DESCRIBES HOW PROTECTED MEDICAL INFROMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT.

Our office is permitted to make use and disclosures of protected health information of:
a.\tTreatment – i.e. ordering and obtaining off site tests/results, written prescriptions, contact lens and eyeglass order forms, etc.
b.\tPayment – i.e. submitting insurance claims on your behalf for treatment rendered.
c.\tHealth care operations – i.e. internal business planning activities and quality of care evaluations.

Our office is permitted or required, under specific circumstances, to use or disclose protected health information without the individual’s written authorization, including, but not limited to:
a.\tDisclosers required by law.
b.\tDisclosers to avert serious threats to health or safety.
c.\tDisclosers with reference to workers compensations.

Other uses and/or disclosers will be made only with the individual’s written authorization, and the individual may revoke such authorization.

Our office may contact the individual to provide appointment reminders or information about alternative treatments or health-related benefits and services that may be of interest to the individual or patient. We will routinely contact patients via telephone at home and/or work and, unless other wise requested, may leave messages in the appropriate voice mail or answering services regarding appointments, notice of received eyeglasses and/or contact lenses, etc.

The individual has the following rights regarding protected health information:
a.\tThe right to request restrictions on certain uses and disclosers of protected health information. However, our office is not required to agree to a request restriction.
b.\tThe right to receive confidential communications of protected health information, as applicable.
c.\tThe right to inspect and copy protected health information, as provided in the Privacy Regulations.
d.\tThe right to amend protected health information, as provided in the Privacy Regulations.
e.\tThe right to receive an accounting of disclosures of protected health information.
f.\tThe right to obtain a paper copy of the notices from the covered entity upon request. This right extends to an individual who has agreed to receive the notice electronically.

Our office is required by law to maintain the privacy of protected health information and to provide individuals with a notice of its legal duties and price/vary practices with respect to the protected health information. We are required to abide by the terms of the notice currently in effect.

Our office reserves the right to change the terms of this notice. The new notice provisions will be effective for all protected health information that it maintains. We will provide individuals or patients with a revised notice by posting new regulations in our office.

Individuals may complain to our office and to the Secretary of the Department of Health and Human Services, without fear of retaliation by the organization, if they believe their privacy rights have been violated. If you have any complaints, please contact out office at:

9665 Main Street
Fairfax, VA 22031
(703) 978-2020

		Dean A. Wright, O.D.
	Reorder Contacts Home Locations Our Practice Our Services Eye Care Articles	Privacy Notice Medical Privacy Act Dr. Dean A. Wright, O.D. and Dr. Cheryl T. Bloom, O.D. THIS NOTICE DESCRIBES HOW PROTECTED MEDICAL INFROMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT. Our office is permitted to make use and disclosures of protected health information of: a.\tTreatment – i.e. ordering and obtaining off site tests/results, written prescriptions, contact lens and eyeglass order forms, etc. b.\tPayment – i.e. submitting insurance claims on your behalf for treatment rendered. c.\tHealth care operations – i.e. internal business planning activities and quality of care evaluations. Our office is permitted or required, under specific circumstances, to use or disclose protected health information without the individual’s written authorization, including, but not limited to: a.\tDisclosers required by law. b.\tDisclosers to avert serious threats to health or safety. c.\tDisclosers with reference to workers compensations. Other uses and/or disclosers will be made only with the individual’s written authorization, and the individual may revoke such authorization. Our office may contact the individual to provide appointment reminders or information about alternative treatments or health-related benefits and services that may be of interest to the individual or patient. We will routinely contact patients via telephone at home and/or work and, unless other wise requested, may leave messages in the appropriate voice mail or answering services regarding appointments, notice of received eyeglasses and/or contact lenses, etc. The individual has the following rights regarding protected health information: a.\tThe right to request restrictions on certain uses and disclosers of protected health information. However, our office is not required to agree to a request restriction. b.\tThe right to receive confidential communications of protected health information, as applicable. c.\tThe right to inspect and copy protected health information, as provided in the Privacy Regulations. d.\tThe right to amend protected health information, as provided in the Privacy Regulations. e.\tThe right to receive an accounting of disclosures of protected health information. f.\tThe right to obtain a paper copy of the notices from the covered entity upon request. This right extends to an individual who has agreed to receive the notice electronically. Our office is required by law to maintain the privacy of protected health information and to provide individuals with a notice of its legal duties and price/vary practices with respect to the protected health information. We are required to abide by the terms of the notice currently in effect. Our office reserves the right to change the terms of this notice. The new notice provisions will be effective for all protected health information that it maintains. We will provide individuals or patients with a revised notice by posting new regulations in our office. Individuals may complain to our office and to the Secretary of the Department of Health and Human Services, without fear of retaliation by the organization, if they believe their privacy rights have been violated. If you have any complaints, please contact out office at: 9665 Main Street Fairfax, VA 22031 (703) 978-2020