Privacy Notice
NOTE: This Notice of Privacy Practices is provided for educational and informational purposes only. This Notice is not intended as legal advice, and is not provided for adoption or publication by any party. The publication of any such notice may create lagal obligations or liabilities which may vary depending upon the legal status and business operations of different organizations. The form and content of any Notice of Privacy Practices should be determined only upon informed consultation with qualified legal counsel.
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 IS EFFECTIVE 04/14/2003 UNTIL FURTHER NOTICE.
RIGHT TO NOTICE
As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPPA), Tracy Wells,OD can use your protected health information for treatment, payment and health care operations.
YOUR AUTHORIZATION
Most uses and disclosures that do not fall under treatment, payment, healthcare operations will require your written authorization. Upon signing, you may revoke your authorization(in writing) through our practice at any time.
EMERGENCY SITUATIONS
Please contact us at:
4092 Austin Bluffs Pkwy
Colorado Springs, CO 80918
Phone: 719-590-1765
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 IS EFFECTIVE 04/14/2003 UNTIL FURTHER NOTICE.
RIGHT TO NOTICE
As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPPA), Tracy Wells,OD can use your protected health information for treatment, payment and health care operations.
- Treatment- We may use or disclose your health information to a physician or other healthcare provider providing treatment to you.
- Payment- We may use and disclose your health information to obtain payment for services we provide you.
- Health care options- We may use and disclose your health information in connection with our healthcare operations. healthcare operations include quality assessment and improvement activities, reviewing the competency or qualifications of healthcare professionals, evaluating provider performances, conducting training programs, accreditation, certification, licensing or credentialing activities.
YOUR AUTHORIZATION
Most uses and disclosures that do not fall under treatment, payment, healthcare operations will require your written authorization. Upon signing, you may revoke your authorization(in writing) through our practice at any time.
EMERGENCY SITUATIONS
Please contact us at:
4092 Austin Bluffs Pkwy
Colorado Springs, CO 80918
Phone: 719-590-1765