HIPAA Policy

Wilkinson Eye Center
Notice of Privacy Practices for Protected Health Information

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.

It is the policy of the Wilkinson Eye Center to disclose your Protected Health Information (Medical Record) that includes pertinent procedures and diagnoses to the following

Your health insurance plan for payment of claims for services rendered at Wilkinson Eye Center by our physicians
To your primary care physician or referring physician for treatment
In the case of an emergency for treatment purposes
For teaching and case studies after it has been de-identified, in other words, not personally identifiable by your name, social security number or date of birth.
As required by law, for example, a subpoena requesting your medical record.

It is the practice of the Wilkinson Eye Center to make reminder calls to patients that give the date of your appointment, the reason you are being seen and that your glasses or contact lenses are ready for pickup. This information may be left on your voice mail or answering machine.

You may be contacted by telephone or email with test results or follow up treatment options. Normal test results may be left on your answering machine or voice mail. We make every effort to protect your privacy. If you do not wish to be contacted in this manner please indicate this to our staff.

The Wilkinson Eye Center will not use or disclose your Protected Health Information or Medical Record in any way other than those listed in this Notice without your signed authorization. This authorization may be revoked by written notification, except to the extent that Wilkinson Eye Center has taken action in reliance thereon. In addition you have the following rights

The right to request restrictions on certain Uses and Disclosures
The right to receive confidential communications
The right to inspect and copy your Protected Health Information (Medical Record)
The right to amend your Protected Health Information
The right to an accounting of disclosures of your Protected Health Information.
The right to request a paper copy of any electronic Notice.

The Wilkinson Eye Center is required by law to maintain the privacy of your Medical Record and to abide by this Notice effective May 1, 2002. We reserve the right to change this Notice of our Privacy Practices and will issue a revised Notice if it changes. This revised Notice would be available to all patients at their scheduled appointment times or upon request.

You are entitled to file a complaint with our Privacy Officer, Lisa Coyle, should you feel that your rights under the HIPAA regulations have been violated. All complaints will be investigated and no retaliation would be taken in any manner for lodging a complaint. A written description of the alleged violation should be sent to Wilkinson Eye Center, Attn: Lisa Coyle, 44555 Woodward Avenue, Suite 203, Pontiac, MI 48341.