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Health Insurance Portability and Accountability Act (HIPAA)

This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.

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.

Uses and Disclosures of Protected Health Information (PHI)

Your PHI may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you. Your PHI may also be used and disclosed to pay your health care bills and to support the operation of the physician’s practice.

Following are examples of the types of uses and disclosures of your PHI that we may carry out. They are not meant to be exhaustive but to describe some of the practices of our office.


We will use and disclose your PHI to provide, coordinate, or manage your health care and any related services. We may disclose medical information about you to doctors, nurses, health care technicians, or other facility personnel who are involved in taking care of you at our facility. When we provide treatment, we may request that your primary care physician or medical specialist share your medical information with us. Also, we may provide your primary care or referring physician information about your particular condition so that he or she can appropriately treat you for other conditions, if any. We also may disclose medical information about you to people outside the facility who may be involved in your medical care after you leave the facility, such as family members or other health care professionals we use to provide services that are part of your care.

If applicable, we may provide PHI to a nursing home or home health agency that will need to be involved in your care. If your care requires the involvement of another specialist, we may share some or all of your medical information with that physician to facilitate delivery of care. Other disclosures of your medical information for treatment may include, but are not limited to, calling a medical prescription to a pharmacist, glasses or contact lens prescription to an optician, sending a specimen to a pathologist, or scheduling surgery with a hospital.


Your PHl will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you. Examples may be making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity and undertaking utilization review activities. We may need to obtain approval for surgery, when it requires that relevant PHI be disclosed to the health plan to obtain approval for the procedure.

Healthcare Operations

We may use or disclose your PHI, as needed, in order to support the business activities of The Center For Sight, P.A. These activities include, but are not limited to, quality assessment/improvement activities, employee review activities, licensing, marketing and fundraising activities, and conducting or arranging for other business activities.

For Example, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may also call you by name in the waiting room when your physician is ready to see you. We may use or disclose your PHI, as necessary, to contact you by telephone or mail to remind you of your appointment, or to report results of testing that may have been done by our office, or for a follow-up phone call to check on your condition after a surgical procedure.

We will share your PHI with third party “business associates” that perform various activities (e.g., billing, transcription, answering service, practice management consultant, or a lab that is involved in making your prescription lenses for glasses) for the practice. Whenever an arrangement between our office and a business associate involves the use of your PHI, we will have a written contract that contains terms that will protect the privacy of your PHI.

We may use or disclose your PHI, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also use and disclose your PHI for other marketing activities. For example, your name and address may be used to send you a newsletter about our practice and services we offer. We may also send you information about products or services that we believe may be beneficial to you. We may send you a card for bereavement, congratulations, or holiday.

You may contact our Privacy Contact, listed on the final page of this notice, to request that these materials not be sent to you. The Center For Sight will continue to obtain consent, treatment, and/or release of protected health information for minors per guidelines established by the Texas Family Code.

Other Permitted and Required Uses and Disclosures That May Be Made Unless You Object and Provide Us With Written Notice

We may use and disclose your PHI in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your PHI. If you are not present or able to agree or object to the use or disclosure of the PHI, then your physician may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only PHI that is relevant to your health care will be disclosed.

Individuals Involved in Your Care or Payment for Your Care

Unless you tell us otherwise, we may release medical information about you to a friend or family member who is involved in your medical care. We may give information to someone who helps pay for your care. We may also tell your family or friends your condition and that you are in the facility. In addition, we may disclose medical information about you to an entity assisting us in a disaster relief effort so that your family can be notified about your condition, status, and location.


We may use or disclose your PHI in an emergency treatment situation. If this happens, we will try to obtain your acknowledgement to use or disclose your PHI to treat you as soon as reasonably possible after the delivery of treatment.

Other Permitted and Required Uses and Disclosures That May Be Made Without Your Consent, Authorization, or Opportunity to Object

Required By Law

We may release your medical information where the disclosure is required by law.

Public Health, Abuse or Neglect, and Health Oversight

We may disclose your medical information for public health activities. Public health activities are mandated by federal, state, or local government for the collection of information about disease, vital statistics (like births and death), or injury by a public health authority. We may disclose medical information, if authorized by law, to a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition. We may disclose your medical information to report reactions to medications, problems with products, or to notify people of recalls of products they may be using.

We may also disclose PHI to a public agency authorized to receive reports of child abuse or neglect. Texas law requires physicians to report child abuse or neglect. Regulations also permit the disclosure of information to report abuse or neglect of elders or the disabled. We may disclose your PHI to a health oversight agency for those activities authorized by law. Examples of these activities are audits, investigations, licensure applications and inspections, which are all government activities undertaken to monitor the health care delivery system and compliance with other laws, such as civil rights laws.

Legal Proceedings and Law Enforcement

We may disclose your PHI in the course of judicial or administrative proceedings in response to an order of the court (or the administrative decision maker) or other appropriate legal process. Certain requirements must be made before the information is disclosed.

If asked by a law enforcement official, we may disclose your PHI under limited circumstances provided that the information: 1. Is released pursuant to legal process, such as a warrant or subpoena, 2. Pertains to a victim of a crime, and you are incapacitated, 3. Pertains to a person who has died under circumstances that may be related to criminal conduct, 4. Is about a victim of crime, and we are unable to obtain the person’s agreement, 5. Is released because of a crime that has occurred on these premises, or 6. Is released to locate a fugitive, missing person, or suspect.

We may also release information if we believe that disclosure is necessary to prevent or lessen an imminent threat to the health or safety of a person.

Worker’s Compensation

We may disclose your medical information as required by the Texas Worker’s Compensation Law.


If you are an inmate or under custody of law enforcement, we may release your medical information to the correctional institution or law enforcement official. This release is permitted to allow the institution to provide you with medical care, to protect your health or the health and safety of others, or for the safety and security of the institution.

Military Activity and National Security

We may disclose your medical information for specialized governmental functions such as separation or discharge from military service, requests as necessary by appropriate military command officers (if you are in the military), authorized national security and intelligence activities, as well as authorized activities for the provision of protected services for the President of the United States, other authorized government officials, or foreign heads of state.

Research, Organ Donation, Coroners, Medical Examiners, and Funeral Directors

When a research project and its privacy protections have been approved by an Institutional Review Board or Privacy Board, we may release medical information to researchers for research purposes. We may release medical information to organ procurement organizations for the purpose of facilitating organ, eye, or tissue donation if you are a donor. Also, we may release your medical information to a coroner or medical examiner to identify a deceased or a cause of death. Further, we may release your medical information to a funeral director where such a disclosure is necessary for the director to carry out his duties.

We can refuse to provide some of the information you ask to inspect or ask to be copied if the information:

  • Includes the identity of a person who provided information, if it was obtained under a promise of confidentiality,
  • Is subject to the Clinical Laboratory Improvements Amendments of 1988,
  • Has been compiled in anticipation of litigation, or
  • Included psychotherapy notes.

We can refuse to provide access to or copies of some information for other reasons, provided that we provide a review of our decision upon your request. Another licensed health care provider who was not involved in the prior decision to deny access will make any such review.

Texas law requires that we provide copies or a narrative within 15 days of your request. We will inform you of when the records are ready or if we believe access should be limited. If we deny access, we will inform you in writing.

HIPAA permits us to charge a reasonable cost-based fee. Texas State Board of Medical Examiners (TSBME) provides regulation fees for copies of medical records.

Amendment of Medical Information

You may request an amendment of your medical information in the designated record set. Any such request must be made in writing to the privacy officer. We will respond within 60 days of your request. We may refuse to allow an amendment if the information:

  • Was not created by this practice or the physicians here in this practice,
  • Is not part of the Designated Record Set,
  • Is not available for inspection because of an appropriate denial, or
  • If the information is accurate and complete.

Copy of Notice

You have the right to obtain a paper copy of this notice from us, upon request.

Accounting of Certain Disclosures

The HIPAA privacy regulations permit you to request, and us to provide, an accounting of disclosures made after April 14, 2003 that are other than for treatment, payment, health care operations, or made via an authorization signed by you or your representative. Please submit any request for an accounting to the person listed below.


If you are concerned that your privacy rights have been violated, you may contact the Privacy Officer at the conclusion of this privacy notice. You may also send a written complaint to the United States Department of Health and Human Services. We will not retaliate against you for filing a complaint with the government or us.

Our Promise to You

We are required by law and regulation to protect the privacy of your medical information, to provide you with this notice of our privacy practices with respect to PHI, and to abide by the terms of the Notice of Privacy Practices in effect.

Questions and Contact Person for Requests

If you have any questions or want to make a request pursuant to the rights described in this notice, please contact:

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