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Notice of
Privacy
Practices
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This notice describes how health information about you
may be used and disclosed and how you can get access to this
information. Please review it carefully. The privacy of your health
information is important to us.
Our legal duty
We are required by applicable federal and state law to maintain the
privacy of your health information. We are also required to give you
this Notice about our privacy practices, our legal duties, and your
rights concerning your health information. We must follow the privacy
practices that are described in this Notice while it is in effect. This
Notice takes effect April 14, 2003, and will remain in effective until
we replace it.
We reserve the right to change our privacy practices and the terms of
this Notice at any time, provided such changes are permitted by
applicable law. We reserve the right to make the changes in our privacy
practices and the new terms of our Notice effective for all health
information that we maintain, including health information we created or
received before we made the changes. In the event we make a material
change in our privacy practices, we will change this Notice and provide
it to you.
You may request a copy of our Notice at any time. For more information
about our privacy practices, or for additional copies of this Notice,
please contact us using the information listed at the end of this
Notice.
Use and disclosures of health information
We use and disclose health information about you for treatment, payment,
and healthcare operations. For example:
Treatment: We may use or disclose health information to an optician,
ophthalmologist or other healthcare provider providing treatment to you
for: a) the provision, coordination, or management of health care and
related services by health care providers:
b) consultation between health care providers relating to a patient c)
the referral of a patient for health care from one health care provider
to another or d) recall information.
Payment: We may use and disclose your health information to obtain
payment for services we provide to you. This may include: a) billing and
collection activities and related data processing b) actions by a health
plan or insurer to obtain premiums or to determine or fulfill it
responsibilities for coverage and provision of benefits under it health
plan or insurance agreement, determinations of eligibility or coverage,
adjudication or subrogation of health benefit claims c) medical
necessity and appropriateness of care reviews , utilization review
activities, and d) disclosure to consumer reporting agencies of
information relating to collection of premiums or reimbursement.
Healthcare Operations: We may use and disclose your health information
in connection with our healthcare operations. Healthcare operations
include things such as quality assessment and improvement activities,
reviewing the competence or qualifications of healthcare professionals,
evaluating practitioner and provider performance, conducting training
programs, accreditation, certifications, licensing or credentialing
activities
Your Authorization: In addition to our use of your health information
for information for treatment, payment or healthcare operations, you may
give us written authorization to use your health information or to
disclose it to anyone for any purpose. If you give us an authorization,
you may revoke it in writing at any time. Your revocation will not
affect any use or disclosures permitted by our authorization while it
was in effect unless you give us written authorization, we cannot use or
disclose your health information for any reason except those described
in this Notice.
Marketing Health Products or Services: We will not use your health
information for marketing communications without your prior written
authorization. We may provide you with information regarding products or
services that we offer related to your health care needs. We will never
sell your health information without your prior authorization.
To You, Your Family and Friends: We must disclose your health
information to you, as described in the Patients Rights section of this
Notice. We may disclose your health information to a family member,
friend, or other person to the extent necessary to help with your
healthcare or with payment for your healthcare, but only if you agree
that we may do so or, if you are not able to agree. If it is necessary
in our professional
judgement
Persons Involved in Care: We may use or disclose health information to
notify, or assist in the notification of (including identifying or
location) a family member, your personal representative or another
person responsible for your care, of your location, your general
condition or death. If you are present, then prior to use or disclose of
your health information, we will provide you with an opportunity to
object to such uses or disclosures. In the event of your incapacity
emergency circumstances, we will disclose health information based on a
determination using our professional judgement disclosing only health
information that is directly relevant to the person’s involvement in
your healthcare. We will also use our professional judgement and our
experience with common practice to make a reasonable inferences of your
best interest in allowing a person to pick up filled prescriptions,
medical supplies, x-rays, or other similar forms of health information
Required by Law: We may use or disclose your health information when we
are required to do so by law, including judicial and administrative
proceedings.
Abuse or Neglect: We may disclose your health information to appropriate
authorities if we reasonably believe that you are possible victim of
abuse, neglect, or domestic violence or the possible victim of other
crimes. We may disclose your health information to the extent necessary
to avert a serious threat to health or safety or the health or safety of
others.
National Security: We many disclose to military authorities the health
information of Armed Forces personnel under certain circumstances. We
may disclose to authorized federal officials health information required
for lawful intelligence, counter intelligence, or other national
security activities. We may disclose to correctional institutions or law
enforcement official having lawful custody of protected health
information of
inmate or patient or patient under certain circumstances.
Appointment Reminders and Treatment Alternatives: We may use or disclose
your health information to provide you with appointment reminders (such
as voicemail messages, postcards, or letters) or opinion about treatment
alternatives or other health related benefits and services that may be
of interest to you.
Patient Rights:
Access: You have the right to review or get copies of your health
information, with limited exceptions. You may request that we provide
copies in a format other than photocopies. We will use the format you
request unless we cannot practicably do so. You must make a request in
writing to obtain access to your health information. You many obtain a
form to request access by using the contact information listed at the
end of this Notice. We will charge you a reasonable cost-based fee for
providing your health information in that format. If you prefer, we will
prepare a summary or an explanation of your health information for a
fee. Contact us using the information listed at the end of this Notice
for a full explanation of our fee structure.
Disclosure Accounting: You have the right to receive a list of instances
in which we or our business associates disclosed your health information
for purposes other than treatment, payment, healthcare operations, where
you have provided an authorization and certain other activities, for the
last 6 years, but not before April 14, 2003. If you request this
accounting more than once in a 12 month period, we may charge you a
reasonable, cost based fee for responding to these additional requests.
Restrictions: You have the right to request that we place additional
restrictions on our use or disclosure of your health information. We are
not required to agree to these additional restrictions, but if we do, we
will abide by our agreement
(except in an emergency).
Alternative Communication: You have the right to request that we amend
your health information. Your request must specifiy the alternative
means or location and provide satisfactory explanation how payments will
be handled under alternative means or location you request
Amendment: You have the right to request that we amend your health
information. Your request must be in writing and it must explain why the
information should be amended. We may deny your request under certain
circumstances.
Questions and Complaints
If you want more information about our privacy practices or have
questions or concerns, please contact us. If you are concerned that we
may have violated your privacy rights, or you disagree with a decision
we made about access to your health information or in response to a
request you made to amend or restrict th use or disclosure of your
health information or to have us communicate with you by alternative
means or at alternative locations, you may complain to us using the
contact information listed at the end of this Notice. You also may
submit a written complaint to the US Department of Health and Human
Services. We support your right to the privacy of your health
information. We will not retaliate in any way if you choose to file a
complaint with us or with the US Department of Health and Human
Services.
Contact Person: Don Nakatsuchi, OD
Telephone: 336-0022
Address: 10900 Lakeline Mall Dr. Austin, Tx. 78717 |
Welcome to Nakatsuchi Eyecare. We are actually
located inside Super Target next to
Target
Optical. We do have an Outside Entrance to the
office. So you can enter either through the
front door located below the Super Target sign
or enter from the Optical. Two great
locations to serve you!
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Please Note: Only
Super Targets
have an Optical Department with an Independent
Doctor of Optometry located adjacent to them.
Regular Targets do not have them. Austin has 4
Super Targets. |
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10900 Lakeline Mall Dr.
Austin, Tx. 78613
336-0022
CALL FOR HOURS |
1101 C-Bar Ranch
(FM1431)
Cedar Park, Tx. 78613
528-1919
CALL FOR HOURS |
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