Privacy Notice
This notice describes how the medical information of the patients of Dr. James Blume may be used and disclosed. Also, this notice describes how you as a patient of Dr. Blume can have access to this information.
This notice is effective on 4 Jan 2003
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 (HIPAA), Dr. James Blume, Optometrist, can use your protected health information for Treatment, Payment, and Health Care Operations.
A) Treatment: Dr. Blume may use or disclose your health information to a physician or another healthcare provider who is providing treatment to you.
B) Payment: Dr. Blume may use and disclose your health information to obtain payment for services he and his staff have provided to you.
C) Health Care Operations: Dr. Blume may use and disclose your health information in connection with his health care operations. Health care operations include quality assessment and improvement acitivities, reviewing the competency or qualifications of Dr. Blume, evaluating provider performance, conducting training programs, accreditation, certification, licensing, or credentialing activities.
YOUR AUTHORIZATION
Most uses of disclosures that do not fall under treament, payment, or health care operatons will require your written authorization. Upon signing, you may revoke your authorization (in writing) through Dr. Blume's office at any time.
EMERGENCY SITUATIONS
In the event of your incapacity or an emergency situation, Dr. Blume's office will disclose health information to a family member, or antoher person responsible for your care, using his professional judgement. Dr. Blume will only disclose health information that is directly relevant to the provider's involvement in your health care.
MARKETING
Dr. Blume will not use your health information for marketing communication without your written authorization.
REQUIRED BY LAW
Dr. Blume may use or disclose your health information when he is required to do so by law.
ABUSE AND NEGLECT
Dr. Blume may disclose your health information to appropriate authorities if he reasonably believes that you are a possible victim of abuse, neglect, or domestic violence or the victim of other crimes. Dr. Blume may disclose your information to the extent necessary to avert a serious threat to you or another person's health or safety.
NATIONAL SECURITY
Dr. Blume may disclose the health information of Armed Forces personnel to military authorities under certain circumstances. Dr. Blume may disclose health information to authorized federal officials required for lawful intelligence, counter-intelligence, and other national security activities. Dr. Blume may disclose health information of inmates or patients to the appropriate authorities under cerain circimstances.
APPOINTMENT REMINDERS
Dr. Blume may use or disclose your health information to provide you with appointment reminders via telephone, E-Mail, letter, postcard.
YOUR RIGHTS AS A PATIENT
You have the right to restrict the disclosure of your protected health information (in writing). The request for restriction may be denied if the information is required for Treatment, Payment, or Health Care Operations. You are entitled to receive, upon written request to Dr. Blume, a record of any subsequent disclosures Dr. Blume may make of your protected health information as allowed by law. You are also entitled to see and copy, in person, or to obtain a copy by mail, of the protected health information that Dr. Blume has regarding you in his possession. Once you have received this health information, you also have the right to request that Dr. Blume correct, amend, or deleted the protected health information. Dr. Blume will rspond to each request as required by law. All such requests should be in writing, include a description of the information requested and mailed to: Dr. James Blume, 5917 Stoney Creek Drive, Fort Wayne, IN 46825. You have the right to a paper copy of this notice of privacy practices.
LEGAL REQUIREMENTS
Dr. James Blume, Optometrist, is required by law to maintain the privacy of your protected health information. Dr. Blume is required to abide by the terms of this notice as it is currently stated, and reserves the right to change this notice. The policies in any new notice will not be in effect until they are posted to this site, or are available within Dr. Blume's office.
COMPLAINTS
IF you have a complaint with the way that your protected health information was handled, you may submit a complaint in writing to Dr. Blume's office.
CONTACT INFORMATION
For more information regarding Dr. James Blume, Optometrist, privacy policies, contact Dr. Blume at: Dr. James Blume
5917 Stoney Creek Drive
Fort Wayne, IN 46825
260-482-8435
This notice is effective on 4 Jan 2003
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 (HIPAA), Dr. James Blume, Optometrist, can use your protected health information for Treatment, Payment, and Health Care Operations.
A) Treatment: Dr. Blume may use or disclose your health information to a physician or another healthcare provider who is providing treatment to you.
B) Payment: Dr. Blume may use and disclose your health information to obtain payment for services he and his staff have provided to you.
C) Health Care Operations: Dr. Blume may use and disclose your health information in connection with his health care operations. Health care operations include quality assessment and improvement acitivities, reviewing the competency or qualifications of Dr. Blume, evaluating provider performance, conducting training programs, accreditation, certification, licensing, or credentialing activities.
YOUR AUTHORIZATION
Most uses of disclosures that do not fall under treament, payment, or health care operatons will require your written authorization. Upon signing, you may revoke your authorization (in writing) through Dr. Blume's office at any time.
EMERGENCY SITUATIONS
In the event of your incapacity or an emergency situation, Dr. Blume's office will disclose health information to a family member, or antoher person responsible for your care, using his professional judgement. Dr. Blume will only disclose health information that is directly relevant to the provider's involvement in your health care.
MARKETING
Dr. Blume will not use your health information for marketing communication without your written authorization.
REQUIRED BY LAW
Dr. Blume may use or disclose your health information when he is required to do so by law.
ABUSE AND NEGLECT
Dr. Blume may disclose your health information to appropriate authorities if he reasonably believes that you are a possible victim of abuse, neglect, or domestic violence or the victim of other crimes. Dr. Blume may disclose your information to the extent necessary to avert a serious threat to you or another person's health or safety.
NATIONAL SECURITY
Dr. Blume may disclose the health information of Armed Forces personnel to military authorities under certain circumstances. Dr. Blume may disclose health information to authorized federal officials required for lawful intelligence, counter-intelligence, and other national security activities. Dr. Blume may disclose health information of inmates or patients to the appropriate authorities under cerain circimstances.
APPOINTMENT REMINDERS
Dr. Blume may use or disclose your health information to provide you with appointment reminders via telephone, E-Mail, letter, postcard.
YOUR RIGHTS AS A PATIENT
You have the right to restrict the disclosure of your protected health information (in writing). The request for restriction may be denied if the information is required for Treatment, Payment, or Health Care Operations. You are entitled to receive, upon written request to Dr. Blume, a record of any subsequent disclosures Dr. Blume may make of your protected health information as allowed by law. You are also entitled to see and copy, in person, or to obtain a copy by mail, of the protected health information that Dr. Blume has regarding you in his possession. Once you have received this health information, you also have the right to request that Dr. Blume correct, amend, or deleted the protected health information. Dr. Blume will rspond to each request as required by law. All such requests should be in writing, include a description of the information requested and mailed to: Dr. James Blume, 5917 Stoney Creek Drive, Fort Wayne, IN 46825. You have the right to a paper copy of this notice of privacy practices.
LEGAL REQUIREMENTS
Dr. James Blume, Optometrist, is required by law to maintain the privacy of your protected health information. Dr. Blume is required to abide by the terms of this notice as it is currently stated, and reserves the right to change this notice. The policies in any new notice will not be in effect until they are posted to this site, or are available within Dr. Blume's office.
COMPLAINTS
IF you have a complaint with the way that your protected health information was handled, you may submit a complaint in writing to Dr. Blume's office.
CONTACT INFORMATION
For more information regarding Dr. James Blume, Optometrist, privacy policies, contact Dr. Blume at: Dr. James Blume
5917 Stoney Creek Drive
Fort Wayne, IN 46825
260-482-8435