We often have patients that have both vision and medical insurance. They are very different in terms of the services they cover and it’s important for our patients to understand those differences. Vision coverage is mainly designed to determine a prescription for glasses, help pay for eyeglasses or contact lenses, and to evaluate the health of the eyes. It is not designed or equipped to deal with medical conditions, diagnoses, and/or treatment plans.
When a medical diagnosis or condition is present (such as high blood pressure, diabetes or an eye disease such as infections, dry eyes, allergy, or cataracts, to name just a few) it maybe necessary to file the claim for your visit with your major medical carrier. The co-pays/deductibles for that insurance will apply. Vision insurance does not cover medical eye problems, just as medical insurance does not cover routine vision problems. Our office does not make these rules; they are defined by the insurance carriers themselves.
There is no way to know prior to the examination which type of insurance will apply or with whom our office will be able to file a claim for you. In the event that we do not take your major medical/vision insurance, we will provide you with an itemized receipt so that you may file with your carrier for reimbursement. If you have any questions, please let us know.
Our schedule is structured to ensure that you receive the highest level of care possible. ‘We understand that your time is valuable also and we have set this time aside especially for you.
We do require 24 hours notice to change your appointment. If we don’t receive 24 hours notice you can be charged a $50.00 fee to reserve your next appointment.
contracting or spreading a disease or condition; and the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law. Health Oversight Activities. We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activites include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. Lawsuits.
If you ate involved in a lawsuit or a dispute, we may disclose Health Information in response to a court or administrative order. We also may disclose Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested. Law Enforcement. We may release Health Information if asked by a law enforcement official if the information is:
(1) in response to a court order, subpoena, warrant, summons or similar process; (2) limited information to identify or locate a suspect, fugitive, material witness, or missing person; (3) about the victim of 2 crime even if, under certain very limited circumstances, we are unable to obtain the person's agreement; (4) about a death we believe may be the result of criminal conduct; (5) about criminal conduct on out premises; and (6) in an emergency to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors. We may release Health Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We also may release Health Information to funeral directors as necessary for their duties. National Security and Intelligence Activities, We may release Health Information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law. Protective Services for the President and Others.
We may disclose Health Information to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or to conduct special investigations. Zamates or Individuals is Castody. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release Health Information to the correctional institution or law enforcement official. This release would be if necessary:
(1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) the safety and security of the correctional institution. YOUR RIGHTS: You have the following rights regarding Health Information we have about you: Right to Taspect and Copy. You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records, other than psychotherapy notes. To inspect and copy this Health Information, you must make your request, in writing, to our office. Right to Amend.
If you fee! that Health Information we have is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, you must make your fequest, in writing, to our office. Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment and health care operations or for which you provided written authorization, To request an accounting of disclosures, you must make your request, in writing, to our office. Right to Request Restrictions.
You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or healthcare operations. You also have the right to request a limit on the Health Information we disclose to someone involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about a particular diagnosis or treatment with your spouse. To request a restriction, you must make your request, in writing, to our office. We are got required to agree to all such requests.
If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment. Right to Request Confidential Cammuasaication. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by mail or at work. To request confidential communication, you must make your request, in writing, to our office. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests. Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice.
You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our website, www.northlandeyecare.com To obtain a paper copy of this notice please request it in writing. Right to Electronic Records. You have the right to receive a copy of your electronic health records in electronic form. Right to Breach Notification. You have the right to be notified if there is a Breach of privacy such that your Health Information is disclosed or used improperly or in an unsecured way.
CHANGES TO THIS NOTICE: We reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a copy of our current notice at out office. The notice will contain the effective date on the first page, in the top right-hand corner.
COMPLAINTS: If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Ilealth and Human Services. All complaints must be made in writing. You will not be penalized for filing a complaint.
I acknowledge having been provided this Notice.
