Mary Reed DaCanal, OD Vision Source Health Privacy Policy Notice

The following notice describes how your medical information may be used and disclosed, and how you can get access to this information. Please review the information carefully.

Your confidential healthcare information may be released to your insurance provider for the purpose of Mary Reed DaCanal OD receiving payment for providing you with needed healthcare services.
Your confidential healthcare information may be released to public or law enforcement officials in the event of an investigation in which you are a victim of abuse, crime or domestic violence.
Your confidential healthcare information may be released to other healthcare providers in the event you need emergency care.
Your confidential healthcare information may be released to a public health organization or federal organization in the event of a communicable disease or to report a defective device or untoward event to a biological product (food or medication).
Your confidential healthcare information may be released to worker’s compensation programs.
Your confidential healthcare information may not be released for any other purpose than that which is identified in this notice.
Your confidential healthcare information may be released only after receiving written authorization from you. You may revoke your permission to release confidential healthcare information at any time.
You may be contacted by Mary Reed DaCanal OD to remind you of any appointments, healthcare treatment options or other health services that may be of interest to you.
You have the right to restrict the use of your confidential healthcare information. However, Mary Reed DaCanal OD may choose to refuse your restriction if it is in conflict of providing you with quality healthcare or in the event of an emergency situation.
You have the right to receive confidential communication about your health status.
You have the right to review and photocopy any/all portions of your healthcare information.
You have the right to make changes to your healthcare information.
You have the right to possess a copy of this privacy notice upon request. This copy can be in the form of an electronic transmission or on paper.
Mary Reed DaCanal OD is required by law to protect the privacy of our patients and will keep confidential any and all patient healthcare information and will provide patients with a list of duties or practices that protect confidential healthcare information.
Mary Reed DaCanal OD is required by law to agree to your request to restrict disclosure of your health information to a health plan if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law and such information pertains solely to a health care item or service for which you have paid in full.
Mary Reed DaCanal OD will abide by the terms of this notice and reserves the right to make changes to this notice and continue to maintain the confidentiality of all healthcare information. Patients will receive a mailed copy of any changes to this notice within 60 days of implementing a change.
You have the right to notify Mary Reed DaCanal OD if you believe your rights to privacy have been violated. If you feel your privacy rights have been violated, please mail your complaint to Mary Reed DaCanal OD. All complaints will be investigated. No personal issue will be raised for filing a complaint with Mary Reed DaCanal OD.
This notice is effective September 15, 2013.

For further information about this privacy notice, please contact: Mary Reed DaCanal OD., 516 Market Street. Johnsonburg, PA 15845.