Privacy Notice

NOTICE OF PRIVACY PRACTICES
CHARLES R. MEAD, O.D.
Jessica L. Schara, O.D.
1502 WOODLANE DRIVE
WOODBURY, MN 55125
651-735-9550

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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.
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TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS
The most common reason why we use or disclose your health information is for treatment, payment or health care operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you; examining your eyes; prescribing glasses, contact lenses, or eye medications and faxing them to be filled; giving your health information to another professional who requests it; referring you to another doctor or clinic for eye care; or getting copies of your health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about your health or vision care plans, or other sources of payment; preparing and sending bills or claims; and collecting unpaid amounts. "Health Care Operations" mean those administrative and managerial functions that we have to do in order to run our office. Examples of how we use or disclose your health care information for health care operations are: financial or billing audits; participation in managed care plans; defense of legal matters.

We routinely use your health information inside our office for these purposes without any special permission. If we need to disclose your health information outside of our office for reasons other than what is listed above, we will ask you for special written permission.

USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION
In some limited situations, the law allows or requires us to use or disclose your health information without your permission. Such uses or disclosures may include but are not limited to: law enforcement; Public health research and reporting; legal proceedings.
Health information may also be disclosed to "business associates" who perform health care operations for us and who commit to respect the privacy of your health information.
Unless you object, we will also share relevant information about your care with your family or friends who are helping you with eye care.

APPOINTMENT REMINDERS
We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We may also call or write to notify you of other treatments or services available at our office that might help you.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
The law gives you many rights regarding your health information. You can:
-- ask us to restrict our uses and disclosures for purposes of treatment, payment or
health care operations. To ask for a restriction, send a written request to our office at the
address above.
-- ask us to communicate with you in a confidential way, such as by phoning you at work
rather than at home, or mailing health information to a different address. If you want
to ask for confidential communications, send a written request to our office at the
address listed above.
-- ask to see or to get photocopies of your health information. By law, there are a few
limited situations in which we can refuse to permit access or copying. You will be able
to review or have copies of your health information within 30 days of asking us. If you
want copies, send a written request to our office at the address listed above.
-- ask us to amend your health information if you think that it is incorrect or incomplete.
Send a written request to our office at the address listed above.
-- get additional paper copies of this Notice of Privacy Practices upon request.

OUR NOTICE OF PRIVACY PRACTICES
By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information that we already have as well as such information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our office, have copies available in our office.

COMPLAINTS
If you think that we have not properly respected the privacy of your health information, you are free to complain to us or the U.S. Department of Health and Human Services or Office for Civil Rights. If you want to complain to us, send a written complaint to our office at the address listed above to the attention of the Privacy Officer. If you prefer, you can discuss your complaint in person or by phone by asking for the Privacy Officer.