HIPAA Notice of Privacy
Practices Statement
Notice of Information Practices and Privacy Statement as
required by HIPAA 45CFR164.520
For Retina Institute of Texas, PA
3414 Oak Grove Avenue
Dallas, TX 75204
How We Collect
Information About You: Retina Institute of Texas, PA and its employees and
any volunteers collect data through a variety of means including but not
necessarily limited to letters, phone calls, emails, voice mails, and from the
submission of applications that is either required by law, or necessary to
process applications or other requests for assistance through our organization.
What We Do Not Do
With Your Information: Information about your financial situation and
medical conditions and care that you provide to us in writing, via email, on
the phone (including information left on voice mails), contained in or attached
to applications, or directly or indirectly given to us, is held in strictest
confidence.
We do not give out, exchange, barter, rent, sell, lend, or
disseminate any information about applicants or clients who apply for or
actually receive our services that is considered patient confidential, is
restricted by law, or has been specifically restricted by a patient/client in a
signed HIPAA consent form.
How We Do Use Your Information:
Information is only used as is reasonably necessary to process your application
or to provide you with health or counseling services which may require
communication between Retina Institute of Texas, PA and health care providers,
medical product or service providers, pharmacies, insurance companies, and
other providers necessary to: verify your medical information is accurate;
determine the type of medical supplies or any health care services you need
including, but not limited to; or to obtain or purchase any type of medical
supplies, devices, medications, insurance,
If you apply or attempt to apply to receive assistance
through us and provide information with the intent or purpose of fraud or that
results in either an actual crime of fraud for any reason including willful or
un-willful acts of negligence whether intended or not, or in any way
demonstrates or indicates attempted fraud, your non-medical information can be
given to legal authorities including police, investigators, courts, and/or attorneys
or other legal professionals, as well as any other information as permitted by
law.
Information We Do Not
Collect: We do not use cookies on our website to collect data from our site
visitors. We do not collect information about site visitors except for the
purpose of website visitor statistics (http://retinainstitute.com/)
that simply records the number of visitors and no other data.
Limited Right to Use Non-Identifying Personal Information
From Biographies, Letters, Notes, and Other Sources: Any pictures, stories,
letters, biographies, correspondence, or thank you notes sent to us become the
exclusive property of Retina Institute of Texas, PA. We reserve the right to
use non-identifying information about our clients (those who receive services or
goods from or through us) for fund raising and promotional purposes that are
directly related to our mission.
Clients will not be compensated for use of this information
and no identifying information (photos, addresses, phone numbers, contact
information, last names or uniquely identifiable names) will be used without
client’s express advance permission.
You may specifically request that NO information be used
whatsoever for promotional purposes, but you must identify any requested
restrictions in writing. We respect your right to privacy and assure you no
identifying information or photos that you send to us will ever be publicly
used without your direct or indirect consent.
Courtesy Med Tech USA, LLC www.HIPAAaudit.com |