Notice of privacy practices

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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. The privacy of your medical information is important to  us.

Overview

The law requires us to keep your  protected health information ("PHI") private in accordance with this  Notice of Privacy Practices ("Notice"), as long as this Notice remains  in effect. We are also required to provide you with a paper copy of this  Notice, which contains our privacy practices, our legal duties, and  your rights concerning your PHI.

From time to time, we may revise  our privacy practices and the terms of our Notice at any time, as  permitted or required by applicable law. Such revisions to our privacy  practices and our Notice may be retroactive. Our Notice will be updated  and made available to our patients prior to any significant revisions of  our privacy practices and policies.

Our Privacy Practices

Use and Disclosure  - We may use or disclose your PHI for treatment, payment, or health  care operations. For your convenience, we have provided the following  examples of such potential uses or disclosures:

Treatment -  Your PHI may be used by or disclosed to any physicians or other health  care providers involved with the medical services provided to you.

Payment - Your PHI may be used or disclosed in order to collect payment for the medical services provided to you.

Health Care Operations  - Your PHI may be used or disclosed as part of our internal health care  operations. Such health care operations may include, among other  things, quality of care audits of our staff and affiliates, conducting  training programs, accreditation, certification, licensing, or  credentialing activities.

Authorizations - We will not use  or disclose your medical information for any reason except those  described in this Notice, unless you provide us with a written  authorization to do so. We may request such an authorization to use or  disclose your PHI for any purpose, but you are not required to give us  such authorization as a condition of your treatment. Any written  authorization from you may be revoked by you in writing at any time, but  such revocation will not affect any prior authorized uses or  disclosures.

Patient Access - We will provide you with  access to your PHI, as described below in the Individual Rights section  of this Notice. With your permission, or in some emergencies, we may  disclose your PHI to your family members, friends, or other people to  aid in your treatment or the collection of payment. A disclosure of your  PHI may also be made if we determine it is reasonably necessary or in  your best interests for such purposes as allowing a person acting on  your behalf to receive filled prescriptions, medical supplies, X rays,  etc.

Locating Responsible Parties - Your PHI may be  disclosed in order to locate, identify or notify a family member, your  personal representative, or other person responsible for your care. If  we determine in our reasonable professional judgment that you are  capable of doing so, you will be given the opportunity to consent to or  to prohibit or restrict the extent or recipients of such disclosure. If  we determine that you are unable to provide such consent, we will limit  the PHI disclosed to the minimum necessary.

Disasters - We  may use or disclose your PHI to any public or private entity authorized  by law or by its charter to assist in disaster relief efforts.

Required by Law  - We may use or disclose your medical information when we are required  to do so by law. For example, your PHI may be released when required by  privacy laws, workers' compensation or similar laws, public health laws,  court or administrative orders, subpoenas, certain discovery requests,  or other laws, regulations or legal processes. Under certain  circumstances, we may make limited disclosures of PHI directly to law  enforcement officials or correctional institutions regarding an inmate,  lawful detainee, suspect, fugitive, material witness, missing person, or  a victim or suspected victim of abuse, neglect, domestic violence or  other crimes. We may disclose your PHI to the extent reasonably  necessary to avert a serious threat to your health or safety or the  health or safety of others. We may disclose your PHI when necessary to  assist law enforcement officials to capture a third party who has  admitted to a crime against you or who has escaped from lawful custody.

Deceased Persons  - After your death, we may disclose your PHI to a coroner, medical  examiner, funeral director, or organ procurement organization in limited  circumstances.

Research - Your PHI may also be used or  disclosed for research purposes only in those limited circumstances not  requiring your written authorization, such as those which have been  approved by an institutional review board that has established  procedures for ensuring the privacy of your PHI.

Military and National Security  - We may disclose to military authorities the medical information of  Armed Forces personnel under certain circumstances. When required by  law, we may disclose your PHI for intelligence, counterintelligence, and  other national security activities.

Your Individual Rights

Access and Copies  - In most cases, you have the right to review or to purchase copies of  your PHI by requesting access or copies in writing to our Privacy  Officer. Please contact our Privacy Officer regarding our copying fees.

Disclosure Accounting  - You have the right to receive an accounting of the instances, if any,  in which your PHI was disclosed for purposes other than those described  in the following sections above: Use and Disclosures, Facility  Directories, Patient Access, and Locating Responsible Parties. For each  12-month period, you have the right to receive one free copy of an  accounting certain details surrounding such disclosures that occurred  after April 13, 2003. If you request a disclosure accounting more than  once in a 12-month period, we will charge you a reasonable, cost-based  fee for each additional request. Please contact our Privacy Officer  regarding these fees.

Additional Restrictions - You have  the right to request that we place additional restrictions on our use or  disclosure of your PHI, but we are not required to honor such a  request. We will be bound by such restrictions only if we agree to do so  in writing signed by our Privacy Officer.

Alternate Communications  - You have the right to request that we communicate with you about your  PHI by alternative means or in alternative locations. We will  accommodate any reasonable request if it specifies in writing the  alternative means or location, and provides a satisfactory explanation  of how future payments will be handled.

Amendments to PHI -  You have the right to request that we amend your PHI. Any such request  must be in writing and contain a detailed explanation for the requested  amendment. Under certain circumstances, we may deny your request but  will provide you a written explanation of the denial. You have the right  to send us a statement of disagreement to which we may prepare a  rebuttal, a copy of which will be provided to you at no cost. Please  contact our Privacy Officer with any further questions about amending  your medical record.

Complaints

If you believe we  have violated your privacy rights, you may complain to us or to the  Secretary of the U.S. Department of Health and Human Services. You may  file a complaint with us by notifying our Privacy Officer. We support  your right to protect the privacy of your medical information. We will  not retaliate in any way if you choose to file a complaint with us or  with the U.S. Department of Health and Human Services.

If there are any questions or concerns about our privacy policies, feel free to contact us:

Crane Optical
236 W. Nine Mile Road
Ferndale, MI 48220
248-545-5600
service@craneoptical.com

Crane Optical - 236 W. 9 Mile Road, Ferndale, MI 48220 - Phone: (248) 545-5600