We understand that your health information is personal to you, and we are committed to protecting the information about you. This Notice of Privacy Practices describes how we will use and disclose protected information and data that we receive or create related to your health care.

Our Duties
We are required by law to maintain the privacy of your health information, and to give you this Notice describing our legal duties and privacy practices. We are also required to follow the terms of the Notice currently in effect.

How We May Use And Disclose Health Information About You
We will not use or disclose your health information without your authorization, except in the following situations:

Treatment: We will use and disclose your health information while providing, coordinating or managing your health care. For example, information obtained by a technician, physician, or other member of our staff will be recorded in your record and used to determine the course of treatment that should work best for you. We may also provide (including via fax) other healthcare providers with your information to assist him or her in treating you.

Payment: We will use and disclose your medical information to obtain reimbursement for services, confirm coverage, billing or collection activities and utilization review. For example, we may send a bill to you or your health plan or disclose information about you to your health plan so we may determine your eligibility for payment for certain services.

Health Care Operations: We will use and disclose your health information to deal with certain administrative aspects of your health care, and to manage our business more efficiently. For example, members of our office may use information, in your health record to assess the quality of care and outcomes in your case in an effort to improve the quality and effectiveness of the healthcare and services we provide.

Business Associates: There are some services provided in our office through contracts with business associates. We may disclose your health information, to our business associates so they can perform the job we’ve asked them to do. However, we require the business associates to take precautions to protect your health information.

Directory: Unless you notify us that you object, we will use your name, location in the office, general condition, for directory purposes. This information may be provided to people who ask for you by name.

Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or other person responsible for your care of your location and general condition.

Communication: We may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care.

Research: Consistent with applicable law we may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events, product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability, including child abuse and neglect.

Victims of Abuse, Neglect or Domestic Violence: We may disclose your health information to appropriate governmental agencies, such as adult protective or social services agencies, if we reasonably believe you are a victim of abuse, neglect, or domestic violence.

Health Oversight: In order to oversee the health care system, government benefits programs, entities subject to governmental regulation and civil rights laws for which health information is necessary to determine compliance, we may disclose your health information for oversight activities authorized by law, such as audits and civil, administrative, or criminal investigations.

Court Proceeding: We may disclose your health information in response to requests made during judicial and administrative proceedings, such as court orders or subpoenas.

Law Enforcement: Under certain circumstances, we may disclose your health information to law enforcement officials.

Workers Compensation: We may disclose health information, when authorized and necessary to comply with laws relating to workers compensation or other similar programs.

Other Uses; We may also use and disclose your personal health information for the following purposes:
• To contact you by mail or phone (includes leaving messages on your answering machine or calling your work) to remind you of an appointment for treatment;
• To describe or recommend treatment alternatives to you;
• To contact you or your representative by phone or mail regarding billing or account balance issues;
• To furnish information about health-related benefits and services that may be of interest to you;
• We may also create and distribute de-identified health information by removing all references to individually identifiable information;
• To get patient’s fundus photos developed by an outside vendor;
• During your visit to our office we may disclose diagnosis and treatment information to family members, relatives, close personal friends or any other person you identify that is involved in your care.

Prohibition on Other Uses or Disclosures
We may not make any other use or disclosure of your personal health information without your written authorization. Once given, you may revoke the authorization by writing to the contact person listed below. Understandably, we are unable to take back any disclosure we have already made with your permission.

Individual Rights
You have many rights concerning the confidentiality of your health information. You have the right:

• To request restrictions on the health information we may use and disclose for treatment, payment, and health care operations. We are not required to agree to these requests. To request restrictions, please send a written request to the address below,
• To receive confidential communications of health information about you in a certain manner or at a certain location. For instance, you may request that we only contact you at work or by mail. To make such a request, you must write to us at the address below, and tell us how or where you wish to be contacted.
• To inspect or copy your health information. You must submit your request in writing to the address below. If you request a copy of your health information we may charge you a fee for the cost of copying, mailing or other supplies. In certain circumstances we may deny your request to inspect or copy your health information. If you are denied access to your health information, you may request that the denial be reviewed.
• To amend health information. If you feel that the health information we have about you is incorrect or incomplete, you may ask us to amend the information. To request an amendment, you must write to us at the address below. You must also give us a reason to support your request. We may deny your request to amend your health information if it is not in writing or does not provide a reason to support your request. We may also deny your request if:

• The information was not created by us, unless the person that created the information, is no longer available to make the amendment,
• The information is not part of the health information kept by or for us,
• Is not part of the information you would be permitted to inspect or copy, or
• Is accurate and complete

• To receive an accounting of disclosures of your health information. You must submit a request in writing to the address below. Not all health information is subject to this request. Your request must state a time period, no longer than 6 years and may not include dates before April 14, 2003. Your request must state how you would like to receive the report. The first accounting you request within a 12-month period is free. For additional accountings, we may charge you the cost of providing the accounting. We will notify you of this cost and you may choose to withdraw or modify your request before charges are incurred.
• To receive a paper copy of this Notice upon request. You must submit a request for a paper notice in writing to the address below.

All requests to restrict use of your health information for treatment, payment, and health care operations, to inspect and copy health information, to amend your health information, or to receive an accounting of disclosures of health information must be made in writing to the contact person listed below.

Complaints
If you believe that your privacy rights have been violated, a complaint may be made to our Privacy Officer at (443) 394-6400 or at the address listed below. You may also submit a complaint or request additional information at The U.S. Department of Health and Human Services, Office of Civil Rights, 200 Independence Avenue, S.W. Washington, DC 20201 (877) 696-6775. We will not retaliate against you for filing a complaint.

Contact Person
Our contact person for all questions, requests or for further information related to the privacy of your health information is:

Kerry Cole
McDonogh Crossroads
25 Crossroads Dr., Suite 412
Owings Mills, MD 21117-5421
Attn: Privacy Officer

Changes to This Notice
We reserve the right to change our privacy practices and to apply the revised practices to health information about you that we already have. Any revision to our privacy practices will be described in a revised Notice that will be posted prominently in our facility.

Notice Effective Date: April 2, 2003