NOTICE OF PRIVACY PRACTICES
Pinnacle Eye, PLLC
Effective Date: September 1, 2025
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.
OUR PLEDGE REGARDING MEDICAL INFORMATION
At Pinnacle Eye, we understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive to provide you with quality care and to comply with certain legal requirements. This Notice applies to all records of your care generated by our practice.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
We may use and disclose medical information about you for the following purposes without your express written permission:
For Treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, or other personnel who are involved in your care. For example, we may share your records with a specialist to whom we refer you or a pharmacy to fill your prescription.
For Payment: We may use and disclose medical information about you so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party.
For Health Care Operations: We may use and disclose medical information about you to run our practice and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff.
Special Notices - We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment. We may contact you by phone or other means to provide results from exams or tests, to provide information that describes or recommends treatment alternatives regarding your care, or to provide information about health-related benefits and services offered by our office.
Individuals Involved in Your Care: Unless you object, we may release medical information about you to a friend or family member who is involved in your medical care or helps pay for your care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine, based on our professional judgment, that it is in your best interest. If you are not present or able to agree or object to the use or disclosure of PHI (e.g., in a disaster relief situation), then your healthcare provider may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the PHI that is necessary will be disclosed.
III. SPECIAL SITUATIONS
We may also use or disclose your information in the following situations as allowed or required by law:
Public Health & Safety: To prevent a serious threat to your health and safety or the health and safety of the public (e.g., recalling defective products, reporting abuse or neglect).
Required by Law: When required to do so by federal, state, or local law, including workers' compensation laws, law enforcement subpoenas, or court orders.
Coroners and Medical Examiners: To identify a deceased person or determine the cause of death.
Organ Donation: If you are an organ donor, we may release information to organizations that handle organ procurement.
IV. SPECIAL PROTECTIONS (REGULATORY UPDATES)
Reproductive Health Care: Protected Health Information (PHI) potentially related to reproductive health care is prohibited from being disclosed for the purposes of investigating or imposing liability on any person for seeking, obtaining, facilitating, or providing lawful reproductive health care.
Substance Use Disorder Records: Records received from substance use disorder programs (Part 2 programs) will not be used or disclosed in criminal investigations or proceedings against you without your specific authorization or a court order.
V. YOUR RIGHTS REGARDING MEDICAL INFORMATION
You have the following rights regarding medical information we maintain about you:
Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. You must submit your request in writing. We may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.
Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You must provide a reason that supports your request in writing.
Right to an Accounting of Disclosures: You have the right to request a list of the disclosures we made of medical information about you, excluding disclosures for treatment, payment, or health care operations.
Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. If you pay for a service or health care item out-of-pocket in full, you have the right to request that we not share that information with your health insurer, and we must agree to that request.
Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location (e.g., only at work or by mail).
Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice at any time.
VI. TEXT MESSAGING PRIVACY POLICY
No mobile information will be shared with third parties or affiliates for marketing or promotional purposes or publicly. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties. No mobile opt-in or text message consent will be shared with third parties or affiliates.
VII. CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our office.
VIII. COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with Pinnacle Eye, contact our Privacy Officer. You will not be penalized for filing a complaint.
Privacy Officer Contact:
Karan Patel, MD; Pinnacle Eye HIPPA Privacy and Compliance Officer: (425) 800-0393