Professional Vision

Right to Notice
As a patient, you have the right to adequate notice of the uses and disclosures of your
protected health information. Under the Health Insurance Portability and Accessibility Act
(HIPAA), [Practice Name here] can use your protected health information for treatment,
payment and health care operations.
a) Treatment - We may use or disclose your health information to a physician or other
healthcare provider providing treatment to you.
b) Payment - We may use and disclose your health information to obtain payment for services
we provide you.
c) Health care operations - We may use and disclose your health information in connection
with our healthcare operations. Healthcare operations include quality assessment and
improvement activities, reviewing the competency or qualifications of healthcare
professionals, evaluating provider performance, conducting training programs, accreditation,
certification, licensing or credentialing activities.