Family Eye Care of O'Fallon

Policy Number: 14A
Effective Date 4.14.03

In order to comply with HIPAA's Privacy Rule, it is the policy of this office to:

Distribute a Notice of Privacy Practices ("NPP") to every patient at their first appointment, eyewear pickup, or similar encounter on or after April 14, 2003.

The NPP to use is attached to this Policy. Only Dr. Kloke has authority to change this NPP.

Front desk personnel is responsible to distribute the NPP.

Front desk personnel must give the patient a copy of the NPP when patient comes for an appointment or glasses pick up.

Front desk pesonnel must ask the patient to sign an acknowledgement of receipt of the NPP ("AOR"). The AOR to use is attached to this Policy. Put all signed AORs in patient's record.

If the patient opts not to sign the AOR, front desk personnel must make a note of the fact that you asked and that the patient refused. Put this note in patient's record.

It is not necessary to give a NPP to a patient every time they come in after April 14, 2003 unless we change the NPP.

• At every patient encounter, front desk personnel must look in patient's record to determine if the patient has previously signed an AOR.
• If yes, it is not necessary to give that patient another NPP unless we have changed our NPP since the date of the AOR. Our most current NPP will always have an effective date on the front.
• If no, then it is necessary to distribute a NPP and ask for signature on an AOR.