Notice of Patient Privacy
Kresloff Eye Associates
A division of Richard S. Kresloff, M.D., P.A.
Effective Date: September 1, 2026
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.
YOUR RIGHTS
You have the right to:
- Get a paper or electronic copy of your medical and billing records, subject to limited exceptions
- Ask us to correct or amend information you believe is incorrect or incomplete
- Ask us to communicate with you in a specific way or at a specific location
- Ask us to limit certain uses or disclosures of your information
- Get a list (accounting) of certain disclosures we have made
- Get a paper copy of this Notice at any time
- Choose someone who is legally authorized to act for you
- File a complaint if you believe your privacy rights have been violated
YOUR CHOICES
For certain health information, you may tell us your preferences about what we share. If you have a clear preference, tell us and we will follow applicable law and your instructions where required. These choices apply to:
- Sharing information with family, friends, or others involved in your care or payment for your care
- Sharing information in a disaster-relief situation
- Marketing communications or sale of your information when HIPAA requires your written authorization
- Fundraising communications, if KEA ever conducts them; you may opt out where required
HOW WE MAY USE AND SHARE YOUR INFORMATION
Treatment
We may use and share your health information to provide, coordinate, or manage your care and to communicate with other health professionals involved in your treatment.
Payment
We may use and share your information to bill and obtain payment from health plans or other responsible parties and to perform related payment activities.
Health Care Operations
We may use and share information to run the Practice, improve quality, train staff, conduct compliance and business operations, and contact you when necessary for care and operations.
Appointment Reminders and Health-Related Communications
We may contact you about appointments, follow-up care, treatment alternatives, health-related benefits or services, and other communications permitted by law.
Persons Involved in Your Care or Payment
Unless you object when applicable, we may share relevant information with family members, friends, or others involved in your care or payment.
Public Health and Safety
We may disclose information for public-health activities, reporting of abuse or neglect, preventing or reducing serious threats, and other purposes permitted or required by law.
Health Oversight, Legal and Government Functions
We may disclose information for health-oversight activities, workers’ compensation, law-enforcement purposes, judicial and administrative proceedings, medical examiners, coroners and funeral directors, organ and tissue donation, certain research, and special government functions when permitted or required by law.
SUBSTANCE USE DISORDER (SUD) / 42 CFR PART 2 RECORDS
Federal law provides additional protections for certain records created or maintained by federally assisted substance use disorder programs under 42 CFR Part 2. When KEA receives or maintains information that remains protected by Part 2, KEA will use and disclose that information only as permitted by applicable law and any valid consent. Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against a patient based on the content of those records unless the patient provides specific written consent for that proceeding or an applicable court order authorizes the use or disclosure. A consent for use or disclosure of Part 2 records in a proceeding may not be combined with a consent for another use or disclosure when prohibited by Part 2.
If KEA uses Part 2 information for fundraising communications where permitted, you have the right to opt out. Additional restrictions may apply to SUD counseling notes and other specially protected information.
USES AND DISCLOSURES REQUIRING WRITTEN AUTHORIZATION
Your written authorization is required for:
- Most uses and disclosures of psychotherapy notes, when applicable
- Uses and disclosures for marketing when HIPAA requires authorization
- Sale of PHI when HIPAA requires authorization
- Other uses or disclosures not otherwise permitted by law or described in this Notice
If you give us written authorization, you may revoke it in writing at any time, except to the extent we have already acted in reliance on it.
YOUR RIGHTS IN MORE DETAIL
Access
You may ask to inspect or receive a copy of PHI in our designated record set. We will provide access within the time required by law and may charge only fees permitted by law.
Amendment
You may ask us to amend PHI you believe is incorrect or incomplete. We may deny a request in circumstances permitted by law and will explain a denial in writing when required.
Accounting of Disclosures
You may request an accounting of certain disclosures made during the applicable look-back period. HIPAA excludes some categories, including many treatment, payment, and health-care-operations disclosures.
Restrictions
You may ask us not to use or share certain PHI for treatment, payment, or operations. We generally do not have to agree, except where law requires us to honor a restriction, including certain disclosures to a health plan for an item or service you paid for out of pocket in full.
Confidential Communications
You may ask us to contact you in a specific way or at a specific location. We will accommodate reasonable requests as required by law.
Personal Representative
If someone has legal authority to act for you, that person may exercise your HIPAA rights to the extent permitted by law after we verify the authority.
OUR RESPONSIBILITIES
- We are required by law to maintain the privacy and security of your PHI
- We must give you this Notice describing our legal duties and privacy practices and follow the Notice currently in effect
- We will notify affected individuals following a breach of unsecured PHI when required by law
- We will not use or share your information other than as described here or otherwise permitted by law unless you authorize us in writing
- We may change this Notice and make the revised terms effective for PHI we already maintain as well as information we receive in the future. The current Notice will be available in our office and on our website.
COMPLAINTS AND QUESTIONS
You may contact KEA’s Privacy Officer if you have questions, want to exercise a privacy right, or believe your privacy rights have been violated. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. KEA will not retaliate against you for filing a complaint or exercising a privacy right.
Privacy Officer
Randi Kresloff, Practice Administrator
Kresloff Eye Associates
1055 Haddon Avenue
Collingswood, NJ 08108
Phone: 856-854-4242
U.S. Department of Health & Human Services, Office for Civil Rights
www.hhs.gov/ocr
1-800-368-1019
SPECIALLY PROTECTED INFORMATION
Some categories of information may receive greater protection under federal or New Jersey law, including certain substance use disorder, mental-health, HIV/AIDS, genetic, reproductive-health, minor-consent, or other sensitive records. KEA will follow the more protective law when it applies.
Effective Date: September 1, 2026