HIPAA PRIVACY REGULATIONS: Federal law, the Health Insurance Portability and Accountablity Act of 1996, authorized the Department of Health and Human Services to adopt new rules to protect patient privacy. Notification is therefore given that the office of Coastal Eye Associates will not reveal to any person personal information about you or about a family member (i.e. name, address, Social Security Number, as well as other health information)without permission. Your information will never be sold, or listed for the purpose of advertisement, solicitation or fund raising. It is however understood that within the realm of doing business and for general patient care purposes, your personal information will be necessary and used in the following context: Patient registration; Procure medical records from former physicians; Converse with colleagues for opinions/care; Insurance: verifications, billing, paper and wire(includes fax transmissions); Insurance company follow up or interaction with billing services relating to patient care; Pursue collection of unpaid bills; Hospital workers, nurses, aids and medical records department; emergency officials, Paramedic, fire personnel, emergency room physicians, nurses, or technicians; Personal Religious designate; Pharmacists, drug program personnel/workers; Completion of disability forms; Computer and electronically stored information, (i.e. related business vendor and service persons)I AUTHORIZE THE RELEASE OF THIS NECESSARY INFORMATION. In order to control the cost of billing, we ask that the patient's portion is paid at the time services are rendered. We would rather control billing costs than be forced to raise our fees. All professional services and materials are charged to the patient.Accounts 90 days old are subject to collection fees. There will be a service charge on all returned checks.