Notice of Privacy Policy

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.

We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give you notice of our privacy practices. This Notice describes how we protect your health information and what rights you have regarding it.

TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS

The most common reason why we use or disclose your health information is for treatment, payment, or health care operations.

Treatment Purposes Examples: Setting up an appointment for you; testing or examining your eyes ; prescribing glasses, contact lenses, or eye medications and faxing them to be filled ; showing you low vision aids; referring you to another doctor or clinic for eye care or low vision aids or services ; or getting copies of your health information from another professional that you may have seen before us.
Payment Purposes Examples: Asking you about your health or vision care plans, or other sources of payment ; preparing and sending bills or claims; and collecting unpaid amounts (either ourselves or through a collection agency or attorney).
Health Care Operations Examples: "Health care operations" mean those administrative and managerial functions that we have to do in order to run our office. Examples include: financial or billing audits ; internal quality assurance; personnel decisions; participation in managed care plans; defense of legal matters; business planning ; and outside storage of our records.

We routinely use your health information inside our office for these purposes without any special permission. If we need to disclose your health information outside of our office for these reasons, we will ask you for special written permission.

USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION

In some limited situations, the law allows or requires us to use or disclose your health information without your permission.

Such uses or disclosures include (but not all may apply to our office):

When a state or federal law mandates that certain health information be reported for a specific purpose.
For public health purposes, such as contagious disease reporting, investigation or surveillance ; and notices to and from the federal Food and Drug Administration regarding drugs or medical devices.
Disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence.
Uses and disclosures for health oversight activities, such as for the licensing of doctors; for audits by Medicare or Medicaid ; or for investigation of possible violations of health care laws.
Disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies.
Disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime; to provide information about a crime at our office; or to report a crime that happened somewhere else.
Disclosure to a medical examiner to identify a dead person or to determine the cause of death; or to funeral directors to aid in burial; or to organizations that handle organ or tissue donations.
Uses or disclosures for health-related research.
Uses and disclosures to prevent a serious threat to health or safety.
Uses or disclosures for specialized government functions, such as for the protection of the president or high-ranking government officials; for lawful national intelligence activities; for military purposes; or for the evaluation and health of members of the foreign service.
Disclosures of de-identified information.
Disclosures relating to worker's compensation programs.
Disclosures of a "limited data set" for research, public health, or health care operations.
Incidental disclosures that are an unavoidable by-product of permitted uses or disclosures.
Disclosures to "business associates" who perform health care operations on our behalf, and have committed to respect the privacy of your health information.
Unless you object, we will also share relevant information about your care with your family or friends who are helping you with your eye care.

APPOINTMENT REMINDERS / EYEWEAR & CONTACT LENSES READY NOTIFICATION

We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We may also call or write to notify you of other treatments or services available at our office that might help you. Unless you tell us otherwise, we will mail you an appointment reminder on a post card or letter, and/or leave you a message on your home, work, cell phone or other answering machine/voice mail or with someone who answers your phone.

OTHER USES AND DISCLOSURES

We will not make any other uses or disclosures of your health information unless you sign a written "authorization form". Federal law determines the content of this form.

You do not have to sign an authorization form if we initiate the process. If you do not sign, we cannot make the use or disclosure.
If you sign an authorization, you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be in writing and sent to the office contact person named at the beginning of this Notice.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

The law gives you many rights regarding your health information:

Right to Request Restrictions: You can ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment, or health care operations. We don't have to agree, but if we do agree, we must honor the restrictions. Requests must be in writing.
Right to Confidential Communications: You can ask us to communicate with you in a confidential way, such as phoning you at work or mailing information to a different address. We will accommodate reasonable requests, but you may have to pay for any extra cost. Requests must be in writing.
Right to Access and Copy: You can ask to see or get photocopies of your health information. For the most part, you will be able to review or have a copy within 30 days of asking (or 60 days if stored off-site). You may have to pay for photocopies in advance. We can have one 30-day extension if we notify you in writing. Requests must be in writing.
Right to Amend: You can ask us to amend your health information if you think it's incorrect or incomplete. If we agree, we will amend it within 60 days and send the corrected information to persons who got the wrong information. If we don't agree, you can write a statement of your position, which we will include with your health information. We can have one 30-day extension if we notify you in writing. Requests must be in writing, including your reasons for the amendment.
Right to an Accounting of Disclosures: You can get a list of the disclosures we have made of your health information within the past six years (or a shorter period if you want). The list will not include disclosures for treatment, payment, or health care operations, or those made with your authorization, among others. You are entitled to one list per year without charge. We usually respond within 60 days, but can have one 30-day extension. Requests must be in writing.
Right to Additional Paper Copies: You can get additional paper copies of this Notice upon request.

OUR NOTICE OF PRIVACY PRACTICES

We must abide by the terms of this Notice until we choose to change it. We reserve the right to change this notice at any time as allowed by law. If we change it, the new practices will apply to all your health information, both existing and future. If changed, we will post the new notice and have copies available in our office.

COMPLAINTS

If you think that we have not properly respected the privacy of your health information, you are free to complain to us or the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint. You can send a written complaint to the office contact person, or discuss it in person or by phone.

FOR MORE INFORMATION

If you want more information about our privacy practices, call or visit the office contact person at the address or phone number shown at the beginning of this Notice.