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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.
Table of Contents
The purpose of this notice is to:
Eyefinity is required to abide by the terms of this notice currently in effect by:
Eyefinity reserves the right to revise the terms of this notice, and to make the revised terms effective for all Protected Health Information that it maintains. If Eyefinity revises this notice, we will make the revised notice available on our website.
A person or entity that uses Protected Health Information to perform a service for Eyefinity. These services may include, but are not limited to:
Health Care Operations
Activities related to Eyefinity’s operations, including but not limited to:
Transmission or processing of claims.
Protected Health Information
Information relating to a patient’s past, present or future health or condition, the provision of health care to a patient, or payment for the provision of health care to a patient.
Protected Health Information includes, but is not limited to:
The provision, coordination or management of vision care and related services by one or more vision care providers.
How EYEFINITY Uses and Discloses Information About You
Eyefinity will only use and disclose your Protected Health Information without your authorization when necessary for:
Disclosure to EYEFINITY’s Business Associates
Eyefinity will only disclose your Protected Health Information to Business Associates who have agreed in writing to maintain the privacy of Protected Health Information as required by law.
Use or Disclosure Requiring Authorization
EYEFINITY will not use or disclose your Protected Health Information for purposes other than those described in this notice. If it becomes necessary to disclose any of your Protected Health Information for other reasons, EYEFINITY will request your written authorization. EYEFINITY will obtain your authorization for any sale of Protected Health Information, to use or disclose your Protected Health Information for marketing.
If you provide written authorization, you may revoke it at any time in writing, except to the extent that EYEFINITY has relied upon the authorization prior to its being revoked.
Use or Disclosure Required or Permitted by Law
EYEFINITY may use or disclose your Protected Health Information to the extent that the law requires the use or disclosure:
EYEFINITY may disclose your Protected Health Information to a person who has legal authority to make health care decisions on your behalf.
Disclosure Requiring Opportunity to Object
EYEFINITY may disclose your Protected Health Information to a family member, friend, or other person involved in your care or payment if the information is relevant to their involvement and you have agreed or had an opportunity to object.
EYEFINITY is prohibited from using or disclosing your genetic information for underwriting purposes.
Exercising Your Rights
You may exercise any of your below rights by sending us a written request.
Review Your Protected Health Information
You have a right to inspect and obtain a copy of your Protected Health Information.
If you feel your Protected Health Information is incomplete or incorrect, you have the right to request that it be amended.
Request to Amend
You have the right to ask us to correct health and claims records. If you feel your health records are incomplete or inaccurate, you have the right to request an amendment or correction to your protected health information. Eyefinity will respond to all requests to amend. However, Eyefinity doesn’t create patient medical or billing records and generally can’t grant an amendment. In most cases, Eyefinity will direct you to submit the request to the provider or facility that rendered care.
Request to Restrict Your Protected Health Information
You can request restrictions on the use and disclosure of your Protected Health Information. EYEFINITY is not required to agree to a requested restriction.
If a restriction request prevents us from providing service to you or from performing payment related functions, we will not be able to agree to the request.
When necessary, EYEFINITY may seek to contact you by calling you at your home or by sending mailings containing your Protected Health Information to your home. If you feel that such communications could compromise your safety, you may request in writing an alternate communication method and/or location.
EYEFINITY may require that a request contain a statement that disclosure of all or part of the information to which the request pertains could endanger the individual, and EYEFINITY may, if and to the extent that applicable law allows, request payment for this service.
The patient may decide, for his or her safety, to have correspondence containing his or her Protected Health Information sent somewhere other than to his or her home, or to have the information sent via fax rather than mailed.
Accounting of Disclosures
If a disclosure of your Protected Health Information was made for a reason other than treatment, payment or health care operations, you have a right to receive an accounting of the disclosure.
If the disclosure was made to you, EYEFINITY will not provide an accounting.
Receive a Copy Complaints
You can view and print a copy of this Notice of Privacy Practices through Eyefinity.com.
If you believe that your privacy rights have been violated, you may submit a complaint to EYEFINITY or to the U.S. Secretary of Health and Human Services at any time. EYEFINITY will not retaliate against you for filing a complaint. You may file a complaint with EYEFINITY at Eyefinity.com.
If you have questions about your HIPAA privacy rights, contact Eyefinity at:
Attention: Privacy Specialist
3333 Quality Drive
Rancho Cordova CA 95670