General Rule

We respect our legal obligation to keep health information, that identifies you, private. The law obligates us to give you notice of our privacy practices.

Generally, we can only use your health information in our office or disclose it outside of our office, without your written permission, for purposes of treatment, payment or healthcare operation. In most other situations, we will not use or disclose your health information unless you sign a written authorization form. In some limited situations, the law allows or requires us to disclose your health information without written authorization.

Uses or Disclosures of Health Information

Examples of how we use information for treatment purposes:
- When we set up an appointment for you.
- When our technician or doctor tests your eyes.
- When the doctor prescribes glasses or contacts.
- When the doctor prescribes medication.
- When our staff helps you select and order
glasses or contacts.
- When we show you low vision aids.

We may disclose your health information outside of our office for treatment purposes, for example:
- If we refer you to another doctor or clinic for
eye care or low vision aids or service.
- If we send a prescription for glasses or
contacts to another professional to be filled.
- When we provide a prescription for medication
to a pharmacist.
- When we phone to let you know that your glasses
or contact lenses are ready to be picked up.

Sometimes we may ask for copies of your health information from another professional that you may have seen before.

We may use your health information within our office or disclose your health information outside of our office for payment purposes. Some examples are:

- When our staff asks you about health or vision
care plans that you may belong to, or about
other sources of payment for our services.
- When we prepare bills to send to you or your
health or vision care plan.
- When we process payment by credit card and
when we try to collect unpaid amounts due.
- When bills or claims for payment are mailed,
faxed, or sent by computer to you or your health
or vision plan.
- When we occasionally have to ask a collection
agency or attorney to help us with unpaid
amounts due.

We use and disclose your health information for
healthcare operations in a number of ways. Health care
operations means those administrative and managerial
functions that we have to do in order to run our office. We may use or disclose your health information, for example, for financial or billing audits, for internal quality assurance, for personnel decisions, to enable our doctors to participate in
managed care plans, for defense of legal matters, to
develop business plans, and for outside storage of our
records.

Appointment Reminders

We may call to remind you of scheduled appointments. We
may also call to notify you of other treatments or services available at our office that might help you.

Uses & Disclosures without an Authorization

In some limited situations, the law allows or requires us to use or disclose your health information without your permission. Not all of these situations will apply to us; some may never happen at our office at all. Such uses or disclosures are:

- A state or federal law that mandates certain health
information be reported for a specific purpose.
- Public health purposes, such as contagious disease
reporting, investigation or surveillance; and
notices to and from the 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,
audits by Medicare or Medicaid, or investigation of
possible violations of healthcare 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; 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 relating to worker's compensation
programs.
- Disclosures to business associates who perform
healthcare operations for us and who agree to
keep your health information private.

Other Disclosures

We will not make any other uses or disclosures of your health information unless you sign a written
authorization form. You do not have to sign such a form. If you do sign one, you may revoke it at any
time unless we have already acted in reliance upon it.

Your Rights Regarding Your Health Information

The law gives you many rights regarding your health information.
- You can ask us to restrict our uses and disclosures
purposes of treatment (except emergency treatment),
payment or healthcare operations. We do not have to
agree to do this, but if we agree, we must honor the
restrictions that you want. To ask for a restriction
send a written request to John Cerbatos at the
address, fax or e-mail shown at the beginning of
web site.
- You can ask us to communicate with you in a
confidential way, such as by phoning you at work
rather than at home, by mailing health information
to a different address, or by using email to your
personal email address. We will accommodate these
requests if they are reasonable, and if you pay us
for any extra cost. If you want to ask for
confidential communications, send a written request
to John Cerbatos at the address, fax or email shown
at the beginning of this notice.
- You can ask to see or to get photocopies of your
health information. By law, there are a few limited
situations in which we can refuse to permit access
or copying. Primarily, however, you will be able to
review or have a copy of your health information
within 30 days of asking us. You may have to pay
for photocopies in advance. If we deny your request,
we will send you a written explanation, and
instructions about how to get an impartial review
of our denial if one is legally required. By law,
we can have one 30-day extension of the time for us
to give you access or photocopies if we sent you a
written notice of the extension. If you want to
review or get photocopies of yur health information,
send a written request to John Cerbatos at the
address, fax or email shown at the beginning of this
website.
- You can ask us to amend your health information if
you think that it is incorrect or incomplete. If we
agree, we will amend the information within 60 days
from when you ask us. We will send the corrected
information to persons who we know got the wrong
information, and others that you specify. If we do
not agree, you can write a statement of your
position, and we will include it with your
health information along with any rebuttal
statement that we may write. Once your statement
of position and/or rebuttal is included in your
health information, we will send it along whenever
we make a permitted disclosure of your health
information. By law, we can have one 30-day
extension of time to consider a request for
amendment if we notify you in writing of the
extension. If you want to ask us to amend your
health information, send a written request,
including your reasons for the admendment, to
John Cerbatos, at the address, fax or email shown
at the beginning of this website.
- You can get a list of the disclosures that we have
made of your health information within the past
six years (or a shorter period if you want), except
disclosures for purposes of treatment, payment or
health care operations, disclosures made in
accordance with an authorization signed by you, and
some other limited disclosures. You are entitled to
one such list per year without charge. If you want
more frequent lists, you will have to pay for them
in advance. We will usually respond to your request
within 60 days of receiving it, but by law we can
have one 30 day extension of time if we notify you
of the extension in writing. If you want a list,
send a written request to John Cerbatos at the
address, fax or email shown at the beginning of this
website.

Our Notice of Privacy Practices

By law, we must abide by the terms of this Notice of
Privacy Practices until we choose to change it. We
reserve the right to change this notice at any time in compliance with and as allowed by law. If we change this notice, the new privacy practices will apply to
your health information that we already have, as well
as to such information that we may generate in the
future. If we change our Notice of Privacy Practices,
we will post the new notice in our office 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 to the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint to John Cerbatos at the address, fax or email shown at the beginning of this website. If youi prefer, you can discuss your complaint in person or by phone.

For More Information

If you want more information about our privacy practices, call or visit us at the office.