HIPAA Privacy Practice Notice

Please Review This Information Carefully

If you have questions about this notice, please contact us at (425) 670-9888.

​

Who Will Follow This Notice

This notice describes the privacy practices of Visionaire Eyecare. All of our optometric physicians and staff may have access to information in your chart for treatment, payment, and health care operations. This notice also applies to any volunteer or trainee we allow to help you while seeking services from us.

​

Our Pledge Regarding the Privacy of Your Medical Information

Your medical information includes information about your physical and mental health. We understand that this information is personal, and we are committed to protecting it.

​

We create a record of the care and services you receive from us. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to any and all records of your care generated by us.

​

This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

​

We reserve the right to revise or amend this notice without additional notice to you. Any revision will be effective for all records our practice has created or maintained in the past, and for any records we may create or maintain in the future. We will post a copy of our current notice in our office and on our website.

Our Obligations to You

We are required by law to:

• Keep medical information that identifies you private, except as otherwise provided by state or federal law

• Give you this notice of our legal duties and privacy practices with respect to your medical information

• Follow the terms of the notice currently in effect

How We May Use and Disclose Your Medical Information

The following categories describe the ways we may use and disclose your medical information. Not every use or disclosure within a category will be listed. Where Washington State law provides greater protection for your medical information, we will follow state law.

For Treatment We may use and disclose your medical information to provide you with medical treatment or services. We may share this information with doctors, nurses, medical students, pharmacists, laboratories, or other health care providers involved in your care. Mental health information, psychotherapy notes, AIDS or HIV-related information, and drug treatment information will only be disclosed with your written authorization, as required by Washington law, HIPAA, and other federal regulations.

​

We may also refer you to outside providers such as independent laboratories. These "indirect treatment providers" are required to comply with all applicable privacy laws and keep your information confidential.

​

For Payment

We may use and disclose your medical information so that treatment and services you receive can be billed and payment can be collected from you, an insurance company, or a third party. We may also contact your health plan to obtain prior approval or determine whether a treatment will be covered.

For Health Care Operations

We may use and disclose your medical information for internal health care operations — activities necessary to run our practice and ensure all patients receive quality care. This may include reviewing treatment, evaluating staff performance, and sharing information with doctors, nurses, students, or consultants for review and learning purposes.

Appointment Reminders

We may contact you by mail or phone to remind you of upcoming appointments, unless you instruct us otherwise in writing.

Treatment Alternatives We may use and disclose your medical information to tell you about possible treatment options or alternatives that may be of interest to you. We will not use your information to market products or services — ours or those of third parties — without your authorization.

Health-Related Benefits and Services

We may use and disclose your medical information to tell you about health-related benefits or services that may be of interest to you.

Individuals Involved in Your Care or Payment We may release medical information to a family member or friend involved in your medical care or who helps pay for your care. We may also share your information with an entity assisting in disaster relief efforts so your family can be notified of your condition, status, and location.

As Required by Law

We will disclose your medical information when required to do so by federal, state, or local law.

To Avert a Serious Threat to Health or Safety We may disclose your medical information when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any such disclosure would only be made to someone able to help prevent the threat.

To Business Associates

We may hire outside consultants, called "business associates," to provide services to us. We may share your medical information with these associates without your authorization. Business associates are required to maintain and comply with all applicable privacy laws. Examples include accounting firms that audit billing information and software vendors who assist with processing medical records.

Military and Veterans

If you are a member of the armed forces, we may release medical information as required by military command authorities. We may also release information about foreign military personnel to the appropriate foreign military authority.

Workers' Compensation

We may release medical information for workers' compensation or similar programs without your authorization. These programs provide benefits for work-related injuries or illnesses.

Public Health Risks

We may disclose your medical information for public health activities, including to:

• Prevent or control disease, injury, or disability

• Report reactions to medications or problems with products

• Notify people of product recalls

• Notify a person who may have been exposed to a disease or condition

• Notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence (only with your agreement or as required by law)

​

Health Oversight Activities

We may disclose your medical information to a health oversight agency, such as the Department of Health and Human Services, for activities authorized by law — including audits, investigations, inspections, and licensure.

Lawsuits and Administrative Proceedings

We may disclose your medical information in response to a court or administrative order, subpoena, discovery request, or other lawful process. We may also disclose mental health treatment information to an opposing party in any lawsuit or proceeding where you have put your physical or mental condition at issue.

Law Enforcement

We may release medical information to a law enforcement official in response to:

• A court order, subpoena, warrant, summons, or similar process

• A request to identify or locate a suspect, fugitive, material witness, or missing person

• Circumstances involving a crime victim, a death believed to result from criminal conduct, or an emergency requiring disclosure of crime-related information

​

Coroners, Medical Examiners, and Funeral Directors

We may release medical information, including mental health information, to a coroner or medical examiner — for example, to identify a deceased person or determine cause of death.

National Security and Intelligence Activities

We may release your medical information to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective Services for the President and Others

We may disclose your medical information to authorized federal officials for the protection of the President, other authorized persons, or foreign heads of state, or to conduct special investigations.

Inmates

If you are an inmate of a correctional institution or in the custody of a law enforcement official, we may release your medical information to the institution or official as necessary for your health care, for the protection of health and safety, or for the safety and security of the facility.

Your Rights Regarding Your Medical Information

Right to Inspect and Copy You have the right to inspect and copy medical information used to make decisions about your care. Requests must be submitted in writing to our office. We may charge a reasonable fee for copying, mailing, and related costs.

In limited circumstances, we may deny your request. If denied, you may request a review by another licensed health care professional chosen by us — someone other than the person who denied the request. We will comply with the outcome of that review.

Right to Request an Amendment

If you believe your medical information is incorrect or incomplete, you may ask us to amend it in writing, with a reason supporting your request.

We may deny your request if the information was not created by us, is not part of the records we maintain, is not information you are permitted to inspect and copy, or is already accurate and complete.

​

Right to an Accounting of Disclosures

You have the right to request a list of the disclosures we have made of your medical information. Requests must be submitted in writing and may cover a time period of up to six years starting April 15, 2003. The first list requested within a 12-month period is free; additional requests may incur a reasonable fee.

​

Right to Request Restrictions

You have the right to request a limit on how we use or disclose your medical information for treatment, payment, or health care operations — including limits on what is shared with family members or others involved in your care. We are not required to agree to your request, but if we do, we will honor it unless the information is needed for emergency treatment.

​

Requests must be submitted in writing and must specify: (1) what information you want to limit; (2) whether you want to limit use, disclosure, or both; and (3) to whom the limits should apply.

​

Right to Request Confidential Communications

You have the right to request that we contact you in a specific way or at a specific location — for example, by mail only or at your work number. Requests must be in writing and must specify how or where you wish to be contacted. We will accommodate all reasonable requests without asking for a reason.

​

Right to a Paper Copy of This Notice

You have the right to a paper copy of this notice at any time, even if you previously agreed to receive it electronically.

Privacy Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services.

​

Contact Us:

Privacy Manager: Dr. Randy L. Wong Phone: (425) 670-9888

You will not be penalized for filing a complaint.

Other Uses of Your Medical Information

Any use or disclosure of your medical information not covered by this notice will only be made with your written authorization. You may revoke that authorization in writing at any time. Please note that we are unable to take back disclosures already made with your permission and are required to retain records of the care we have provided to you.