Effective Date: September 15, 2021
ScottHyver Visioncare (“SHV”) is committed to protecting the privacy of your health information, including your medical records and other information related to your care.
We are required by law to ensure your health information is kept private (with certain exceptions); to give you this Notice of our legal duties and privacy practices with respect to health information about you; and to follow the terms of the Notice currently in effect.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION
The following describes how we may use and disclose your health information:
We may use health information to provide you with medical treatment or services. We may also disclose your health information to providers not affiliated with SHV to facilitate care or treatment they provide you. For example, we may disclose your health information to your personal physician or eye doctor for care coordination purposes.
We may use and disclose your health information to bill and receive payment for health care services that we or others provide to you. This includes uses and disclosures to submit health information and receive payment from your health insurer or other party that pays for some or all of your health care (payor) or to verify that your payor will pay for your health care. We may also tell your payor about a treatment you are going to receive to determine whether your payor will cover the treatment. For certain services, if your permission is needed to release health information to obtain payment, you will be asked for permission.
For Health Care Operations
We may use and disclose health information for health care operations. This includes functions necessary to run SHV or assure that all patients receive quality care, and includes many support functions such as appointment or procedure scheduling. We may also share your information with affiliated health care providers so that they may jointly perform certain business operations along with SHV. We may combine health information about many of our patients to decide, for example, what additional services SHV should offer, what services are not needed, and whether certain new treatments are effective. We may share information with doctors, technicians, patient counselors, and other personnel for quality assurance and training purposes.
SHV contracts with outside entities that perform business services for us, such as laser and diagnostic equipment manufacturers, IT consultants, accountants, and attorneys. In certain circumstances, we may need to share your health information with a business associate so it can perform a service on our behalf.
Individuals Involved in Your Care
We may release health information about you to a family member or friend who is involved in your medical care. We may also give information to someone who helps pay for your care. Unless there is a specific written request to the contrary by you to SHV, we may also notify a family member, personal representative or another person responsible for your care about your location and general condition.
SPECIAL SITUATIONS THAT DO NOT REQUIRE YOUR AUTHORIZATION
We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public Health Activities
We may disclose health information about you for public health activities. These activities include, but are not limited to the following:
- To prevent or control disease, injury or disability;
- To report reactions to medications or problems with products;
- To notify you of the recall of products you may be using;
- To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition
Health Oversight Activities
We may disclose health information to a health oversight agency, such as the California Department of Public Health, for activities authorized by law. These oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes
If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, legally enforceable discovery request, or other lawful process by someone else involved in the dispute.
Other Uses or Disclosures Required by the Law
We may also use or disclose health information about you when required to do so by federal, state, or local laws not specifically mentioned in this Notice. For example, we may disclose health information as part of a lawful request.
SITUATIONS THAT REQUIRE YOUR AUTHORIZATION
For uses and disclosures not generally described above, we must obtain your authorization. If you provide us such authorization, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose health information about you for the activities covered by the authorization, except if we have already acted in reliance on your permission. We are unable to take back any disclosures we have already made with your authorization, and we are required to retain records of health information.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU
You have the following rights regarding health information we maintain about you:
Right to Inspect and Copy
You have the right to inspect and obtain a copy of health information that may be used to make decisions about your care. Usually, this includes medical and payment records. We reserve the right to charge a fee to cover the cost of providing these records to you.
Right to Amend
If you believe that health information SHV has on file about you is incorrect or incomplete, you may ask us to amend the health information. To request an amendment you must file an appropriate written request with us. In addition, you must provide a reason that supports your request. SHV can only amend information that we created or that was created on our behalf. If your health information is accurate and complete, or if the information was not created by SHV, we may deny your request to amend. If we deny your request, we will reply to you in writing with our reasons for doing so. Even if we deny your request to amend, you have the right to submit to us a written addendum, which may not exceed 250 words for each item or statement in your record you believe is incomplete or incorrect.
Right to an Accounting of Disclosures
You have the right to request an “accounting of disclosures” which is a list describing how we have shared your health information with outside parties. This accounting is a list of the disclosures we made of your health information for purposes other than treatment, payment, health care operations, and certain other purposes consistent with law. If you request an accounting more than once during a twelve month period, we will charge you a reasonable fee.
Right to Request Confidential Communications
You have the right to request that we communicate with you about your health information or medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work, rather than at your home. We will not ask you the reason for your request. We will work to accommodate all reasonable requests. Your request must be in writing and specify how and where you wish to be contacted.
Right to be Notified of a Breach
SHV is committed to safeguarding your health information and proactively works to prevent health information breaches from occurring. If a breach of unsecured health information occurs, we will notify you in accordance with applicable state and federal laws.
Right to a Copy of this Notice
You have the right to a copy of this Notice, and may print this webpage for your records.
REQUEST FOR COPY OF HEALTH INFORMATION
To obtain more information about how to request a copy of your health information, receive an accounting of disclosures, amend or add an addendum to your health information, please contact:
2901 Tasman Drive, Suite 208
Santa Clara, CA 95054
CHANGES TO THIS NOTICE
We reserve the right to change our privacy practices and update this Notice accordingly. We reserve the right to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future. Updated versions are posted to ScottHyver.com. The Notice contains the effective date on the first page of the document below the main title.
QUESTIONS ABOUT OUR PRIVACY PRACTICES
SHV values the privacy of your health information as an important part of the care we provide to you. If you have questions about this Notice or SHV’s privacy practices, please contact SHV at 800-454-2747, by email at firstname.lastname@example.org, or by mail at the address above.