HIPAA Notice of Privacy Practices

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.

Who this notice covers

This notice applies separately to care provided by Eye D Vision LLC at Bensonhurst (2071 86th Street, Brooklyn, NY 11214), Eye D Park Slope LLC at Park Slope (361 5th Avenue, Brooklyn, NY 11215), and Eye D Vision Bayside, LLC at Bayside (41-11 Bell Boulevard, Bayside, NY 11361), and personnel acting on behalf of the respective practice. Each business is responsible for its own compliance and records. Sharing this notice does not create a joint health care arrangement or authorize unrestricted sharing between the businesses. Please identify your office when making a request. This notice concerns protected health information, not merely browsing data described in the separate Website Privacy Policy.

Your rights

• Inspect or obtain records. You may request access to your medical and billing records and other information in your designated record set, in an available paper or electronic format. We respond within applicable deadlines—generally 30 days under HIPAA, with any permitted extension explained in writing. New York generally requires an opportunity to inspect records within 10 days of a written request. Any permitted copying fee must comply with applicable cost-based and state limits. If access is denied, we explain the reason and applicable review or appeal rights.
• Request a correction. Ask us to amend information you believe is inaccurate or incomplete. We may deny a request, but will explain why in writing, generally within 60 days, with any lawful extension explained. You may submit a statement of disagreement.
• Request confidential communication. Ask to be contacted in a particular way or at a different address. We accommodate reasonable requests.
• Request limits. You may ask us to limit information used or disclosed for treatment, payment, or operations. We generally do not have to agree, but must honor a request not to disclose information to a health plan for payment or operations when it relates solely to an item or service you paid for in full out of pocket, unless disclosure is required by law. Tell us before information is submitted to the plan.
• Obtain an accounting. You may request a list of certain disclosures during the previous six years. Exceptions include treatment, payment, operations, and certain authorized or otherwise exempt disclosures. One accounting in a 12-month period is free; we notify you of any permitted fee for an additional request.
• Receive this notice. Ask for a paper copy at any time, even if you agreed to electronic delivery.
• Use a personal representative. A person legally authorized to act for you may exercise your rights, subject to legal exceptions. We verify that person's authority. Parents' and guardians' rights are subject to laws protecting certain minor-consented care.
• Complain without retaliation. Contact our privacy contact or the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for making a complaint.

Routine uses and disclosures

When permitted by law, we may use or disclose protected health information without a separate written authorization for:

• Treatment: examining your eyes, prescribing lenses, coordinating care, and sharing relevant information with other professionals involved in your treatment. For example, we may send findings to a treating ophthalmologist.
• Payment: billing you or your insurer, reviewing coverage, and obtaining payment. For example, a claim may include services provided and diagnoses supporting the claim.
• Health care operations: managing the practice, quality improvement, staff training, compliance, and necessary administration. Vendors handling protected health information on our behalf must be subject to appropriate safeguards and agreements where required.

We may contact you about appointments, treatment alternatives, or health-related services as permitted by law. Tell us how you prefer to receive communications.

Your choices and written authorization

You may tell us whether to share relevant information with family, friends, or others involved in your care or payment, or with disaster-relief organizations. If you cannot state a preference, we may use professional judgment to make a permitted disclosure in your best interests. Disclosures to address a serious and imminent threat must meet applicable legal requirements.

Uses or disclosures not described in this notice require your written authorization unless otherwise permitted or required by law. This includes marketing and the sale of protected health information where authorization is required, and most disclosures of psychotherapy notes if we hold them. You may revoke an authorization in writing at any time, except to the extent we have already relied on it or another legal exception applies. Cookie acceptance is not a HIPAA authorization.

We do not use patient information for fundraising.

Other legally permitted or required disclosures

Subject to the conditions and safeguards required by law, information may be disclosed for public health activities such as disease reporting, product recalls, and adverse reactions; reporting suspected abuse, neglect, or domestic violence; authorized health oversight; legally permitted research; organ or tissue donation; coroners, medical examiners, and funeral directors; workers' compensation; qualifying law-enforcement or special government functions; and compliance with law, including HHS compliance reviews. Court orders, subpoenas, and administrative proceedings require the applicable legal conditions to be satisfied; a request alone does not always authorize release.

Additional protections

More protective laws take precedence when applicable. New York law imposes additional limits on certain HIV-related information, genetic information, mental-health records, and information about certain care minors may consent to themselves. We obtain the specific consent or authorization required for those records unless a legal exception permits disclosure. General permissions elsewhere in this notice do not override those protections.

If we receive substance use disorder patient records protected by 42 CFR Part 2, we may not use or disclose those records, or testimony describing their contents, in civil, criminal, administrative, or legislative investigations or proceedings against you without your qualifying written consent or a qualifying court order and subpoena. These protections apply even where other information could otherwise be disclosed.

Our responsibilities

We are required by law to protect the privacy of your protected health information, provide this notice, and follow the terms of the notice currently in effect. We must notify affected individuals of a breach of unsecured protected health information as required by law. We use applicable safeguards and limit uses and disclosures as required; no notice is a substitute for these obligations.

Questions, requests, and complaints

Privacy contact:
Eye D Vision — Practice Management
2071 86th Street, Brooklyn, NY 11214
(718) 355-9656
info@eyedvision.com

Ask for the person handling privacy requests. Please do not send medical details in an initial ordinary email; ask for an appropriate way to submit your request.

You can also file a complaint with the HHS Office for Civil Rights, call 1-877-696-6775, or write to 200 Independence Avenue, S.W., Washington, D.C. 20201. Filing a complaint will not affect your right to care.

Changes to this notice

We may revise this notice consistent with law and make the revised notice apply to information already held as well as new information. The current notice, with its effective date, will be available on the website, at our offices, and upon request.

Learn more about your rights

HHS privacy notice guidance · New York patient-record access guidance