This notice describes how information about you may be used and disclosed and how you can access this information. Please read it carefully. A law called HIPAA (Health Insurance Portability and Accountability Act) requires Optimus Vision Care to keep your health information confidential and to provide this notice to you.
Uses and Disclosures of Protected Health Information Your protected health information may be used and disclosed by your physician, our staff, and others who are involved in your treatment. Below is an explanation.
Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care. For example, your information may be provided to a physician whom you have been referred to.
Payment: Your protected health information will be used and disclosed to obtain payment for services by us. For example, we may use your information regarding your medical treatment to process claims.
Healthcare operations: We may use or disclose your health information to support the business activities of our office. For example, your information may be used for quality assessment and improvement activities.
Other permitted or required uses and disclosures of protected health information may be made without your authorization. These include the following purposes: required by law, to avert a serious threat to health or safety, for public health activities, and for authorities if abuse, neglect, or domestic violence is suspected.
Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described above.
- You have the right to inspect and obtain a copy your protected health information.
- You have the right to request a restriction of your protected health information. You may request a restriction by writing a letter to our office. Optimus Vision Care is not required to agree to the restriction.
- You have the right to request to receive confidential communications from us by alternative means.
- You have the right to amend your protected health information.
- You have the right to receive an accounting of certain disclosures about your protected health information, such as an accounting of mandatory public health reporting. This right excludes disclosures that you authorized us to make and also treatment, payment, or operations described in this notice.
- You have the right to revoke this authorization in writing at any time. Please understand that Optimus Vision Care is unable to take back any disclosures already made with your authorization.
- You have the right to obtain a paper copy of this notice upon request.
Complaints You may complain to us or to the Secretary of Health and Human Services if you believe your rights have been violated. You may file a complaint by writing a letter to us. We will not retaliate against you.
This notice is effective as of July 26th, 2011. We may change the terms of our notice at any time. You may request a revised version during your next appointment or by calling our office.
If you have questions about this notice, please contact Dr. Son T. Nguyen by writing to Optimus Vision Care, 4155 Moorpark Ave. Suite 21, San Jose, CA 95117, or by calling (408) 243-2020.
RECEIPT OF NOTICE OF PRIVACY PRACTICES
My signature on this form acknowledges that I have received a copy of Optimus Vision Care’s Notice of Privacy Practices. I understand that the notice provides an explanation of the ways in which my health information may be used or disclosed by Optimus Vision Care, and I understand my rights with respect to my health information.
Patient’s Signature or Legal Guardian’s Signature
What information do we collect?
We collect information from you when you register on our site, subscribe to our newsletter, respond to a survey or fill out a form.
When ordering or registering on our site, as appropriate, you may be asked to enter your: name, e-mail address, mailing address or phone number. You may, however, visit our site anonymously.
What do we use your information for?
Any of the information we collect from you may be used in one of the following ways:
To personalize your experience
(your information helps us to better respond to your individual needs)
To improve our website
(we continually strive to improve our website offerings based on the information and feedback we receive from you)
To improve customer service
(your information helps us to more effectively respond to your customer service requests and support needs)
How do we protect your information?
We implement a variety of security measures to maintain the safety of your personal information when you enter, submit, or access your personal information.
Yes (Cookies are small files that a site or its service provider transfers to your computers hard drive through your Web browser (if you allow) that enables the sites or service providers systems to recognize your browser and capture and remember certain information
Do we disclose any information to outside parties?
We do not sell, trade, or otherwise transfer to outside parties your personally identifiable information. This does not include trusted third parties who assist us in operating our website, conducting our business, or servicing you, so long as those parties agree to keep this information confidential. We may also release your information when we believe release is appropriate to comply with the law, enforce our site policies, or protect ours or others rights, property, or safety. However, non-personally identifiable visitor information may be provided to other parties for marketing, advertising, or other uses.
Third party links
Occasionally, at our discretion, we may include or offer third party products or services on our website. These third party sites have separate and independent privacy policies. We therefore have no responsibility or liability for the content and activities of these linked sites. Nonetheless, we seek to protect the integrity of our site and welcome any feedback about these sites.
Childrens Online Privacy Protection Act Compliance
We are in compliance with the requirements of COPPA (Childrens Online Privacy Protection Act), we do not collect any information from anyone under 13 years of age. Our website, products and services are all directed to people who are at least 13 years old or older.
Terms and Conditions
Please also visit our Terms and Conditions section establishing the use, disclaimers, and limitations of liability governing the use of our website at http://www.optimusvisioncare.com/terms-and-conditions
Optimus Vision Care
4155 Moorpark Ave. Suite 21
San Jose, CA 95117