Notice of Privacy Practices
Effective Date: October 04, 2019
THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED, AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We are required by law to provide you with this Notice of Privacy Practices (“Notice”) and follow the terms of this Notice while it is in effect. This Notice is a summary of your privacy rights, and your use of Gatorz Eyewear Services evidences your acceptance of the terms of this Notice. “Services” include dispensing of prescription eyeglasses. Gatorz Eyewear also operates the website gatorz-prescription.com that contain links to this Notice.
Your rights with respect to your private health information
You have the following rights with respect to your private health information maintained by Gatorz Eyewear.
- Get a copy. You can request a copy of health information we have about you.
- Amend. You have the right to amend your personal health information if you feel that it is incorrect or incomplete.
- Receive a list of those with whom we’ve shared information. You have the right to an accounting of our disclosures of your personal health information made over the past six years. This right does not apply to disclosures made for treatment, payment, or healthcare operations; disclosures made to you about your treatment; disclosures made pursuant to an authorization; and certain other disclosures.
- Restrictions on disclosure. You have the right to request restrictions on how we use or disclose your private health information. We’re not required to agree with your request, and we may say “no” if it would affect your care or as required by law.
- Request confidential Communication. You have the right to request that we communicate with you at a specific telephone number or address.
- Paper copy. You have the right to obtain a paper copy of this Notice (even if you’re currently reading it electronically!).
- Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your healthcare information.
Use and disclosure of private health information
Gatorz Eyewear uses and discloses your private health information for the normal business activities that fall in the categories of treatment, payment, and healthcare operations, in accordance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). Below are a few examples of those activities (but note that not every use or disclosure that falls within each category is included!).
Treatment. Gatorz Eyewear keeps a record of the private health information you provide to us in the course of using the Services. This record may include the results of your eye exam, information we receive, your prescription information, the prescription products that you purchase, and other information we learn about your health or vision through our provision of the Services. We may disclose this information so that doctors, nurses, other optical dispensers, and other entities like laboratories can meet your healthcare needs.
Payment. Gatorz Eyewear documents the Services that you receive when we provide care to you so that you can pay us for the Services.
Healthcare Operations. Gatorz Eyewear uses private health information to improve the Services and train staff, and for business management, quality improvement, performance evaluation, marketing activities permitted under HIPAA, customer service activities, and other internal business purposes.
Gatorz Eyewear may also use or disclose your private health information to:
- Comply with federal, state, or local laws.
- Assist in public health activities, such as tracking diseases or medical devices.
- Respond to law enforcement officials or to judicial orders, subpoenas, or other process.
- Assist in specialized government functions, such as national security, intelligence, and protective services.
- Inform military and veteran authorities if you are an armed forces member.
- Inform workers’ compensation carriers or your employer if you are injured at work, as authorized by and as necessary to comply with relevant laws.
- Tell you about health-related products and services.
- Communicate with individuals, such as friends and family, who are involved in your care or involved in the payment for that care.
- Communicate within our organization for treatment, payment, or healthcare operations.
- Communicate with other providers, health plans, or their related entities for their treatment, payment, or healthcare operations activities.
- Provide information to other third parties with whom we do business in order to allow those third parties to provide services to us or on our behalf. (Don’t worry—in these situations, we require third parties to provide us with assurances that they will safeguard your information.)
Our responsibilities with respect to your private health information
Gatorz Eyewear is required by HIPAA to:
- Maintain the privacy of your private health information.
- Provide this Notice setting forth our duties and privacy practices.
- Abide by the terms of the version of this Notice currently in effect.
- Tell you if there has been a security breach that compromises your private health information.
Please note that some states have laws that may require that we apply extra protections to some of your health information.
Changes to this Notice
We occasionally review this Notice to make sure it complies with applicable laws and conforms to changes in our business. We may need to update this Notice, and we reserve the right to do so at any time. If we change the terms of this Notice, the new terms will apply to all private health information that we maintain, including private health information that you provided to us before such changes were made. We will post the new Notice on our websites and mobile applications, and will update the “Effective Date” at the top of this page so you can tell if it has changed since your last visit. We will make the new Notice available upon request. Your continued use of the Services constitutes your acceptance of the terms of such revised Notice.
If you believe that your privacy has been violated or that Gatorz Eyewear has not followed its obligations under HIPAA, you may file a complaint with us or with the Secretary of Health and Human Services. We will not retaliate against you or penalize you for filing any such complaint.
To file a complaint with the Secretary of Health and Human Services, call 877.696.6775 or write to 200 Independence Avenue S.W., Washington, D.C. 20201.
Contacting Gatorz Eyewear
To exercise any of your rights set forth in this Notice, or for more information about Gatorz Eyewear privacy practices, email firstname.lastname@example.org, or call 884-560-7179.