(586) 286-7200 metrovision@sbcglobal.net

HIPAA NOTICE OF PRIVACY PRACTICES

Effective Date: 12-1-2025
Issued by: Metro Vision
Address: 39087 Garfield Road, Clinton Township, Michigan
Phone: (586) 286-7200 | Fax: (586) 286-4144
Email: metrovision@sbcglobal.net

This Notice describes how your medical and vision information may be used and disclosed and how you can obtain access to this information.
Please review it carefully. Your privacy is very important to us.

1. Our Legal Duty

Metro Vision is committed to protecting the confidentiality of your Protected Health Information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA) and applicable Michigan privacy laws.
We are required by law to:

  • Maintain the privacy and security of your PHI.

  • Provide you with this Notice of our legal duties and privacy practices.

  • Follow the terms of this Notice currently in effect.

  • Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

2. Your Rights Regarding Your Health Information

You have the following rights concerning your PHI:

A. Right to Access

You may request to inspect or obtain a copy of your health and vision records, including exam results and prescriptions. Requests must be made in writing. Reasonable copying or mailing fees may apply.

B. Right to Amend

If you believe information in your record is incorrect or incomplete, you may request an amendment. We may deny your request if the record is accurate and complete, but you will be notified in writing of any denial and your right to appeal.

C. Right to Confidential Communications

You may request that we contact you by alternative means or at a specific location (for example, at your workplace instead of your home). We will accommodate reasonable requests.

D. Right to Request Restrictions

You may ask us to restrict how we use or disclose your PHI for treatment, payment, or health-care operations. While we are not required to agree to all restrictions, if we do agree, we will abide by them unless required by law to release information.

E. Right to an Accounting of Disclosures

You may request a list (accounting) of certain disclosures we have made of your PHI, excluding those made for treatment, payment, or operations.

F. Right to a Paper or Electronic Copy of This Notice

You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically. You may also view or download it from our website.

G. Right to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at metrovision@sbcglobal.net or with the U.S. Department of Health and Human Services (HHS). We will not retaliate against you for filing a complaint.

3. How We May Use and Disclose Your Health Information

Your PHI may be used or disclosed for the following purposes without your written authorization:

A. Treatment

We may use or disclose your PHI to provide, coordinate, or manage your vision care. This includes sharing information with optometrists, ophthalmologists, laboratories, or other health-care professionals involved in your care.
Example: Sharing your eyeglass prescription with a lens manufacturer.

B. Payment

We may use or disclose PHI to obtain payment for services rendered, verify insurance coverage, or process billing and claims.
Example: Providing necessary information to your insurance company for reimbursement.

C. Health Care Operations

We may use or disclose PHI for our administrative and quality-assurance activities.
Example: Reviewing employee performance, auditing billing, or evaluating service quality.

D. Appointment Reminders and Service Notices

We may contact you by phone, text, mail, or email to remind you of appointments, follow-ups, or to inform you about products and services related to your care. You may request not to receive these communications.

E. Family Members and Others Involved in Your Care

We may share relevant information with family members or others involved in your care if you do not object or if you are unable to agree (for example, during an emergency).

F. Business Associates

We may share PHI with third-party vendors or partners (e.g., billing services, labs, IT support) who perform functions on our behalf. Each business associate is required by contract to safeguard your information.

4. Other Permitted or Required Uses and Disclosures

We may also use or disclose your PHI without your authorization in the following situations:

  • Public Health Activities: To report diseases, injuries, or vital statistics.

  • Health Oversight: For audits, investigations, or licensing actions.

  • Legal Requirements: In response to a court order, subpoena, or law enforcement request.

  • Coroners and Medical Examiners: To identify a deceased person or determine cause of death.

  • Organ or Tissue Donation: To assist with organ procurement organizations.

  • Research: Under approved conditions that protect your privacy.

  • To Prevent Serious Threats: To reduce or prevent serious threats to health or safety.

  • Workers’ Compensation: To comply with laws relating to work-related injuries or illnesses.

  • Military or National Security: For authorized national security or protective service activities.

  • Disaster Relief: To assist in notification of family members during emergencies.

All such disclosures will be limited to the minimum information necessary and permitted by law.

5. Uses and Disclosures Requiring Written Authorization

Metro Vision will obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice. Examples include:

  • Marketing or promotional communications not related to your care.

  • Sale of your PHI to third parties.

  • Most uses or disclosures of psychotherapy notes (if applicable).

You may revoke an authorization at any time in writing. Revocation will not affect information already disclosed under your prior authorization.

6. Your Choices

You have the right to make certain decisions about how we share your information.
You may specifically instruct us to:

  • Limit contact for appointment reminders or marketing materials.

  • Restrict sharing with family or friends involved in your care.

  • Communicate only through certain channels (e.g., email vs. phone).

Please make such requests in writing to our Privacy Officer.

7. Data Security

We employ administrative, physical, and electronic safeguards to protect your PHI against unauthorized access, disclosure, alteration, or destruction.
These include secure record storage, password-protected systems, encryption for electronic communications where feasible, and staff training on privacy compliance.

Despite these safeguards, no system is completely secure. You acknowledge that electronic transmission of information may still carry some risk.

8. Breach Notification

If a breach of unsecured PHI occurs, Metro Vision will notify you without unreasonable delay, no later than 60 days after discovery. The notice will describe what happened, the types of information involved, steps you should take to protect yourself, and what we are doing to investigate and mitigate harm.

9. Retention of Records

We are required by law to maintain patient records, including PHI, for a minimum period in accordance with Michigan regulations. After that period, records may be securely destroyed in compliance with federal and state law.

10. Changes to This Notice

Metro Vision reserves the right to revise this Notice of Privacy Practices at any time. Any updates will apply to all existing and future PHI.
The latest version will be posted prominently in our office and available on our website. You may request a copy at any time.

11. Questions or Complaints

If you have questions about this Notice or wish to exercise your rights, contact:

Metro Vision Privacy Officer
Phone: (586) 286-7200
Fax: (586) 286-4144
Email: metrovision@sbcglobal.net

If you believe your privacy rights have been violated, you may also contact:

U.S. Department of Health and Human Services (HHS)
Office for Civil Rights
200 Independence Avenue SW
Washington, DC 20201
Website: https://www.hhs.gov/ocr/privacy/hipaa/complaints/

Metro Vision will not retaliate against any patient for filing a complaint.

Acknowledgment of Receipt

Patients may be asked to sign an acknowledgment form confirming receipt of this Notice.
Your signature simply verifies that you have received and reviewed the document — it does not alter your rights or grant additional permissions.

Thank you for trusting Metro Vision with your eye care.
We remain committed to protecting your privacy while delivering the highest standard of professional vision care in the Detroit area.