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Effective Date:<\/b><\/span> <\/span>12-1-2025<\/b><\/span> This Notice describes how your <\/span>medical and vision information<\/b><\/span> may be used and disclosed and how you can obtain access to this information. \n 1. Our Legal Duty<\/b><\/span><\/span><\/p>\n Metro Vision is committed to protecting the confidentiality of your <\/span>Protected Health Information (PHI)<\/b><\/span> under the <\/span>Health Insurance Portability and Accountability Act (HIPAA)<\/b><\/span> and applicable Michigan privacy laws. Maintain the privacy and security of your PHI.<\/span><\/p>\n<\/li>\n Provide you with this Notice of our legal duties and privacy practices.<\/span><\/p>\n<\/li>\n Follow the terms of this Notice currently in effect.<\/span><\/p>\n<\/li>\n Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.<\/span><\/p>\n<\/li>\n<\/ul>\n \n 2. Your Rights Regarding Your Health Information<\/b><\/span><\/span><\/p>\n You have the following rights concerning your PHI:<\/span><\/p>\n A. Right to Access<\/b><\/span><\/span><\/p>\n 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.<\/span><\/p>\n B. Right to Amend<\/b><\/span><\/span><\/p>\n 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.<\/span><\/p>\n C. Right to Confidential Communications<\/b><\/span><\/span><\/p>\n 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.<\/span><\/p>\n D. Right to Request Restrictions<\/b><\/span><\/span><\/p>\n 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.<\/span><\/p>\n E. Right to an Accounting of Disclosures<\/b><\/span><\/span><\/p>\n You may request a list (accounting) of certain disclosures we have made of your PHI, excluding those made for treatment, payment, or operations.<\/span><\/p>\n F. Right to a Paper or Electronic Copy of This Notice<\/b><\/span><\/span><\/p>\n 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.<\/span><\/p>\n G. Right to File a Complaint<\/b><\/span><\/span><\/p>\n If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at <\/span>metrovision@sbcglobal.net<\/b><\/span> or with the <\/span>U.S. Department of Health and Human Services (HHS)<\/b><\/span>. We will not retaliate against you for filing a complaint.<\/span><\/p>\n \n 3. How We May Use and Disclose Your Health Information<\/b><\/span><\/span><\/p>\n Your PHI may be used or disclosed for the following purposes without your written authorization:<\/span><\/p>\n A. Treatment<\/b><\/span><\/span><\/p>\n 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. B. Payment<\/b><\/span><\/span><\/p>\n We may use or disclose PHI to obtain payment for services rendered, verify insurance coverage, or process billing and claims. C. Health Care Operations<\/b><\/span><\/span><\/p>\n We may use or disclose PHI for our administrative and quality-assurance activities. D. Appointment Reminders and Service Notices<\/b><\/span><\/span><\/p>\n 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.<\/span><\/p>\n E. Family Members and Others Involved in Your Care<\/b><\/span><\/span><\/p>\n 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).<\/span><\/p>\n F. Business Associates<\/b><\/span><\/span><\/p>\n 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.<\/span><\/p>\n \n 4. Other Permitted or Required Uses and Disclosures<\/b><\/span><\/span><\/p>\n We may also use or disclose your PHI without your authorization in the following situations:<\/span><\/p>\n Public Health Activities:<\/b><\/span> To report diseases, injuries, or vital statistics.<\/span><\/p>\n<\/li>\n Health Oversight:<\/b><\/span> For audits, investigations, or licensing actions.<\/span><\/p>\n<\/li>\n Legal Requirements:<\/b><\/span> In response to a court order, subpoena, or law enforcement request.<\/span><\/p>\n<\/li>\n Coroners and Medical Examiners:<\/b><\/span> To identify a deceased person or determine cause of death.<\/span><\/p>\n<\/li>\n Organ or Tissue Donation:<\/b><\/span> To assist with organ procurement organizations.<\/span><\/p>\n<\/li>\n Research:<\/b><\/span> Under approved conditions that protect your privacy.<\/span><\/p>\n<\/li>\n To Prevent Serious Threats:<\/b><\/span> To reduce or prevent serious threats to health or safety.<\/span><\/p>\n<\/li>\n Workers\u2019 Compensation:<\/b><\/span> To comply with laws relating to work-related injuries or illnesses.<\/span><\/p>\n<\/li>\n Military or National Security:<\/b><\/span> For authorized national security or protective service activities.<\/span><\/p>\n<\/li>\n Disaster Relief:<\/b><\/span> To assist in notification of family members during emergencies.<\/span><\/p>\n<\/li>\n<\/ul>\n All such disclosures will be limited to the minimum information necessary and permitted by law.<\/span><\/p>\n \n 5. Uses and Disclosures Requiring Written Authorization<\/b><\/span><\/span><\/p>\n Metro Vision will obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice. Examples include:<\/span><\/p>\n Marketing or promotional communications not related to your care.<\/span><\/p>\n<\/li>\n Sale of your PHI to third parties.<\/span><\/p>\n<\/li>\n Most uses or disclosures of psychotherapy notes (if applicable).<\/span><\/p>\n<\/li>\n<\/ul>\n You may revoke an authorization at any time in writing. Revocation will not affect information already disclosed under your prior authorization.<\/span><\/p>\n \n 6. Your Choices<\/b><\/span><\/span><\/p>\n You have the right to make certain decisions about how we share your information. Limit contact for appointment reminders or marketing materials.<\/span><\/p>\n<\/li>\n Restrict sharing with family or friends involved in your care.<\/span><\/p>\n<\/li>\n Communicate only through certain channels (e.g., email vs. phone).<\/span><\/p>\n<\/li>\n<\/ul>\n Please make such requests in writing to our Privacy Officer.<\/span><\/p>\n \n 7. Data Security<\/b><\/span><\/span><\/p>\n We employ administrative, physical, and electronic safeguards to protect your PHI against unauthorized access, disclosure, alteration, or destruction. Despite these safeguards, no system is completely secure. You acknowledge that electronic transmission of information may still carry some risk.<\/span><\/p>\n
<\/span>Issued by:<\/b><\/span> <\/span>Metro Vision<\/b><\/span>
<\/span>Address:<\/b><\/span> <\/span>39087 Garfield Road, <\/span><\/b><\/span><\/span>Clinton Township, Michigan<\/b><\/span>
<\/span>Phone: (586) 286-7200<\/b><\/span>\u2003|\u2003<\/span>Fax:<\/b><\/span> <\/span>(586) 286-4144<\/b><\/span>
<\/span>Email:<\/b><\/span> <\/span>metrovision@sbcglobal.net<\/b><\/span><\/p>\n
Please review it carefully. Your privacy is very important to us.<\/span><\/p>\n
We are required by law to:<\/span><\/p>\n\n
<\/span>Example:<\/i><\/span> Sharing your eyeglass prescription with a lens manufacturer.<\/span><\/p>\n
<\/span>Example:<\/i><\/span> Providing necessary information to your insurance company for reimbursement.<\/span><\/p>\n
<\/span>Example:<\/i><\/span> Reviewing employee performance, auditing billing, or evaluating service quality.<\/span><\/p>\n\n
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You may specifically instruct us to:<\/span><\/p>\n\n
These include secure record storage, password-protected systems, encryption for electronic communications where feasible, and staff training on privacy compliance.<\/span><\/p>\n