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NOTICE OF PRIVACY PRACTICES

Effective July 2013 (Reviewed July 18, 2022)

YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.

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.

YOUR RIGHTS

When it comes to your health information, you have certain rights. This section
explains your rights and some of our responsibilities to help you.

Exercising Your Rights: You may exercise any of your below rights by visiting
the Patient Rights page or completing the Member Complaint/Grievance Form, or
calling Member Services at 800.877.7195.

Get a copy of your health and claims records
 * You can ask to see or get a copy of your health and claims records and other
   health information we have about you.
 * We will provide a copy of your health and claims records, usually 10
   business days from receipt of your request.

Ask us to correct health and claims records
 * You can ask us to correct your health and claims records if you think they
   are incorrect or incomplete.
 * We may say "no" to your request, but we'll tell you why in writing 10
   business days from receipt of your request.

Request confidential communications
 * You can ask us to send your protected health information directly to you at
   an alternative address.
 * We will consider all reasonable requests, and must say "yes" if you submit
   legal documentation that shows us you would be in danger if we do not.

Ask us to limit what we use or share
 * You can ask us not to use or share certain health information for treatment,
   payment, or our operations.
 * We are not required to agree to your request, and we may say "no" if it would
   affect payment or your health care services.

Get a copy of this privacy Notice
 * You can ask for a paper copy of this Notice at any time, even if you have
   agreed to receive the Notice electronically.
 * We will provide you with a paper copy promptly.

Get a list of those with whom we've shared information
 * You can ask for a list (accounting) of the times we’ve shared your health
   information for six years (non-electronic PHI) or three years (electronic
   PHI) prior to the date you ask, who we shared it with, and why.
 * We will include all the disclosures except for those about treatment,
   payment, and health care operations, and certain other disclosures (such as
   any you asked us to make). We’ll provide one accounting a year for free but
   may charge a reasonable, cost-based fee if you ask for another one within 12
   months.

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 health information.
 * We will make sure the person has this authority and can act for you before we
   take any action.

File a complaint if you feel your rights are violated
 * You can complain if you feel we have violated your rights by submitting a
   written complaint using the contact information included in this Notice or by
   completing the Member Complaint/Grievance Form.
 * You can file a complaint with the U.S. Department of Health and Human
   Services Office for Civil Rights by sending a letter to 200 Independence
   Avenue, S.W., Washington, D.C. 20201, calling 877.696.6775, or
   visiting Filing a Complaint.
 * We will not retaliate against you for filing a complaint.

YOUR CHOICES

For certain health information, you can tell us your choices about what we
share. If you have a clear preference for how we share your information in
situations described below, talk to us. Tell us what you want us to do, and we
will follow your instructions.

In these cases, you have both the right and choice to
tell us to:
 * Share information with your family, close friends, or others involved in
   payment for your care.
 * Share information in a disaster relief situation.
 * If you are not able to tell us your preference, we may share your information
   when needed to lessen a serious and imminent threat to health or safety.

In these cases, we never share your information unless
you give us written permission:
 * Marketing purposes.
 * Sale of your information.

OUR USES AND DISCLOSURES

How do we typically use or share your health information? We typically use or
share your health information in the following ways:

Help manage the health care treatment you receive We can use your health
information and share it with professionals who are treating you. Example: We
authorize your care, so your doctor can provide services to you. Run our
organization We can use and disclose your information to run our organization
and contact you when necessary. VSP does not collect genetic information.
Example: We use health information about you to conduct audits and review claims
payment activity to ensure claims are paid correctly and to develop better
services for you. Pay for your health services We can use and disclose your
health information as we pay for your health services. Example: We share
information about you with your health plan to coordinate payment for your
vision care services. Administer your plan We may disclose your information to
your health plan sponsor for plan administration. Example: Your company
contracts with us to provide vision care services insurance, and we provide your
company with certain statistics to explain the premiums we charge.

How else can we use or share your health information? We are allowed or required
to share your information in other ways – usually in ways that contribute to the
public good, such as for public health and research purposes. We have to meet
many conditions in the law before we can share your information for these
purposes. For more information visit the Department of Health & Human
Services Your Rights Under HIPAA.

Help with public health and safety issues

We can share health information about you for certain situations such as:

 * Preventing disease
 * Helping with product recalls
 * Reporting adverse reactions to medications
 * Reporting suspected abuse, neglect, or domestic violence
 * Preventing or reducing a serious threat to anyone’s health or safety

Do research VSP does not use or collect protected health information for
research purposes. Comply with the law We will share information about you if
state or federal laws require it, including with the Department of Health and
Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation
requests and work with medical examiner
or funeral director
 * We can share health information about you with organ procurement
   organizations.
 * We can share health information with a coroner, medical examiner, or funeral
   director when an individual dies.

Address workers’ compensation, law enforcement, and
other government requests

We can use or share health information about you:

 * For workers' compensation claims
 * For law enforcement purposes or with a law enforcement official
 * With health oversight agencies for activities authorized by law
 * For special government functions such as military, national security, and
   presidential protective services

Respond to lawsuits and legal actions We can share health information about you
in response to a court or administrative order, or in response to a subpoena.

ADDITIONAL APPLICABLE LAW REQUIREMENTS:

VSP will abide by more stringent state and federal laws where applicable.

OUR RESPONSIBILITIES

 * We are required by law to maintain the privacy and security of your protected
   health information.
 * Breach Notification: We will let you know promptly if a breach occurs that
   may have compromised the privacy or security of your information.
 * We must follow the duties and privacy practices described in this Notice and
   give you a copy of it.
 * Right to Revoke: If you tell us we can share your information other than as
   described in this Notice, you may change your mind at any time. Let us know
   in writing if you change your mind.
 * For more information see Department of Health & Human Services Notice of
   Privacy Practices.

SPECIAL NOTES

VSP does not collect genetic information and is prohibited from using or
disclosing genetic information for underwriting purposes.

VSP does not collect substance abuse treatment records and will never share any
substance abuse treatment records without your written permission.

Nondiscrimination Statement: VSP complies with applicable Federal civil rights
laws and does not discriminate on the basis of race, color, national origin,
age, disability, or sex.

Notice Revisions: We can change the terms of this Notice, and the changes will
apply to all information we have about you. The new Notice will be available
upon request, on our website, and we will notify you by mail or email.


CONTACT INFORMATION Contact VSP Contact VSP if you have questions about your
privacy rights, believe that we may have violated your privacy rights, or
disagree with a decision that we made about access to your PHI, you may contact
us at the following address, telephone number, or email:
VSP Vision
Attention: Privacy Specialist
3333 Quality Drive
MS-163
Rancho Cordova CA 95670
916-858-7432
HIPAA@vsp.com

 



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