• We pride ourselves on giving great patient service and hope that you are satisfied and happy with your service and products. However, we understand that situations can arise and we ask that you review our office and store policies so that your experience can be more enjoyable and stress free.
• Please be aware of what your insurance is and what the coverage entails. We try to do our best to find your insurance and get an authorization before your exam. Medical eye visits and routine vision are different and can be used together with the visit.
• You will be billed for any services and materials that your insurance does not cover and you are ultimately responsible for the balance on the bill.
• We require at least half the amount of the balance before an order is processed or ordered.
• If you are not completely satisfied with your purchase, you are allowed to cancel before the job is processed for a full refund. If the job has been processed, there is a 25% cancellation fee, because lab charges have been accrued on the order. All custom Oakley sunglasses and prescription Maui Jim orders are non-refundable.
• NON PRESCRIPTION SUNGLASS PURCHASES ARE NON-REFUNDABLE. ONLY STORE CREDIT MAY BE GIVEN.
• You may be allowed to return prescription glasses if you are unhappy with your selection within 30 days, but there is a 25% restocking fee for your return on the prescription lenses (not on the frame). If you have insurance, there is a onetime exchange for frame and lenses within 30 days.
• Designer frames are unconditionally warranted for one year for manufacturer defects if they are not discontinued.
• If a frame becomes discontinued during your warranty period, then you may be allowed to choose a new frame of equal value and lenses will be made for that new frame without any charges made to you.
• Lab breakages and delays from insurances or lab orders are not our responsibility.
• Remakes due to lab errors and doctor’s prescription changes are free for the first time around. Please be advised that we will remake your glasses at most twice if it’s a lab error. If you are still unhappy with the result of the order or the prescription, then the third remake will be at your own expense.
• We are not responsible for breakages on patient’s own frame. We will adjust them and repair them at your own risk. However, in the event of a breakage, you will be given a 20% courtesy discount off the retail value if you wish to replace it at our office.
• Lenses are not scratch proof. If you upgrade to a polycarbonate lens which are scratch resistant (not scratch proof) they can be replaced in full if the scratch is within 30 days. If they are scratched before 6 months, then you can replace them at 50% of our listed price.
• Adjustments, screws, and nose pads are complimentary on frames that were purchased from us.
• Contact lens services are non-refundable and expire 3 months from the date of the fitting. Conventional and custom contact lenses are neither returnable nor refundable.
• You can return unopened, non expired and unaltered contact lens boxes in re-saleable condition if bought from us for exchange only.
• Rigid gas permeable contact lenses can be replaced at 50% of the listed price if lost within 30 days from the dispensing date.
• Eye Exams, Corneal Reshaping Therapy, and Vision Therapy services are non-refundable.
Central Eyecare NOTICE OF HIPPA PRIVACY PRACTICES
If you have any questions about this Notice please contact our Privacy Officer who is Dr. Hollie Huynh, OD
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. You may request a revised version by accessing our website, or calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.
1. Uses and Disclosures of Protected Health Information Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office who are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information may also be used and disclosed to pay your health care bills and to support the operation of your physician’s practice. Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with another provider. Payment: Your protected health information will be used and disclosed, as needed, to obtain payment for your health care services provided by us or by another provider. Health Care Operations: We may use or disclose, as needed, your protected health information in order to support the business activities of your physician’s practice.
Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Agree or Object
We may use or disclose your protected health information in the following situations without your authorization or providing you the opportunity to agree or object. These situations include: Required By Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, if required by law, of any such uses or disclosures. Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition. Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration for the purpose of quality, safety, or effectiveness of FDA-regulated products or activities including, to report adverse events, product defects or problems, biologic product deviations, to track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required. Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in certain conditions in response to a subpoena, discovery request or other lawful process. Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes. Coroners, Funeral Directors, and Organ Donation: We may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. Research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information. Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. Workers’ Compensation: We may disclose your protected health information as authorized to comply with workers’ compensation laws and other similar legally-established programs. Inmates: We may use or disclose your protected health information if you are an inmate of a correctional facility and your physician created or received your protected health information in the course of providing care to you.
Uses and Disclosures of Protected Health Information Based upon Your Written Authorization 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 below. You may revoke this authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your protected health information for the reasons covered by your written authorization. Please understand that we are unable to take back any disclosures already made with your authorization.
Other Permitted and Required Uses and Disclosures That Require Providing You the Opportunity to Agree or Object We may use and disclose your protected health information in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information. If you are not present or able to agree or object to the use or disclosure of the protected health information, then your physician may, using professional judgment, determine whether the disclosure is in your best interest. Facility Directories: Unless you object, we will use and disclose in our facility directory your name, the location at which you are receiving care, your general condition (such as fair or stable), and your religious affiliation. Others Involved in Your Health Care or Payment for your Care: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person’s involvement in your health care.
2. Your Rights Following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights. You have the right to inspect and copy your protected health information. This means you may inspect and obtain a copy of protected health information about you for so long as we maintain the protected health information. You have the right to request a restriction of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or health care operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not request an explanation from you as to the basis for the request. Please make this request in writing to our Privacy Officer. You may have the right to have your physician amend your protected health information. This means you may request an amendment of protected health information about you in a designated record set for so long as we maintain this information. You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice of Privacy Practices. You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.
3. Complaints You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer of your complaint. We will not retaliate against you for filing a complaint.
You may contact our Privacy Officer, Hollie Huynh OD at (714) 373-2020 or firstname.lastname@example.org for further information about the complaint process.
This notice was published and becomes effective on October 1, 2006. (2003 American Medical Association)