Consumer Info

HIPAA and Policy

Monarch Bay Optometry, INC

This notice describes how health information about you can be used and disclosed. Please review it.

Our legal duty:

We are required by law to maintain the privacy of your health information. We are also required to give you this Notice. We reserve the right to change our privacy practices, provided such changes are permitted by applicable law. You may request a copy of our Notice at any time.

Uses and Disclosures of Health Information: We use and disclose health information about you for treatment, payment, and healthcare operations. For example,

Treatment: We may use or disclose your health information to an optician, ophthalmologist, or other health care provider providing treatment to you for a) the provision, coordination, or management of health care and related services by health care providers; b) consultation between health care providers relating to a patient; c) the referral of a patient for health care from one health care provider to another; or d) recall information.

Payment: We may use or disclose your health information to obtain payment for services we provide to you. This may include: a) billing and collection activities and related data processing; b) actions by the health plan or insurer to obtain premiums or to determine or fulfill its responsibilities for coverage and provisions of benefits under its health plan or insurance agreement, determinations of eligibility or coverage, adjudication or subrogation of health benefit claims; c) medical necessity and appropriateness of care reviews, utilization review activities, and d) disclosure to consumer reporting agencies of information relating to the collection of premiums or reimbursement.

Healthcare Operations: We may use or disclose your health information in connection with our healthcare operations, including things such as quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.

Your authorization: You may give us written authorization to use your health information or to disclose it to anyone for any purpose. You may revoke your authorization at any time, in writing. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us written authorization, we cannot use or disclose your health information for any reason except those described in this Notice.

We do not sell your information.

Marketing Health Products or Services: We will not use your health information for marketing purposes without your prior written authorization. We may provide you with information regarding products or services that we offer related needs. We will never sell your health information without your prior authorization.

To You, Your Family, and Friends: We must disclose your health information to you as described in the Patient Rights section. We may disclose your health information to a family member, friend, or another person to the extent necessary to help with your healthcare or with payment for your healthcare, but only if you agree that we may do so or if you are not able to agree if it is necessary for our professional judgment.

Persons Involved with Care: We may use or disclose health information to notify, or assist in the notification of (including identifying and locating) a family member, your personal representative, or another person responsible for your care, your location, your general condition, or death. If you are present, we will provide you with the opportunity to object to such uses or disclosures. In the event of emergency circumstances, we will disclose health information based on a determination using our professional judgment disclosing health information that is directly relevant to the person's involvement in your healthcare. We will also use our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up a filled prescription, medical supplies, x-rays, or other similar forms of health information.

Required by law: We may use or disclose your health information when we are required to do so by law, including judicial and administrative proceedings.

Abuse or Neglect: We may disclose your health information to authorities if we reasonably believe you are a possible victim of abuse, neglect or domestic violence, or other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or to the health or safety of others.

National Security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to the correctional institutions or law enforcement officials having lawful custody of protected health information of inmates or patients under circumstances.

Appointment Reminders and Treatment Alternatives: We may use or disclose your health information to provide you with appointment reminders (such as voicemail messages, postcards, or letters) or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Your Rights

Access: You have a right to review or get copies of your health information, with limited exceptions. You must make a request in writing to obtain access to your health information. You may obtain a form to request access by contacting us. We reserve the right to charge you a reasonable cost-based fee for expenses such as copies or staff time. You may also request access by sending us a letter. If you prefer, we will prepare a summary or an explanation of your health information for a reasonable fee.

Disclosure Accounting: You have a right to receive a list of instances in which we or our business associates disclosed your health information for purposes, other than treatment, payment, or healthcare operations, where you have provided authorization and certain other activities, for the last six years, but not for disclosures made prior to April 14, 2008.

Restriction: You have a right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree with these additional restrictions, but if we do, we will abide by our agreement (except in an emergency).

Alternative Communication: You have a right to request in writing that we communicate with you about your health information by alternative means or to alternative locations. Your request must specify the alternative means or location, and provide a satisfactory explanation of how payments will be handled under the alternative means or location you request.

Amendment: You have the right to request that we amend your health information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request under certain circumstances.

Electronic Notice: If you receive this Notice on our website or by email, you are entitled to receive this Notice in written form.

Questions and Complaints: If you are concerned that we may have violated your privacy rights or you disagree with a decision we made about access to your health information, you may complain to us or the U.S. Department of Health and Human Services.

We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint.

Refund Policies and Warranties

We will do everything reasonable and in our control to make our service a success and our products to your satisfaction.

Spectacles:

All orders for frames and/or prescription lenses require a minimum 50% deposit unless special arrangements are made with Dr. Lin.

A one-time store credit or exchange only for each order and the request must be completed within the first 30 days from the purchase/order date. The original order must be in perfect condition for credit or exchange, as determined by our staff.

Every transaction is reviewed independently. Because the majority of our products are custom-made for your eyes:

• a one-time redo for lenses (e.g. you want to upgrade the order)

• or a one-time exchange on eyewear

• or issuance of store credit only

• or charge a 50% cancellation fee (if the job was cancelled at your request and at no fault of ours.)

will be allowed at the business owner's discretion. Each case is treated separately due to circumstances surrounding the order.

If you want to change the lenses AND the frame, it must be decided at the same time.

Warranty Policy for items purchased at our office:

All eyeglass frames (except "budget frames") have a minimum 1-year warranty for manufacturer's defects. If your frames break, please bring them in for us to evaluate. A minimum $20 shipping and handling fee applies. We use this fee to send the frame to the manufacturer and have them evaluate it for warranty coverage. The decision is up to the manufacturer. We will do our best to be your advocate and have the frames covered under the guidelines of "defects in workmanship." This warranty does not cover mishandling the frames and/or the frames showing damage from accidents or destruction, e.g. stepping on frames, dog chewing frames, dropping frames.

All prescription lenses have a one-time "Dr. Redo" warranty,( i.e. change to a new prescription and one time only). The time frame allowed to make that redo depends on the lab's policy. This can vary between 30 to 90 days. Use 30 days as the safest guideline. Inquire about the time frame for your specific order. Maui Jim and Rudy Project have a one-time 30-day redo warranty due to contractual restrictions. A 50% cancellation fee may apply to special orders, e.g. Rudy Project.

All prescription lenses purchased with anti-reflection coating have a minimum 1-year warranty against peeling and scratches. The one-time redo is done with the same exact specifications as the original order. No modifications, except upgrades, are allowed.

For frames, Maui Jim has a 2-year warranty and Rudy Project has a 3-year warranty for manufacturer's defects only. All warranties are from the original purchase date. No exceptions.

Contact lenses come with no warranty. However, if you discover that a lens is missing or is torn from its original packaging, we will do our best to replace the lens in the form of a free trial lens. Opened and/or marked boxes cannot be returned for a refund or exchange.

Any fees for returns ( i.e. a return shipping and handling and/or restocking fee may apply) is the responsibility of the consumer. Again we will do everything possible to represent you for problems with the lab and/or vendor.