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 located on vsp.com, or calling Member Services at 800.877.7195.

Patient Rights

• Access: You can ask to see or get a copy of your health and claims records and other health information we have about you.
• Amend: You can ask us to correct your health and claims records if you think they are incorrect or incomplete.
• Confidential communication: You can ask us to send your protected health information directly to you at an alternative address.
• Restrict: You can ask us not to use or share certain health information for treatment, payment (no cost to patient claims processing), or our operations.
• Accounting of Disclosures: You can ask for a list of the times we’ve shared your health information.
• Appointment of Representative: 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.
• Complain: 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 also 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.
• Notice: You can ask for a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically.

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.
• VSP never shares sells your information or shares it for marketing purposes unless you give us written permission.

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:

Use and Disclose for treatment, payment, and healthcare operations.

• Treatment: We can use your health information and share it with professionals who are treating you.
• Payment: Eyes of Hope/Mobile Clinics submits no cost to patient claims to help us track and improve healthcare services and for auditing purposes.
• Healthcare Operations: We can use and disclose your information to run our organization and contact you when necessary.

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, but also to respond to lawsuits and legal actions. We have to meet many conditions in the law before we can share your information for these purposes. For more information visit hhs.gov > HIPAA – Health Information Privacy Your Rights under HIPAA.

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, visit hhs.gov 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 use protected health information for research purposes.
• VSP does not collect substance abuse treatment records and will never share any substance abuse treatment records without your written permission.
• VSP will abide by more stringent state and federal laws where applicable.
• 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

VSP Global Attention: Privacy Specialist, 3333 Quality Drive MS 163, Rancho Cordova, CA 95760, Phone: 916.858.7432, HIPAA@vsp.com