Effective date: November 3, 2026
This Notice of Privacy Practices (“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.
This Notice applies to all Protected Health Information (“PHI”) created, received, maintained, or transmitted by Siepser Eyecare. (“we,” “us,” or “our”), whether in written, electronic, or oral form.
Our Responsibilities
We are required by law to:
- Maintain the privacy and security of your PHI.
- Provide you with this Notice explaining our legal duties and privacy practices.
- Follow the terms of this Notice currently in effect.
- Notify you if a breach occurs that may have compromised the privacy or security of your PHI.
How We May Use and Disclose Your Health Information
The following categories describe the ways we may use and disclose your PHI. Not every use or disclosure is listed, but all permitted uses fall within these categories.
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. This may include sharing information with physicians, therapists, nurses, or other healthcare professionals involved in your care.
Payment
We may use and disclose your PHI to bill and receive payment for services provided to you. This may include disclosures to insurance companies, health plans, or other payers.
Healthcare Operations
We may use and disclose your PHI for healthcare operations, including quality assessment and improvement activities, training, licensing, accreditation, auditing, compliance, and business planning.
Appointment Reminders and Health-Related Services
We may use your PHI to contact you with appointment reminders and information about treatment alternatives or other health-related services that may interest you.
Business Associates
We may disclose your PHI to business associates that perform services on our behalf, such as billing, scheduling, and technology services. They are required by law and by contract to protect your PHI.
Family and Friends
We may share relevant PHI with a family member, friend, or other person involved in your care or in paying for your care, unless you object.
Uses and Disclosures Without Your Authorization
We may use or disclose your PHI without your authorization as required or permitted by law, including for:
- Public health activities (such as reporting certain diseases or adverse events).
- Health oversight activities (such as audits, investigations, inspections, and licensure).
- Legal proceedings and law enforcement purposes, as permitted by law.
- Compliance with workers’ compensation laws.
- To prevent or lessen a serious threat to health or safety, consistent with applicable law.
- As required by federal, state, or local law.
- Reporting suspected abuse, neglect, or domestic violence, as required or permitted by law.
- Organ and tissue donation, and to coroners, medical examiners, and funeral directors.
- Research, subject to privacy protections required by law.
- Specialized government functions, such as military, national security, and correctional institution purposes.
Uses and Disclosures Requiring Authorization
We will obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice, including:
- Most uses and disclosures of psychotherapy notes.
- Marketing purposes (where an authorization is required by law).
- Sale of PHI.
You may revoke an authorization at any time by submitting a written request, except to the extent that we have already taken action based on your authorization.
Special Protections for Substance Use Disorder Records (42 C.F.R. Part 2)
Certain health information related to the treatment of Substance Use Disorders (SUD) is subject to additional federal confidentiality protections under 42 C.F.R. Part 2.
If this practice creates, receives, or maintains records that identify an individual as having sought or received Substance Use Disorder treatment, those records are afforded heightened protections beyond standard HIPAA requirements. In general, such information may not be used or disclosed without the patient’s written consent, except as expressly permitted or required by law.
Federal law further prohibits the use or disclosure of Substance Use Disorder records in civil, criminal, administrative, or legislative proceedings against the patient, except as authorized by a court order or otherwise permitted under applicable regulations.
Patients have specific rights related to Substance Use Disorder records, including limitations on disclosures and the right to revoke certain authorizations, subject to applicable legal requirements.
These additional protections apply only to information covered by 42 C.F.R. Part 2 and do not necessarily apply to all health information maintained by this practice.
Your Rights Regarding Your Health Information
You have the right to:
- Inspect and obtain a copy of your medical and billing records, and other PHI we maintain about you, as permitted by law.
- Request a correction (amendment) to your PHI if you believe it is incorrect or incomplete, as permitted by law.
- Request restrictions on certain uses and disclosures of your PHI. We are not required to agree to most requests, but we must agree not to disclose PHI to your health plan for payment or healthcare operations if the PHI relates solely to an item or service you have paid for in full out of pocket.
- Request confidential communications (for example, that we contact you at an alternative phone number or address).
- Receive an accounting of disclosures of your PHI, as permitted by law.
- Obtain a paper copy of this Notice at any time, even if you agreed to receive it electronically.
- Be notified following a breach of unsecured PHI, as required by law.
- Choose someone to act for you, such as a person with medical power of attorney or a legal guardian, who may exercise your rights and make choices about your PHI.
Requests must typically be submitted in writing. We may deny certain requests as permitted or required by law.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below, or with the U.S. Department of Health and Human Services Office for Civil Rights by visiting www.hhs.gov/ocr/complaints (opens in new tab). We will not retaliate against you for filing a complaint.
Changes to This Notice
We reserve the right to change this Notice at any time. Any changes will apply to all PHI we maintain. The revised Notice will be available on our website at https://www.siepservision.com, in our office, and upon request.
Contact Us
If you have questions about this Notice or want to exercise your rights, please contact our Privacy Officer using our contact page.
You can also reach our Privacy Officer by phone or by mail at:
Siepser Eyecare860 Swedesford Rd Ste 100
Wayne, PA 19087
(610) 265-2020