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1900 NE 162nd Ave. D103, Vancouver, WA 98684

Effective date of notice: Oct. 1, 2018


We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give you notice of our privacy practices. This Notice describes how we protect your health information and what rights you have regarding it.


The most common reason why we use or disclose your health information is for treatment, payment or health care operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you; testing or examining your eyes; prescribing glasses, contact lenses, or eye medications and faxing them to be filled; showing you low vision aids; referring you to another doctor or clinic for eye care or services; or getting copies of your health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about your health or vision care plans or other sources of payment; preparing and sending bills or claims; and collecting unpaid amounts (either ourselves or through a collection agency or attorney). “Health care operations” mean those administrative and managerial functions that we have to do in order to run our office. Examples of how we use or disclose your health information for health care operations are: financial or billing audits; internal quality assurance; personnel decisions; participation in managed care plans; defense of legal matters; business planning; and outside storage of our records. We routinely use your health information inside our office for these purposes without any special permission. If we need to disclose your health information outside of our office for these reasons we usually will not ask you for special written permission.

Other Disclosures and Uses We May Make Without Your Authorization or Consent

In some limited situations, the law allows or requires us to use or disclose your health information without your permission. Not all of these situations will apply to us; some may never come up at our office at all. Such uses or disclosures are:

• when a state or federal law mandates that certain health information be reported for a specific purpose;

• for public health purposes, such as contagious disease reporting, investigation or surveillance; and notices to and from the federal Food and Drug Administration regarding drugs or medical devices;

• disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence;

• uses and disclosures for health oversight activities, such as for the licensing of doctors; for audits by Medicare or Medicaid; or for investigation of possible violations of health care laws;

• disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies;

• disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime; to provide information about a crime at our office; or to report a crime that happened somewhere else;

• disclosure to a medical examiner to identify a dead person or to determine the cause of death; or to funeral directors to aid in burial; or to organizations that handle organ or tissue donations;

• uses or disclosures for health related research;

• uses and disclosures to prevent a serious threat to health or safety;

• uses or disclosures for specialized government functions, such as for the protection of the president or high ranking government officials; for lawful national intelligence activities; for military purposes; or for the evaluation and health of members of the foreign service;

• disclosures of de-identified information;

• disclosures relating to worker’s compensation programs;

• disclosures of a “limited data set” for research, public health, or health care operations;

• incidental disclosures that are an unavoidable by-product of permitted uses or disclosures;

• disclosures to “business associates” who perform healthcare operations for us and who commit to respect the privacy of your information;

Unless you object, we will also share relevant information about your care with your family or friends who are helping you with your eye care.

Appointment Reminders

We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We may also call or write to notify you of other treatments or services available at our office that might help you. Unless you tell us otherwise, we may leave you a reminder message on your home answering machine or with someone who answers your phone if you are not home.


We will not make any other uses or disclosures of your health information unless you sign a written “authorization form.” The content of an “authorization form” is determined by federal law. Sometimes, we may initiate the authorization process if the use or disclosure is our idea. Sometimes, you may initiate the process if it’s your idea for us to send your information to someone else. Typically, in this situation you will give us a properly completed authorization form, or you can use one of ours.

If we initiate the process and ask you to sign an authorization form, you do not have to sign it. If you do not sign the authorization, we cannot make the use or disclosure. If you do sign one, you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be in writing. Send them to the office named at the beginning of this Notice.


The law gives you many rights regarding your health information. You can:

• ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment or health care operations. We do not have to agree to do this, but if we agree, we must honor the restrictions that you want. To ask for a restriction, send a written request to the office at the address shown at the beginning of this Notice.

• ask us to communicate with you in a confidential way, such as by phoning you at work rather than home, by mailing health information to a different address, or by using E-mail. We will accommodate these requests if they are reasonable, and if you pay us for any extra cost. If you want to ask for confidential communications, send a written request to the office  at the address shown at the beginning of this Notice.

• ask to see or to get photocopies of your health information. By law, there are a few limited situations in which we can refuse to permit access or copying. For the most part, however, you will be able to review or have a copy of your health information within 30 days of asking us (or sixty days if the information is stored off-site). You may have to pay for photocopies in advance. If we deny your request, we will send you a written explanation, and instructions about how to get an impartial review of our denial if one is legally available. By law, we can have one 30-day extension of the time for us to give you access or photocopies if we send you a written notice of the extension. If you want to review or get photocopies of your health information, send a written request to the office contact person at the address shown at the beginning of this Notice.

• ask us to amend your health information if you think that it is incorrect or incomplete. If we agree, we will amend the information within 60 days from when you ask us. We will send the corrected information to persons who we know got the wrong information, and others that you specify. If we do not agree, you can write a statement of your position, and we will include it with your health information along with any rebuttal statement that we may write. Once your statement of position and/or our rebuttal is included in your health information, we will send it along whenever we make a permitted disclosure of your information. By law, we can have one 30-day extension  to consider a request for amendment if we notify you in writing of the extension. If you want to ask us to amend your health information, send a written request, including your reasons for the amendment, to the office contact person at the address shown at the beginning of this Notice.

• get a list of the disclosures that we have made of your health information within the past six years (or a shorter period if you want). By law, the list will not include: disclosures for purposes of treatment, payment or health care operations; disclosures with your authorization; incidental disclosures; disclosures required by law; and some other limited disclosures. You are entitled to one such list per year without charge. If you want more frequent lists, you will have to pay for them in advance. We will usually respond to your request within 60 days of receiving it, but by law we can have one 30-day extension of time if we notify you of the extension in writing. If you want a list, send a written request to the office contact person at the address shown at the beginning of this Notice.

• get additional paper copies of this Notice upon request. It does not matter whether you got one electronically or in paper form already. If you want additional paper copies, send a written request to the office at the address shown at the beginning of this Notice.


By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to such information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our office and have copies available in our office


If you think that we have not properly respected the privacy of your health information, you are free to complain to us or the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint. If you want to complain to us, send a written complaint to the office at the address shown at the beginning of this Notice. If you prefer, you can discuss your complaint in person or by phone.

Online Response Policy
and Procedures
Insight Eye Clinic
1900 NE 162ND AVE, STE D103
VANCOUVER, Washington 98684
Last Updated: 06/28/2024
Insight Eye Clinic
The purpose of implementing the Online Response Policy and Procedures is to
establish a standard for responding to reviews posted online or on social media
by patients or customers, on sites such as Facebook, Google, and Yelp. The
Health Insurance Portability and Accountability Act (HIPAA) guidelines do not
prevent Insight Eye Clinic from responding to reviews but do require that Insight
Eye Clinic responds in a way that keeps patients’ protected health information
(PHI) or electronic PHI private. Insight Eye Clinic understands the importance of
developing HIPAA-compliant responses to avoid inadvertently violating patient
If Insight Eye Clinic or a representative staff member chooses to respond to
online interactions and/or reviews they will respond in a caring, professional, and
HIPAA-compliant manner. Insight Eye Clinic understands that per HIPAA
regulations, regardless of what a patient says or posts publicly in their review,
Insight Eye Clinic is not authorized to release or acknowledge any PHI in their
response. If Insight Eye Clinic responds to reviews and online comments, Insight
Eye Clinic and all relevant staff members will follow the below procedure in all
responses to avoid a HIPAA violation.
When responding, Insight Eye Clinic should not respond in general terms
regarding how all patients are treated as a whole and should not directly address
any individuals’ concerns. This applies to both negative and positive reviews. In
their responses, Insight Eye Clinic should:
 Not acknowledge whether the reviewer is or has ever been a patient of
Insight Eye Clinic
 Focus only on the general office policies of Insight Eye Clinic
 Use generic language whenever possible
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The below examples demonstrate the type of responses that Insight Eye Clinic
will provide to reviews as well as non-compliant responses to avoid.
Ex. Negative Review
“I had to sit in the waiting room for over an hour before seeing the doctor. While
waiting the front desk person was rude to anyone who asked how much longer.
When I was finally able to see the doctor he spent very little time with me.”
 Non-HIPAA-compliant response: “We’re sorry your appointment
experience was unsatisfactory. Please let us know how we can make it
 HIPAA-compliant response: “Our policy is to schedule plenty of time
between patients in order to avoid long waits. We strive to deliver the best
care possible to all our patients, but we occasionally fall behind schedule
because of emergencies. We value your feedback and want to thank you
for taking the time to share it. You can contact our office at 360-947-2688
if you have any further comments or suggestions.”
Ex. Positive Review
“I can not speak more highly of this clinic! They treated my injury with the proper
sense of urgency and compassion it warranted. Dr. Smith was very sensitive to
my needs and his staff is wonderful!”
 Non-HIPAA-compliant response: “Thank you Mr. Jones! I’m happy you
had a great experience and I could help correct your scoliosis pain.”
 HIPAA-compliant response: “Our goal is to ensure that all of our patients
have the best experience every time they visit our office. We pride
ourselves on our honesty, integrity, and superior clinical skills. ”
Negative Reviews
 “Thank you for taking the time to provide feedback. We strive to make
each patient’s experience exceptional, and it pains us to hear if we fall
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Insight Eye Clinic
short of expectations. Please call our office at 360-947-2688 to discuss
this matter further.”
Schedule Issue
 “Our policy is to schedule plenty of time between patients in order to avoid
long waits. We strive to deliver the best care possible to all our patients,
but we occasionally fall behind schedule because of unforeseeable
emergencies. If you’d like to discuss this further, please contact us at 360-
947-2688 .”
Problem with Treatment
 “Due to HIPAA privacy laws, we are not able to address your concerns in a
public forum. Please feel free to call our office at 360-947-2688 and our
doctor will speak with you personally to address any concerns — whether
before, during, or after any appointments.”
Positive Review
 “We aim to deliver the best care to patients and provide positive
experiences! Thanks for sharing this feedback!”
 “Thank you for sharing this feedback! I strive to provide the best possible
care for every patient.”
Negative/Resolve Offline
 “We’d love to talk about this further—please contact our office manager at
 “We are committed to providing the best patient care experience. It’s our
policy to resolve issues offline. Please feel free to contact us at 360-947-

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