OptiCare Managed Vision
Notice of Privacy Practices
OptiCare Managed Vision (OMV) takes seriously the privacy interests
of our membership, as we know you do. As an eye health
managed care organization, we want you to understand how we
protect members’ confidential
information.
We protect all confidential information we have about our members
and disclose only the information that is legally and
contractually appropriate. Our membership has the right to
expect its legally protected privacy interests will be respected
and protected by OMV.
Our Member Confidentiality Policy is intended to comply with applicable
state and federal laws and regulations, and the accreditation standards
of the National Committee for Quality Assurance. If these requirements
and standards change, we will review and revise our policy. We also
may change our policy (as allowed by law) as necessary to better
serve our membership.
To make sure that our policy is effective, we have designated a
Corporate Compliance Officer who is charged with approving and reviewing
OMV’s privacy and confidentiality standard operations procedures.
This officer is responsible for the oversight, implementation, and
monitoring of our policy.
 OMV’s Core Privacy Principles:
- We will protect Member confidential information and will
not disclose any personal information to any external
party except as we describe in our policy or as permitted or required
by law or
regulation.
- Members have a right to request restrictions in writing
on the uses and disclosures of their confidential
member information. However, OMV is not required to agree with a requested restriction.
- Each of our employees must sign a confidentiality statement
when they begin employment with us, asserting
they will abide by our policy. Only employees who have legitimate business needs
to
use Member confidential information will have
access to such information.
- When we use outside parties to perform work for us, we
require these contractors to sign their own confidentiality
agreements, stating they will protect member confidential information.
- We also require the same kind of confidentiality agreement
with our contracted providers.
- We disclose member confidential information only
where: required or permitted by law; or we obtain
a separate authorization from the Member for specific
purposes. All disclosures
we make are
permitted or required by law. These disclosures
include those for health care treatment and
payment, our company’s health care
operations, various areas where the Member’s consent is not
needed for certain public purposes (such as public health emergencies),
and certain other health care purposes such as coordination of medical
care, quality assessment and measurement, and accreditation. In a
limited number of situations beyond these areas, we will seek a Member’s
separate authorization for a specific purpose.
- Members have the right to review certain records held
in our possession. If Members wish to review
records containing confidential information about them from the previous six
years, they must submit
a written request for copies of the information
(we may charge a fee to obtain these copies).
- Members have the right to request an amendment to their
confidential information. Such requests must
be made in writing.
- If members have questions or concerns about the accuracy
or completeness of information we have about
them, Members should contact us in writing to tell us about their concerns. We
will make
the appropriate changes, as may be required by
law. If a provider or someone other than us created the information, then we
will direct
the Member to that person to make the corrections.
- Prior to responding to a phone request for Member confidential
information, the caller will be asked to provide
identifying information to reduce the possibility of a disclosure of Member confidential
information to an unauthorized individual.
- Individuals seeking Member confidential information will
be required to submit Consent for Release of
Medical Information form signed by the Member or his/her parent/guardian.
- A person who believes OMV is not complying
with these requirements may file
a complaint with the OMV
Corporate Compliance Officer, in accordance with the following
protocol:
- A complaint must be filed in writing, either
on paper or electronically.
- A complaint must name the entity that
is the subject of the complaint
and describe what is believed to be the violation.
- A complaint must be
filed within 180 days of when the complainant
knew or should have known that
the act or omission
complained of occurred, unless the HHS Secretary,
for good cause shown, waives
this
time limit.
- OMV
Corporate Compliance Officer may be contacted
at the following address:
Corporate Compliance Officer
OptiCare Managed Vision
P.O. Box 7548
112 Zebulon Court
Rocky Mount NC 27804
- A person who believes OMV is not complying with these
requirements may file
a complaint with the HHS Secretary, in accordance
with the following protocol:
- A complaint must be filed in writing, either
on paper or electronically.
- A complaint
must name the entity that is the subject
of the complaint and describe
what is believed to be the violation.
- A complaint must be filed within 180 days of
when the complainant knew
or should have known that
the act or omission complained of occurred,
unless
the HHS
Secretary, for good cause shown, waives this
time limit.
- HHS Secretary may be contacted at the following
address and phone number:
The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-877-696-6775
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