NOTICE OF PRIVACY PRACTICES
EFFECTIVE DATE: 07/26/2026
THIS NOTICE DESCRIBES HOW MEDICAL AND VISION INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
OUR LEGAL DUTY
We are required by applicable federal (HIPAA) and Minnesota state laws to maintain the privacy of your Protected Health Information (PHI). We are required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your PHI. We are also required by law to notify affected individuals following a breach of unsecured PHI. We must abide by the terms of this Notice while it is in effect.
We reserve the right to change the privacy practices described in this Notice and make the new practices effective for all PHI that we maintain. Should we make such a change, you may obtain a revised Notice by calling our office and requesting a revised copy be sent in the mail, or by accessing our website at lvtp.vision.
HOW WE MAY USE AND DISCLOSE YOUR PHI
1. Treatment: We may use or share your PHI with optometrists, ophthalmologists, opticians, technicians, or other healthcare professionals involved in your care. For example, we may share your information to order prescription contact lenses, obtain consultation from a retina specialist, or manage a co-managed surgical procedure.
2. Payment: Under Minnesota law (Minn. Stat. § 144.293), with your signed consent, we may use and disclose your PHI to bill and collect payment from you, your health plan, or vision insurance provider (e.g., VSP, EyeMed, Blue Cross Blue Shield).
3. Healthcare Operations: We may use your PHI to run our practice, improve quality of care, conduct clinical audits, and train staff.
4. Business Associates: We may share PHI with third-party vendors (such as EHR platforms, billing services, or contact lens distributors) who perform functions on our behalf, under signed Business Associate Agreements ensuring your privacy.
5. Special Protections for Minnesota Residents: Minnesota law generally provides greater privacy protection than federal law regarding the release of health records. Except for specific emergency care, consultations between active treatment providers, or explicit statutory exemptions, we will obtain your written consent before releasing your health records to outside third parties.
6. Appointment Reminders & Clinical Notices: We may use your contact information to reach you via phone, text message, email, or mail for appointment reminders, eye health recall notices, or pickup notifications for contact lenses or optical goods.
7. Unencrypted Communications: If you request that we send your health information or prescriptions via standard email or text message, please be aware that these methods are not fully secure. By requesting these channels, you acknowledge and accept the risk of unauthorized interception.
8. Product Safety & Recalls: We may disclose your PHI to manufacturers or distributors to process optical product warranties, report adverse events, or notify you of contact lens or device recalls.
9. Prescription Verification: We may confirm or verify the validity of your spectacle or contact lens prescriptions when requested by authorized third-party sellers or dispensers in accordance with federal law.
10. Required by Law & Public Interest: We may disclose PHI when required by law, such as for public health reporting, reporting suspected child or vulnerable adult abuse, responding to court orders, or complying with investigations by the Minnesota Board of Optometry.
11. Workers’ Compensation: We may disclose your PHI as authorized by and to the extent necessary to comply with Minnesota laws relating to workers’ compensation or similar programs that provide benefits for work-related injuries or illnesses.
12. Inmates and Law Enforcement Custody: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your PHI to the correctional facility or officer as necessary for your health and safety, the safety of others, or the security of the institution.
13. Health Information Exchanges (HIE): We may participate in secure Health Information Exchanges to electronically share clinical data with other healthcare providers involved in your care. You have the right to request to opt out of HIE sharing.
14. Marketing & Sale of PHI: We will NEVER sell your personal health information. We will not use your PHI for third-party marketing purposes without your express, written authorization.
15. Fundraising Communications: If we contact you for fundraising efforts, you have the right to opt out of receiving such communications.
16. Other Uses and Disclosures: Uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. You may revoke such authorization in writing at any time, except to the extent that we have already taken action based on it.
YOUR RIGHTS REGARDING YOUR PHI
Right to Inspect and Copy: You have the right to inspect and obtain electronic or paper copies of your medical records and optical prescriptions in accordance with Minnesota law.
Right to Amend: If you feel your health information is incorrect or incomplete, you may request in writing that we amend it.
Right to Request Restrictions: You may ask us not to share certain PHI for treatment, payment, or operations. If you pay out-of-pocket in full for a service or optical item, you have the right to mandate that we do not share details of that service/item with your health or vision insurance plan.
Right to Confidential Communications: You may ask us to contact you in a specific way (e.g., cell phone vs. home phone, email, or alternate mailing address).
Right to an Accounting of Disclosures: You may request a list of disclosures we have made of your PHI for purposes other than treatment, payment, or routine operations.
Right to Notification of a Breach: You will be notified promptly if an unsecured breach of your PHI occurs.
Right to a Paper Copy of This Notice: You have the right to obtain a physical paper copy of this Notice at any time upon request, even if you previously agreed to receive it electronically.
QUESTIONS AND COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or directly with the Secretary of the U.S. Department of Health and Human Services (HHS). We will not retaliate against you for filing a complaint.
To file a complaint with HHS, contact:
U.S. Department of Health and Human Services
Office for Civil Rights - Region V
233 N. Michigan Ave., Suite 240
Chicago, IL 60601
Phone: (800) 368-1019 | TDD: (800) 537-7697
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/
CONTACT INFORMATION
LAKE VISION PLLC
2510 Maple Grove Rd., Ste. 500, Duluth, MN 55811
PRIVACY OFFICER
Phone: 218-740-3000
Email: od@lakevis.com