ARIZONA DEPARTMENT OF ECONOMIC SECURITY

NOTICE OF PRIVACY PRACTICES

“This 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”

Effective August 1, 2013

Confidentiality Practices:

The Arizona Department of Economic Security (DES) is committed to protecting your health information. This notice explains how DES will use, share and protect your health information. It also explains your rights to privacy of your health information as required by law. If our confidentiality practices change, a new notice will be mailed to you within sixty (60) days of the change.

Uses, Sharing and Protection of Health Information

The law only allows our staff to use your health information when doing their jobs or to share your information when it is necessary to run the program. When health information is shared with other agencies or organizations, DES requires them to keep your health information confidential. Your health information will be shared to approve or deny treatment, and to determine if you are getting the right medical treatment. For example, doctors and nurses employed by the programs may review the treatment plan created for you by your health care provider to make sure the care you receive is medically necessary.

The Program Will Use and Share Your Health Information Without Authorization to:

·         Make payments to your health care providers for medical services provided to you.

·         Coordinate payment for your care between the program, other health plans, and other insurance companies that may be responsible for the cost of your care.

·         Coordinate your care between the program, other health plans, and health care providers to improve the quality of your health care.

·         Evaluate the performance of your health care provider. For example, the program contracts with consultants to review hospital and other facilities’ medical records to check on the quality of care you received.

·         Release information to its attorneys, accountants, and consultants so that the program is run efficiently and to detect and prosecute program fraud and abuse.

·         Send you helpful information such as program benefit updates, free medical exams and consumer protection information.

·         Share information with other government agencies or organizations that provide benefits or services when the information is necessary in order for you to receive those benefits or services.

·         The Program May Disclose Your Health Information Without Authorization:

·         To public health agencies for activities such as disease control and prevention, problems with medical products or medications.

·         If you are the victim of abuse, neglect or domestic violence.

·         To health oversight agencies responsible for the Medicaid Program such as the U.S. Department of Health and Human Services and its Office of Civil Rights.

·         In court cases or judicial and administrative hearings when required by law to run the program.

·         To coroners, medical examiners, and funeral directors so they can carry out their jobs as required by law.

·         To organizations involved with organ donation and transplantation, communicable disease registries and cancer registries.

·         To entities authorized to conduct a research project.

·         To prevent a serious threat to a person’s or the public’s health and safety.

·         To the military if you are or have been a member of the armed services.

·         To a correctional facility or law enforcement officials to maintain the health, safety, and security of the corrections systems, if you are held in custody.

·         To workers’ compensation programs that provide benefits for work-related injuries or illness without regard to fault.

·         To law enforcement or national security and intelligence agencies, and to protect the President and others as required by law.

 

 

Please sign below to accept our privacy policies

 

Vision Exam vs Medical Exam

 

·        If you are using a vision discount plan for today’s examination

• Vision exams are a basic health screening
• During these exams we are only able to diagnose visual conditions, such as farsighted, nearsighted, or presbyopia (trouble at near)
• These plans do not accept medical diagnoses for billing, therefore we are unable to use these discount plans towards medical examinations, diagnosis, or treatment of medical issues.

·        Medical Examination

• Using your medical insurance (BCBS, Cigna, etc.) or out of pocket
• If you are having trouble with or have one of the following conditions, this would be considered a medical examination.
• Itching, redness, dry eye, tearing eyes, advancing cataracts, etc.
• Diabetes, immune conditions with ocular side effects, long term monitoring of medication, etc.

Please notify the front desk if you require switching your basic vision examination into a medical examination

 

 

Terms of Service

We want you to feel confident that you chose us so we backup our exam and glasses with our vision plus comfort guarantee. We will always work with you to make sure your prescription is as sharp as can be and your glasses feel great. Pinky swear!

• Rx checks are included within 90 days of eyewear purchase
  • If outside eyewear is purchased, a $65 office visit fee will be charged. If the  prescription requires modification, the fee is waived. If the eyewear is made incorrectly or a poor lens choice was made, the fee will remain
  • After 90 days, a $65 refraction fee will be applied to all Rx checks.
• Most lenses are completed within 2 weeks of purchase. However, due to lens customization and manufacturer availibility, this time can vary. We will always try our best to complete all orders as soon as possible and communicate with any delays. 
  
  • Custom frame purchases may include an extended estimated completion date.
• Broken frames are replaced at ½ retail cost when purchased as a complete package with anti-reflective coating
• Due to customization of lens generation, All Eyewear sales are final

Dilation and/or Optos retinal imaging will be performed annually to monitor the health of the back of your eye

If your appointment is missed or cancelled within 24 hours of your exam, a $50 nonrefundable fee will be charged to schedule your next appointment

Contact Lens Policy

 

    Current contact lens technology offers successful contact lens wear to most of our patients. Because contact lenses are medical devices placed on the eyes, they require expert fitting and careful instruction, as well as conscientious care and compliance with recommended follow‐up examinations to maintain the healthy function of your eyes. A complete ocular examination is necessary to evaluate for contact lens wear. Insertion and removal training will be provided if required. Follow up appointments are included for up to 90 days post-fit using vision insurnace. Other fits include thirty days of follow up and pro-rated appointments thereafter. Payment for CL fittings are due at time of fitting. If changing type of fit, the difference will be charged at time of change. Yearly examinations are required to maintain an active prescription.

 

Contact Lens Material Policy

• Materials purchased directly from UEC will be serviced directly by UEC
  • Ripped lens replacement, lost lens, extra trials etc.

• UEC is unable to service lenses purchased from external vendors
• Materials may be returned within 90 days, in unopened, new, sellable condition and the rebate has not been redeemed. Condition will be determined by UEC at time of return

 

Contact lenses may be ordered through UEC in store, or via phone/email/text.

 

   We are proud to introduce the latest in retinal imaging, the optomap. It is
painless, quick, and the doctor’s preferred method at monitoring the health of
your eye. This instrument will enhance our ability to detect and monitor retinal
defects associated with common systemic diseases such as hypertension,
diabetes, high cholesterol, and systemic disease. Through this digital imaging of
the retina we can observe early changes in the eye relating to diabetes, glaucoma, cataracts, and macular degeneration. There are over 200 systemic diseases that have ocular signs and implications.

• This technology is our preferred way of monitoring the eye over time and required for all patients

   By the time you have symptoms affecting your vision it is typically too late to
prevent permanent sight damage. We care about your vision and want to be sure
we actively monitor your eye; the optomap retinal image is the best way to do
this over time.