Osi Vision LLC dba OsiLife respects the privacy of our customers and every person who visits our sites, including www.osivision.com and
www.osilife.com (“this website”). References to “Osi Vision”, “OsiLife”, “we”, “us” and “our” are references to Osi Vision LLC dba OsiLife, the
owner of this website.Because your privacy is important to us, we are providing you with this notice about our collection and use of the information you provide to us.
We value your right to keep your information private. Likewise, we hope you understand that OsiLife may need to collect and use information
information regarding OsiLife, its facilities, and other unaffiliated institutions with whom we may do business or refer you to (these other
applicable laws as well as expressly consent to our collection, use, storage and disclosure of your information and data as described in this
Osi Vision LLC dba Osilife
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
If you have any questions about this Notice please contact our office (210-885-8055)
1. The scope of this Policy:
operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health
information.“Protected health information” is information about you, including genetic information & demographic information, whether oral or recorded in
any form or medium, that is created or received by a healthcare provider, health plan, public health authority, employer, life insurer, school or
university or health care clearinghouse and relates to the past, present, or future physical or mental health or condition of an individual; the
accessing our website (www.osilife.com), or call the office and request that a revised copy be sent to you in the mail.
2. Uses and Disclosures of Protected Health Information
Uses and Disclosures of Protected Health Information Based Upon Your Written ConsentFollowing are examples of the types of uses and disclosures of your protected health care information that the physician’s office is permitted to
make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office.
- We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related
services. This includes the coordination or management of your healthcare with a third-party provider. For example, we would disclose
protected health information to another physician or healthcare provider (e.g., a specialist or laboratory) who, at the request of your physician,
becomes involved in your care.
- Your protected health information will be used, as needed, to obtain payment for your healthcare services. This may include
providing health information for making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for
medical necessity, and undertaking utilization review activities.
- We may use or disclose, as-needed, your protected health information in order to support the business activities of
your physician’s practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of
medical students, licensing, marketing and fundraising activities, and conducting or arranging for other business activities. For example, we
may use your protected health information to assess the quality of care at OsiLife. We may use or disclose your protected health information,
as necessary, for appointment reminders or to provide you with information about treatment alternatives or other health-related benefits and
services that may be of interest to you. You may contact our Privacy Office to request that these materials not be sent to you. We will share
your protected health information with third party “business associates” that perform various activities (e.g., billing, transcription services) for
the practice. Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health
information, we will have a written contract that contains terms that will protect the privacy of your protected health information.
Uses and Disclosures of Protected Health Information Based upon Your Written Authorization:
Other uses and disclosures of your protected health information will be made only with your written authorization unless otherwise permitted or
required by law. You may revoke this authorization, at any time, in writing, except to the extent that your physician or the physician’s practice has
taken an action in reliance on the use or disclosure indicated in the authorization.
Other Permitted and Required Uses and Disclosures That May Be Made With Your Consent, Authorization or Opportunity to Object:
We may use and disclose your protected health information in the following instances. You have the opportunity to agree or object to the use or
disclosure of all or part of your protected health information. If you are not present or able to agree or object to the use or disclosure of the
protected health information, then your physician may, using professional judgment, determine whether the disclosure is in your best interest. In
this case, only the protected health information that is relevant to your health care will be disclosed.
Others Involved in Your Healthcare
- Unless you object, we may disclose to a member of your family, a relative, a close friend or any other
person you identify, your protected health information that directly relates to that person’s involvement in your healthcare. If you are unable to
agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on
our professional judgment. We may use or disclose protected health information to notify or assist in notifying a family member, personal
representative or any other person that is responsible for the care of your location, general condition or death. Finally, we may use or disclose
your protected health information to an authorized public or private entity to assist in disaster relief efforts(such as the Red Cross) and to
coordinate uses and disclosures to family or other individuals involved in your healthcare.
- We may use or disclose your protected health information in an emergency treatment situation. If this happens, your physician
shall try to obtain your consent as soon as reasonably practicable after the delivery of treatment. If your physician or another physician in the
practice is required by law to treat you and the physician has attempted to obtain your consent but is unable to obtain your consent, he or she
may still use or disclose your protected health information to treat you.
- We may use and disclose your protected health information if your physician or another physician in the practice
attempts to obtain consent from you but is unable to do so due to substantial communication barriers and the physician determines, using
professional judgment, that you intend to consent to use or disclosure under the circumstances.
The following uses and disclosures will be made only with authorization from the patient/representative:
• for use and disclosures for marketing purposes;
• for use and disclosures that constitute the sale of PHI;
• most uses and disclosures of psychotherapy notes (if maintained) and,
• other uses and disclosures as required by law.
Other Permitted and Required Uses and Disclosures That May Be Made Without Your Consent, Authorization or Opportunity to Object
We may use or disclose your protected health information in the following situations without your consent or authorization. These situations
• Required By Law - We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The
use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as
required by law, of any such uses or disclosures.
• Public Health - We may disclose your protected health information to the CDC, the Texas Department of Health, and other public health
authorities for public health activities as permitted by law. The disclosure will be made for the purpose of controlling disease, injury or
• Communicable Diseases - We may disclose your protected health information, if authorized by law, to a person who may have been exposed
to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
• Health Oversight - We may disclose protected health information to the Texas Board of Medical Examiners, US Department of Health and
Human Services, or other health oversight agency for activities authorized by law, such as audits, investigations, and inspections.
• Aggregate and Demographic Information – Aggregate information is information presented in summary form which does not permit the
identification of a specific individual without extraordinary effort. We may also collect and retain demographic information we obtain from you
and from third parties for creating fundraising campaigns OsiLife helps supports. Also, we may collect aggregate information from third parties
for research purposes.
• Abuse or Neglect - We may disclose your protected health information to Child Protective Services, Adult Protective Services, or other
governmental bodies that are authorized by law to receive reports of abuse or neglect. In this case, the disclosure will be made consistent with
the requirements of applicable federal and state laws.
• Food and Drug Administration - We may disclose your protected health information to a person or company required by the Food and Drug
Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to
make repairs or replacements, or to conduct post marketing surveillance, as required.
• Legal Proceedings - We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an
order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), in certain conditions in response to a
subpoena, discovery request or other lawful processes.
• Law Enforcement - We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement
purposes. These law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information requests for
identification and location purposes, (3) pertaining to witnesses, defendants, or victims of a crime, (4) suspicion that death has occurred as a
result of criminal conduct, (5) in the event that a crime occurs on the premises of the practice, and (6) medical emergency (not on the Practice’s
premises) and it is likely that a crime has occurred.
• JPs, Coroners - We may disclose protected health information to a justice of the peace, coroner or medical examiner for identification
purposes, determining cause of death or for the JP, coroner or medical examiner to perform other duties authorized by law.
• Research - We may disclose your protected health information to researchers when their research has been approved by an institutional
review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
• Safety - Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or
disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
• Military Activity and National Security - When the appropriate conditions apply, we may use or disclose protected health information of
individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the
purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a
member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting
national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
• Workers’ Compensation - Your protected health information may be disclosed by us as authorized to comply with workers’ compensation laws
and other similar legally-established programs.
• Required Uses and Disclosures - Under the law, we must make disclosures to you and when required by the Secretary of the Department of
Health and Human Services to investigate or determine our compliance with the requirements of federal law.
3. Your Rights
Following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these
• You have the right to inspect and copy your protected health information - This means you may inspect and obtain a copy of protected
health information about you that is contained in a designated record set for as long as we maintain the protected health information. A
“designated record set” contains medical and billing records and any other records that your physician and the practice use for making
decisions about you. We will provide information in paper or electronic form based on your preference if we have the ability to do so. If not, the
information will be provided in paper format and a reasonable cost-based fee will be charged. This fee includes the cost of supplies, labor and
delivery cost. A physician may deny access to health information if he determines that release of information could be harmful to the physical,
mental, or emotional health of a patient or could endanger a patient.
• You have the right to request a restriction of your protected health information to your health plan - when that information relates solely
to a health care item or service for which you, or another person on your behalf (other than a health plan), has paid us in full. We may release
restricted protected healthcare information as “required by law”. You may also request that any part of your protected health information not
Your request must state the specific restriction requested and to whom you want the restriction to apply. Your physician is not required to
agree to a restriction that you may request. If a physician believes it is in your best interest to permit use and disclosure of your protected
health information, your protected health information will not be restricted. If your physician does agree to the requested restriction, we may
not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. With
this in mind, please discuss any restriction you wish to request with your physician. You may request a restriction by signing our restriction
• You have the right to request to receive confidential communications from us by alternative means or at an alternative location - We will
accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be
handled or specification of an alternative address or another method of contact. We will not request an explanation from you as to the basis for
the request. Please make this request in writing to our Privacy Office (address at bottom of notice).
• You may have the right to have your physician amend your protected health information - This means you may request an amendment of
protected health information about you in a designated record set for as long as we maintain this information. If we deny your request for
amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide
you with a copy of any such rebuttal. Please contact our Privacy Office (address at bottom of notice) to determine if you have questions about
amending your medical record.
• You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information - This right
disclosures we may have made to you, to family members or friends involved in your care, or for notification purposes. The right to receive this
information is subject to certain exceptions, restrictions, and limitations.
• You have a right to or will be notified of a breach of unsecured protected healthcare information - If a breach of your medical information
occurs and if that information is unsecured (not encrypted), we will notify you with a brief description of what happened, a description of the
health information that was involved, recommended steps you can take to protect yourself from harm and what steps we are taking in response
to the breach and contact procedures so you can obtain further information.
• Right to Opt-Out of Fundraising Communications - If we conduct fundraising and we use communications like the U.S. Postal Service or
electronic email for fundraising, you have the right to opt-out of receiving such communications from us. Please contact our Privacy Office
(address at bottom of notice) to opt-out of fundraising communications if you chose to do so. You have the right to obtain a paper copy of this
notice from us, upon request, even if you have agreed to accept this notice electronically.
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. We will not
retaliate against you for filing a complaint. To file a written complaint with us, you may send it to our Privacy Office (address at bottom of
5. Information Protection:
We are committed to protecting the privacy of your PII (Personal Identifying Information). We use what we believe to be industry standard
security measures to protect your information. However, such precautions do not guarantee the absolute safety of such information. OsiLife
makes no guarantees, warranties or representation that your information is protected from viruses and other security attacks.
• Disposing of Protected Health Information - Periodically, we may evaluate the need for us to retain any PII (Personal Identifying Information)
to determine whether it is appropriate for us to dispose of such information. In accordance with all applicable laws, we will consider carefully
the means we use to dispose of such information to reduce the risk of an unauthorized person accessing your PII (Personal Identifying
Information) and we will dispose of such information in a way that reduces the chance of such unauthorized access.
• How We Protect the Privacy of Children - The Children’s Online Privacy Protection Program took effect on April 21, 2000, and pertains to
websites directed towards children under 13 years of age. The website is not directed towards children under 13 and OsiLife does not seek to
collect information on any person under 13 years of age. Therefore, if you are under 13 years of age, you may not search our website, enroll in
any of our programs, or use any of our services. If you are eligible to use our website but are under the age of 18, we ask that your parents be
involved in any information you provide to us about yourself or others. By using this website, you represent that you are not under 13 years of
conditions and/or separate privacy policies may apply if you link to websites of third parties including Other OsiLife Institutions. While Osi
Vision LLC dba OsiLife and Other OsiLife Institutions may have certain contractual relationships, their relationships are only as independent
contractors. There is no partnership, joint venture, agency, authority to act on behalf of the other or any other similar relationship between Osi
Vision LLC dba OsiLife and such Other OsiLife Institutions.
If you have any questions about our policy or our compliance, you may send us an email at firstname.lastname@example.org, or write to:
FOR INFORMATION REQUESTS:
Attn: OsiLife - Information Request
100 Sandau, Ste. 210
San Antonio, TX 78216
FOR PRIVACY MATTERS:
Attn. OsiLife - Privacy Office
100 Sandau, Ste. 210
San Antonio, Texas 78216