Reframed Eye Privacy Policy

Effective Date: December 1, 2024

I consent to recommended examinations, treatments, and/or diagnostic procedures. I understand that there may be associated alternatives, benefits and risks, which can be further explained at any time at my request. I can stop treatment or express concerns or complaints at any time.

If the patient is a minor, I likewise consent to treatment and all policies of this agreement on the minor’s behalf. I understand that if I share legal custody, I am representing that all parties who have legal rights of the minor have been made aware of, and consent to treatment for the minor.

I am responsible for any charges not covered by insurance. Co-payments are due at the time of service.

Some services, like refraction testing may be required as part of the examination. Medicare and many supplemental insurances do not cover this test. I am responsible for all non-covered services, including refraction testing.

I consent to receiving communications at any provided phone number, understanding that these calls may be initiated by us, our affiliates, agents, contractors, or assignees. Methods of contact may include prerecorded/artificial voice messages, automated dialing devices, and text messages. Additionally, I consent to receiving emails under the same terms at any provided email address.

All information concerning my medical treatment may be released to insurance carriers, pharmacies, and referring providers.

I have a right to access my personal medical record concerning diagnosis, treatment options, and expected outcomes. I can also request that this information be provided to a person who is acting on my behalf.

I have the right to amend my health care information if I feel that it is inaccurate or incomplete. My request must be in writing and must include an explanation of why the information should be amended.

My protected health information may be used to provide treatment, obtain payment for treatment, and conduct health care operations. My protected health information may be used or disclosed only for these purposes unless authorization for the use is obtained or disclosure is otherwise permitted by the HIPAA privacy regulations or state law.