SERVICES
Stylish Glasses
Vision Therapy & Sports Vision
We offer a selection of glasses unrivaled in the area including:
Micheal Kors                   Oakley
Tory Burch                       Kate Spade
Jimmy Crystal                  Juicy Couture
Salvatore Ferragamo     RayBan
Polo                                  Calvin Klein
Carerra                             Crocs
Disney                              Sesame Street
DB4K                                Jones New York
You or your child have difficulty reading? Had a concussion or stroke? Want to get better at a particular sport? Vision Therapy, Rehabilitation, and Sports Vision can help you visually analyze your surroundings more effectively and coordinate your eyes to read more accurately and with less stress! Call today to schedule your evaluation! 
Sunglasses Galore! 
Contact Lenses for Today's world
As the only carriers of Tory Burch in the area, of course we have sunglasses too! Come see our large selection of designer sunglasses also including:
Oakley                      RayBan
Tory Burch               Micheal Kors
Polo                          Kate Spade
Coach                       Jimmy Crystal
Contact lens materials have begun to change with ever changing use of technology. Why not have a lens desiged for use with a computer or tablet? Your doctor will recommend one of these top lenses for your eyes:
Biofinity                       Air Optix
Ultra                            Purevision
BioTrue                       Dailies Aqua Comfort Plus
SofLens Daily             Clariti
Dailies Total 1            Oasys 1-Day
1-Day Moist               TruEye
Accepted Insurance
Aetna
Aetna Medicare
AFSCME
Benesight
Blue Cross/Blue Shield Medicare PPO
Blue Cross/Blue Shield Ohio
Blue Cross/Blue Shield (Paccar)
Bricklayers Union
Coresource
Cigna
EyeMed (Most Plans)
GE Vision (Out of Network)
Golden Rule
Great West
Health Reach Advantage
Humana
Humana Gold Choice Medicare
Humana Vision Care Plan
Iron Workers
Mail Handlers
Medical Mutual
Medigold
Medicaid
Medicare
Ohio Carpenters
Ohio Funeral Directors
Ohio Plasterers & Cement Masons
Professional Risk Management (PRM)
Railroad Medicare
Tricare North
United Health Care
Vision Plus
Vision Service Plan (VSP)
We accept cash, personal checks, Visa, Mastercard, American Express, Discover
Notice Revised and Effective: November 19, 2014
NOTICE OF PRIVACY PRACTICES
THIS NOTICE OF PRIVACY PRACTICES ("NOTICE") DESCRIBES HOW WE MAY USE OR DISCLOSE YOUR HEALTH INFORMATION AND HOW YOU CAN GET ACCESS TO SUCH INFORMATION. PLEASE READ IT CAREFULLY.Your "health information," for purposes of this Notice, is generally any information that identifies you and is created, received, maintained or transmitted by us in the course of providing health care items or services to you (referred to as "health information" in this Notice). 
We are required by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and other applicable laws to maintain the privacy of your health information, to provide individuals with this Notice of our legal duties and privacy practices with respect to such information, and to abide by the terms of this Notice. We are also required by law to notify affected individuals following a breach of their unsecured health information.  
USES AND DISCLOSURES OF INFORMATION WITHOUT YOUR AUTHORIZATION

The most common reasons why we use or disclose your health information are for treatment, payment or health care operations. Examples of how we use or disclose your health information for treatment purposes are: setting up an appointment for you; testing or examining your eyes; prescribing glasses, contact lenses, or eye medications and faxing them to be filled; showing you low vision aids; referring you to another doctor or clinic for eye care or low vision aids or services; or getting copies of your health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about your health or vision care plans, or other sources of payment; preparing and sending bills or claims; and collecting unpaid amounts (either ourselves or through a collection agency or attorney). "Health care operations" mean those administrative and managerial functions that we must carry out in order to run our office. Examples of how we use or disclose your health information for health care operations are: financial or billing audits; internal quality assurance; personnel decisions; participation in managed care plans; defense of legal matters; business planning; and outside storage of our records.

OTHER DISCLOSURES AND USES WE MAY MAKE WITHOUT YOUR AUTHORIZATION OR CONSENT 

In some limited situations, the law allows or requires us to use or disclose your health information without your consent or authorization. Not all of these situations will apply to us; some may never come up at our office at all. Such uses or disclosures are:

when a state or federal law mandates that certain health information be reported for a specific purpose; 
for public health purposes, such as contagious disease reporting, investigation or surveillance; and notices to and from the federal Food and Drug Administration regarding drugs or medical devices;
disclures to governmental authorities about victims of suspected abuse, neglect or domestic violence;
 uses and disclosures for health oversight activities, such as for the licensing of doctors; for audits by Medicare or Medicaid; or for investigation of possible violations of health care laws;
disclsures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies;

Unless you object, we will also share relevant information about your care with any of your personal representatives who are helping you with your eye care. Upon your death, we may disclose to your family members or to other persons who were involved in your care or payment for heath care prior to your death (such as your personal representative) health information relevant to their involvement in your care unless doing so is inconsistent with your preferences as expressed to us prior to your death.

SPECIFIC USES AND DISCLOSURES OF INFORMATION REQUIRING YOUR AUTHORIZATION

The following are some specific uses and disclosures we may not make of your health information without your authorization: 

Marketing activities. We must obtain your authorization prior to using or disclosing any of your health information for marketing purposes unless such marketing communications take the form of face-to-face communications we may make with individuals or promotional gifts of nominal value that we may provide. If such marketing involves financial payment to us from a third party your authorization must also include consent to such payment.

Sale of health information. We do not currently sell or plan to sell your health information and we must seek your authorization prior to doing so.

Psychotherapy notes. Although we do not create or maintain psychotherapy notes on our patients, we are required to notify you that we generally must obtain your authorization prior to using or disclosing any such notes.

YOUR RIGHTS TO PROVIDE AN AUTHORIZATION FOR OTHER USES AND DISCLOSURES

Other uses and disclosures of your health information that are not described in this Notice will be made only with your written authorization.
You may give us written authorization permitting us to use your health information or to disclose it to anyone for any purpose.
We will obtain your written authorization for uses and disclosures of your health information that are not identified in this Notice or are not otherwise permitted by applicable law.
We must agree to your request to restrict disclosure of your health information to a health plan if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law and such information pertains solely to a health care item or service for which you have paid in full (or for which another person other than the health plan has paid in full on your behalf).
Any authorization you provide to us regarding the use and disclosure of your health information may be revoked by you in writing at any time. After you revoke your authorization, we will no longer use or disclose your health information for the reasons described in the authorization.  However, we are generally unable to retract any disclosures that we may have already made with your authorization. We may also be required to disclose health information as necessary for purposes of payment for services received by you prior to the date you revoked your authorization.
YOUR INDIVIDUAL RIGHTS
You have many rights concerning the confidentiality of your health information. You have the right: 
To request restrictions on the health information we may use and disclose for treatment, payment and health care operations. We are not required to agree to these requests. To request restrictions, please send a written request to us at the address below.
To receive confidential communications of health information about you in any manner other than described in our authorization request form. You must make such requests in writing to the address below. However, we reserve the right to determine if we will be able to continue your treatment under such restrictive authorizations.
To inspect or copy your health information. You must make such requests in writing to the address below. If you request a copy of your health information we may charge you a fee for the cost of copying, mailing or other supplies. In certain circumstances we may deny your request to inspect or copy your health information, subject to applicable law. 
To amend health information. If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. To request an amendment, you must write to us at the address below. You must also give us a reason to support your request. We may deny your request to amend your health information if it is not in writing or does not provide a reason to support your request. We may also deny your request if the health information:
was not created by us, unless the person that created the information is no longer available to make the amendment,
is not part of the health information kept by or for us,
is not part of the information you would be permitted to inspect or copy, or
is accurate and complete.
To receive an accounting of disclosures of your health information. You must make such requests in writing to the address below. Not all health information is subject to this request. Your request must state a time period for the information you would like to receive, no longer than 6 years prior to the date of your request and may not include dates before April 14, 2003. Your request must state how you would like to receive the report (paper, electronically). 
To designate another party to receive your health information. If your request for access of your health information directs us to transmit a copy of the health information directly to another person the request must be made by you in writing to the address below and must clearly identify the designated recipient and where to send the copy of the health information.
Contact Person:
Our contact person for all questions, requests or for further information related to the privacy of your health information is:

ClearSite Vision
612 Central Center
Chillicothe, Ohio 45601   740-774-2106
Complaints:

If you think that we have not properly respected the privacy of your health information, you are free to complain to us or to the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint. If you want to complain to us, send a written complaint to the office contact person at the address, fax or E mail shown above. If you prefer, you can discuss your complaint in person or by phone.

Changes to This Notice:
We reserve the right to change our privacy practices and to apply the revised practices to health information about you that we already have. Any revision to our privacy practices will be described in a revised Notice that will be posted prominently in our facility. Copies of this Notice are also available upon request at our reception area.