CPS Optical Patient FAQ

Frequently Asked Patient Questions

Our goal at CPS Optical is to provide our members and their families a simple and straightforward process for receiving eye care. Our network of providers consists mostly of privately owned practices to ensure quality customer care.

Q: How do I get my covered pair of eyeglasses?

A: If you are unsure on whether you are eligible or not for an exam and glasses, call us at 212-675-5745. We can let you know on your eligibility status and help you find a provider near you. If you already know you are eligible, you can search for optometrists in your area using our online directory, which can be found on the right hand side of your screen.

Q: How often am I eligible for glasses?

A: Most plans cover members once a year or once every two years. Contact CPS Optical to see which applies to you.

Q: What am I covered for?

A: Most plans cover members, and their dependents, for a thorough and comprehensive Eye Examination and one pair of frames with prescription lenses. Also, most groups now provide the option of contact lenses to their members, and their dependents, instead of prescription eyeglasses. Contact CPS Optical to find out exactly what you are covered for.

Q: What is HIPAA (Health Insurance Portability and Accountability Act), and how does it protect my privacy?

A: HIPAA Privacy Rules and Compliance with Federal and State Employment Laws require the following: That neither the health plan nor a health care provider ("covered entities") may release protected health information (PHI) to a third party unless the participant gives his or her written authorization. Even when the covered entity is authorized by the member to release PHI to a third party, the covered entity may only release the minimum PHI necessary to meet the purpose of the authorization.

Q: What is Protected Health Information(PHI)?

Protected health information (PHI) is information communicated by a covered entity orally, on paper or by electronic means that individually identifies and relates to an individual's (member's, dependent's or retiree's) medical condition, provision of medical care, enrollment, premium payment, health status or treatment. When a covered entity (health plan, physician, hospital, etc.) possesses PHI, the HIPAA privacy rules apply.

Participant Authorization and Confidentiality Policy

A member must authorize a covered entity to release health information to any third party. This must be a written authorization and it must contain all of the elements specified in the HIPAA regulations. Click here for a copy of the HIPAA authorization form.

Additional Required Statements in the Authorization Form

The individual's right to revoke the authorization in writing contains an explicit description of exceptions to the right to revoke and instructions on how the individual may revoke the authorization. The instructions must inform the participant to whom the written revocation must be given. Click here for a copy of the revocation form.