Boyette Facial Plastic Surgery
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.
PURPOSE: This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information (PHI) to carry out treatment, payment, or healthcare operations and for other purposes permitted or required by law. “Protect Health Information” is information that may identify the patient and that relates to the patient’s past, present, or future physical or mental health, and may include name, address, phone numbers, or other identifying information. We are require to give you this Notice and to maintain privacy of your PHI. We must abide by this Notice, but we reserve the right to change the privacy practices described in it. We understand that medical information about you and your health is personal and confidential, and we are committed to protecting the confidentiality of your medical information. We create a record of the care and services you receive at Boyette Facial Plastic Surgery. We need this record to provide services to you and to comply with certain legal requirements. This Notice will tell you about the ways we may use and disclose your information. We also describe your rights and certain obligations we have to use and disclose your health information.
WHO WILL FOLLOW THIS NOTICE: This Notice describes the practice of Boyette Facial Plastic Surgery healthcare professionals, employees, and volunteers.
ACKNOWLEDGEMENT: You will be asked to sign an Acknowledgment of receipt of this Notice. The delivery of your healthcare services will in no way be conditioned upon the signing of this Acknowledgment.
Your Privacy Rights. You have the following rights relating to your PHI. You may:
Obtain a current copy of this Notice.
Inspect or obtain a copy of your records. You may be charged a fee for the cost of copying, mailing, or other supplies. We are allowed to deny this request under certain circumstances.
Request that we amend your record, if you feel the information is incomplete or incorrect. We are allowed to deny this request in certain circumstances and may ask you to put these requests in writing and provide a reason that supports your request.
Request in writing a restriction on certain uses and disclosures of your information. We are not required to agree to the requested restrictions, unless you are requesting to restrict certain information from your health plan and have paid for your services with this clinic in full.
Obtain a record of certain disclosures of your Protected Health Information.
Make a reasonable request to have confidential communications of your PHI sent to you by alternative means or at alternative locations.
Provide us with written permission for uses and disclosures of your PHI that are not covered by the Notice or permitted by law. Except to the extent that the use or disclosure has already occurred, you may cancel this permission. This request to cancel must be put in writing.
Submit any written requests to inspect, copy or amend your records to our office.
Our Responsibilities.
We are required to protect the privacy of your PHI, abide by the terms of the Notice, and make the Notice available to you.
We are also required to notify you if a breach of your health information occurs.
Examples of Uses and Disclosures
We will use your Protected Health Information for treatment. Certain information obtained by a nurse, doctor, or therapist, or other healthcare worker will be put in your record and used to plan and manage your treatment. We may provide reports or other information to your doctor or other authorized persons who are involved in your care, including healthcare providers outside of our practice. We may make your PHI available electronically through an electronic health information exchange to other health care providers and health plans that request your information for their treatment and payment purposes. Participating in an electronic health information exchange may also let us see their information about you for our treatment and payment purposes.
We will use your Protected Health Information for payment. A bill will be sent to you and/or your insurance company with information about your diagnosis, procedures, and supplies used. We may also disclose limited information about your bill to others, such as a collection agency, to obtain payment.
We will used your Protected Health Information for regular healthcare operations. Boyette Facial Plastic Surgery may use your PHI to check on the care you received, how you responded to it, and for other business purposes related to operating the clinic.
Business Associates: We may share some of your PHI with outside people or companies who provide services for us, such as billing services, or typing physician reports.
Notification: We may use or disclose your PHI with a family member, a closure personal friend, or a person that you identify, if we determine they are involved in your care or in payment for your care, unless you tell us not to do so.
Research: Your PHI may be used for research purposes in certain circumstances with your permission.
Coroners, Medical Examiners, Funeral Directors: In the event of your death, we may disclose your PHI to these people, to the extent allowed by law, so that they may carry out their duties.
Organ Donor Organizations: We may share your PHI with the organ donation agency for the purpose of tissue or organ donation in certain circumstances as required by law.
Contacts: We may contact you to provide appointment reminders or to tell you about new treatments or services.
Fundraising and Marketing: We may contact you as part of our fundraising or marketing efforts. You have a right to opt out of Fundraising communications and may do so by calling the office.
Food and Drug Administration: We may share your PHI with certain government agencies like the FDA so they can recall drugs or equipment.
Workers Compensation: We may disclose your PHI for workers’ compensation claims.
Public Health: We may give your PHI to public health agencies who are charged with preventing or controlling disease, injury or disability, and as required by law.
Communicable Disease: We may disclose your PHI 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, if authorized by law to do so, such as a disease requiring isolation.
Correctional Institution: If you are an inmate of a correctional institution, we may disclose your PHI to the institution or law enforcement as need for your health or the health and safety of others.
Law Enforcement: We must disclose your PHI when required by federal, state, or local law, such as to report gunshot wounds.
Health Oversight: We must disclose your PHI to a health oversight agency for activities authorized by law, such as investigations and inspections. Oversight agencies are those that oversee the healthcare system, government benefit programs, such as Medicaid, and other government regulatory programs.
Abuse or Neglect: We must disclose your PHI to government authorities that are authorized by law to receive reports of suspected abuse or neglect involving children or endangered adults.
Legal Proceedings: We must disclose your PHI in the course of any judicial or administrative proceeding or in response to a court order, subpoena, discovery request or other lawful process, as allowed by law.
Required Uses and Disclosures: We must make disclosures when required by Secretary of Department of Health and Human Services to investigate or determine our compliance with the HIPAA Privacy Regulations.
To Avoid Harm: We may use and disclose information about you when necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person.
For Specific Government Functions: In certain situations, we may disclose PHI of military personnel and veterans. We may disclose your PHI for national security activities as required by law.
Sale of Information: Boyette Facial Plastic Surgery will not sell your information without your prior written authorization or as otherwise allowed by law.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us, or the Secretary of the United States, Department of Health and Human Services. To file a complaint with our office, please contact our
Privacy Officer. We will not take action against you or retaliate against you in any way for filing a complaint.
Privacy Officer
You may contact the Privacy Officer with concerns or questions:
Jennings Boyette, 11412 Huron Lane, Little Rock, AR. 72212, phone 501.302.1402
Policy Effective Date: This policy went into effect June 1, 2016 and was most recently revised October 1, 2019.