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MIAMI PLASTIC SURGERY
NOTICE OF PERSONAL PRIVACYTHIS
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. USE
AND DISCLOSURE OF HEALTH INFORMATION Miami Plastic Surgery may use your
health information, information that constitutes protected health information
as defined in the Privacy Rule of the Administrative Simplification provisions
of the Health Insurance Portability and Accountability Act of 1996, for purposes
of providing you treatment, obtaining payment for your care and conducting health
care operations. Your health information may be used or disclosed only after Miami
Plastic Surgery has obtained your written consent. Miami Plastic Surgery has established
policies to guard against unnecessary disclosure of your health information. THE
FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH
YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED. To Provide Treatment.
Miami Plastic Surgery may use your health information to coordinate care within
Miami Plastic Surgery and with others involved in your care, such as your attending
physician and other health care professionals who have agreed to assist Miami
Plastic Surgery in coordinating care. For example, physicians involved in your
care will need information about your symptoms in order to prescribe appropriate
medications. Miami Plastic Surgery also may disclose your health care information
to individuals outside of Miami Plastic Surgery involved in your care including
family members, pharmacists, suppliers of medical equipment or other health care
professionals. To Obtain Payment. Miami Plastic Surgery may include
your health information in invoices to collect payment from third parties for
the care you receive from Miami Plastic Surgery. For example, Miami Plastic Surgery
may be required by your health insurer to provide information regarding your health
care status so that the insurer will reimburse you or Miami Plastic Surgery. Miami
Plastic Surgery also may need to obtain prior approval from your insurer and may
need to explain to the insurer your need for home care and the services that will
be provided to you. To Conduct Health Care Operations. Miami Plastic
Surgery may use and disclose health information for its own operations in order
to facilitate the function of Miami Plastic Surgery and as necessary to provide
quality care to all of Miami Plastic Surgery patients. Health care operations
includes such activities as: - Quality assessment and improvement
activities.
- Activities designed to improve health or reduce health care
costs.
- Protocol development, case management and care coordination.
- Contacting
health care providers and patients with information about treatment alternatives
and other related functions that do not include treatment.
- Professional
review and performance evaluation.
- Training programs including those in
which students, trainees or practitioners in health care learn under supervision.
- Training
of non-health care professionals.
- Accreditation, certification, licensing
or credentialing activities.
- Review and auditing, including compliance
reviews, medical reviews, legal services and compliance programs.
- Business
planning and development including cost management and planning related analyses
and formulary development.
- Business management and general administrative
activities of Miami Plastic Surgery.
- Fundraising for the benefit of Miami
Plastic Surgery and certain marketing activities.
For example, Miami
Plastic Surgery may use your health information to evaluate its staff performance,
combine your health information with other Miami Plastic Surgery patients in evaluating
how to more effectively serve all Miami Plastic Surgery patients, disclose your
health information to Miami Plastic Surgery staff and contracted personnel for
training purposes, use your health information to contact you as a reminder regarding
a visit to you, or contact you as part of general fundraising and community information
mailings (unless you tell us you do not want to be contacted). For Fundraising
Activities. Miami Plastic Surgery may use information about you including
your name, address, phone number and the dates you received care in order to contact
you to raise money for Miami Plastic Surgery. Miami Plastic Surgery may also release
this information to a related Miami Plastic Surgery foundation. If you do not
want Miami Plastic Surgery to contact you, notify The Privacy Officer at 305-595-2969
(1-305-595-2969 outside of Miami-Dade County) and indicate that you do not wish
to be contacted. For Appointment Reminders. Miami Plastic
Surgery may use and disclose your health information to contact you as a reminder
that you have an appointment for a home visit. For Treatment Alternatives.
Miami Plastic Surgery may use and disclose your health information to tell you
about or recommend possible treatment options or alternatives that may be of interest
to you. THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH
AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED WITHOUT
FIRST RECEIVING YOUR WRITTEN CONSENT When Legally Required.
Miami Plastic Surgery will disclose your health information when it is required
to do so by any Federal, State or local law. When There Are Risks to
Public Health. Miami Plastic Surgery may disclose your health information
for public activities and purposes in order to: - Prevent or control
disease, injury or disability, report disease, injury, vital events such as birth
or death and the conduct of public health surveillance, investigations and interventions.
- Report
adverse events, product defects, to track products or enable product recalls,
repairs and replacements and to conduct post-marketing surveillance and compliance
with requirements of the Food and Drug Administration.
- Notify a person
who has been exposed to a communicable disease or who may be at risk of contracting
or spreading a disease.
- Notify an employer about an individual who is
a member of the workforce as legally required.
To Report Abuse,
Neglect Or Domestic Violence. Miami Plastic Surgery is allowed to notify government
authorities if Miami Plastic Surgery believes a patient is the victim of abuse,
neglect or domestic violence. Miami Plastic Surgery will make this disclosure
only when specifically required or authorized by law or when the patient agrees
to the disclosure. To Conduct Health Oversight Activities. Miami
Plastic Surgery may disclose your health information to a health oversight agency
for activities including audits, civil administrative or criminal investigations,
inspections, licensure or disciplinary action. Miami Plastic Surgery, however,
may not disclose your health information if you are the subject of an investigation
and your health information are not directly related to your receipt of health
care or public benefits. In Connection With Judicial and Administrative
Proceedings. Miami Plastic Surgery may disclose your health information in
the course of any judicial or administrative proceeding in response to an order
of a court or administrative tribunal as expressly authorized by such order or
in response to a subpoena, discovery request or other lawful process, but only
when Miami Plastic Surgery makes reasonable efforts to either notify you about
the request or to obtain an order protecting your health information. For
Law Enforcement Purposes. As permitted or required by State law, Miami Plastic
Surgery may disclose your health information to a law enforcement official for
certain law enforcement purposes as follows: - As required by law for
reporting of certain types of wounds or other physical injuries pursuant to the
court order, warrant, subpoena or summons or similar process.
- For the
purpose of identifying or locating a suspect, fugitive, material witness or missing
person.
- Under certain limited circumstances, when you are the victim of
a crime.
- To a law enforcement official if Miami Plastic Surgery has a
suspicion that your death was the result of criminal conduct including criminal
conduct at Miami Plastic Surgery.
- In an emergency in order to report a
crime.
To Coroners and Medical Examiners. Miami Plastic Surgery
may disclose your health information to coroners and medical examiners for purposes
of determining your cause of death or for other duties, as authorized by law. To
Funeral Directors. Miami Plastic Surgery may disclose your health information
to funeral directors consistent with applicable law and if necessary, to carry
out their duties with respect to your funeral arrangements. If necessary to carry
out their duties, Miami Plastic Surgery may disclose your health information prior
to and in reasonable anticipation of your death. For Organ, Eye or Tissue
Donation. Miami Plastic Surgery may use or disclose your health information
to organ procurement organizations or other entities engaged in the procurement,
banking or transplantation of organs, eyes or tissue for the purpose of facilitating
the donation and transplantation. For Research Purposes. Miami Plastic
Surgery may, under very select circumstances, use your health information for
research. Before Miami Plastic Surgery discloses any of your health information
for such research purposes, the project will be subject to an extensive approval
process. Miami Plastic Surgery will almost always request your written authorization
before granting access to your individually identifiable health information. In
the Event of a Serious Threat to Health or Safety. Miami Plastic Surgery may,
consistent with applicable law and ethical standards of conduct, disclose your
health information if Miami Plastic Surgery, in good faith, believes that such
disclosure is necessary to prevent or lessen a serious and imminent threat to
your health or safety or to the health and safety of the public. For
Specified Government Functions. In certain circumstances, the Federal regulations
authorize Miami Plastic Surgery to use or disclose your health information to
facilitate specified government functions relating to military and veterans, national
security and intelligence activities, protective services for the President and
others, medical suitability determinations and inmates and law enforcement custody. For
Worker's Compensation. Miami Plastic Surgery may release your health information
for worker's compensation or similar programs. AUTHORIZATION TO USE OR
DISCLOSE HEALTH INFORMATION Other than is stated above, Miami Plastic
Surgery will not disclose your health information other than with your written
authorization. If you or your representative authorizes Miami Plastic Surgery
to use or disclose your health information, you may revoke that authorization
in writing at any time. YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your health information that Miami Plastic
Surgery maintains: - Right to request restrictions. You may request
restrictions on certain uses and disclosures of your health information. You have
the right to request a limit on Miami Plastic Surgery's disclosure of your health
information to someone who is involved in your care or the payment of your care.
However, Miami Plastic Surgery is not required to agree to your request. If you
wish to make a request for restrictions, please contact Miami Plastic Surgery
Privacy Officer.
- Right to receive confidential communications. You have
the right to request that Miami Plastic Surgery communicate with you in a certain
way. For example, you may ask that Miami Plastic Surgery only conduct communications
pertaining to your health information with you privately with no other family
members present. If you wish to receive confidential communications, please contact
Miami Plastic Surgery's Privacy Officer at 305-595-2969. Miami Plastic Surgery
will not request that you provide any reasons for your request and will attempt
to honor your reasonable requests for confidential communications.
- Right
to inspect and copy your health information. You have the right to inspect and
copy your health information, including billing records. A request to inspect
and copy records containing your health information may be made to Miami Plastic
Surgery's Privacy Officer at 305-595-2969. If you request a copy of your health
information, Miami Plastic Surgery may charge a reasonable fee for copying and
assembling costs associated with your request.
- Right to amend health care
information. You or your representative has the right to request that Miami Plastic
Surgery amend your records, if you believe that your health information is incorrect
or incomplete. That request may be made as long as the information is maintained
by Miami Plastic Surgery. A request for an amendment of records must be made in
writing to the Miami Plastic Surgery's Privacy Officer at 305-595-2969 (1-305-595-2969
outside of Miami-Dade County). Miami Plastic Surgery may deny the request if it
is not in writing or does not include a reason for the amendment. The request
also may be denied if your health information records were not created by Miami
Plastic Surgery, if the records you are requesting are not part of Miami Plastic
Surgery's records, if the health information you wish to amend is not part of
the health information you or your representative are permitted to inspect and
copy, or if, in the opinion of Miami Plastic Surgery, the records containing your
health information are accurate and complete.
- Right to an accounting.
You or your representative have the right to request an accounting of disclosures
of your health information made by Miami Plastic Surgery for any reason other
than for treatment, payment or health operations. The request for an accounting
must be made in writing to the Miami Plastic Surgery's Privacy Officer at 305-595-2969
(1-305-595-2969 outside of Miami-Dade County). The request should specify the
time period for the accounting starting on or after April 14, 2003. Accounting
requests may not be made for periods of time in excess of six (6) years. Miami
Plastic Surgery would provide the first accounting you request during any 12-month
period without charge. Subsequent accounting requests may be subject to a reasonable
cost-based fee.
- Right to a paper copy of this notice. You or your representative
has a right to a separate paper copy of this Notice at any time even if you or
your representative has received this Notice previously. To obtain a separate
paper copy, please contact the Miami Plastic Surgery Privacy Officer at 305-595-2969
(1-305-595-2969 outside of Miami-Dade County).
DUTIES OF MIAMI
PLASTIC SURGERY Miami Plastic Surgery is required by law to maintain
the privacy of your health information and to provide to you and your representative
this Notice of its duties and privacy practices. Miami Plastic Surgery is required
to abide by the terms of this Notice as may be amended from time to time. Miami
Plastic Surgery reserves the right to change the terms of its Notice and to make
the new Notice provisions effective for all health information that it maintains.
If Miami Plastic Surgery changes its Notice, Miami Plastic Surgery will provide
a copy of the revised Notice to you or your appointed representative. You or your
personal representative has the right to express complaints to Miami Plastic Surgery
and to the Secretary of DHHS if you or your representatives believe that your
privacy rights have been violated. Any complaints to Miami Plastic Surgery should
be made in writing to the Miami Plastic Surgery's Compliance Officer. Miami Plastic
Surgery encourages you to express any concerns you may have regarding the privacy
of your information. You will not be retaliated against in any way for filing
a complaint. CONTACT PERSON Miami Plastic Surgery has designated
the Miami Plastic Surgery privacy officer as its contact person for all issues
regarding patient privacy and your rights under the Federal privacy standards.
You may contact this person at 305-595-2969 (1-305-595-2969 outside of Miami-Dade
County).
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