Notice of Privacy Practices

Effective 4/14/03

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.

You have the right to obtain a paper copy of this notice upon request.

Our Legal Duty

We are required by law to protect and maintain the privacy of your health information, provide this notice about our legal duties and privacy practices regarding protected health information, and abide by the terms of the notice currently in effect.

Patient Health Information

Under federal law, your patient health information is protected and confidential. Patient health information includes information about your symptoms, test results, diagnosis, treatment, and related medical information. Your health information also includes payment, billing, and insurance information.

How We Use Your Patient Health Information

We use health information about you for treatment, to obtain payment, and for health care operations, including administrative purposes and evaluation of the quality of care that you may receive. Under some circumstances, we may be required to use or disclose the information even without your permission.

Examples of Treatment, Payment, and Health Care Operations:

• Treatment: We will use and disclose your health information to provide you with medical treatment or services. For example, nurses, physicians, and other members of your treatment team will record information in your record and use it to determine the most appropriate course of care. We may also disclose the information to other health care providers who are participating in your treatment, pharmacists, and family members or friends who are helping with your care.
• Payment: We will use and disclose your health information for payment purposes. For example, we may need to obtain authorization from your insurance company before providing certain types of treatment. We will submit bills and maintain records of payment from your health plan. We may disclose your information to other health care providers (such as the labs) to assist in their billing and collection efforts.
• Health Care Operations: We will use and disclose your health information to conduct our standard internal operations (including proper administration of records), evaluate the quality of treatment, and assess the care and outcome of your case and others like it.

Special Uses

We may use your information to contact you with appointment reminders. We may also contact you to provide information about treatment alternatives and lab results.

Other Uses and Disclosures

We may use or disclose identifiable health information about you for other reasons, even without your consent. Subject to certain requirements, we are permitted to give out health information without your permission for the following purposes:

• Required by Law: We may be required by law to report gunshot wounds, suspected abuse or neglect, or similar injuries and events.
• Public Health Activities: As required by law, we may disclose vital statistics, diseases, information related to recalls of dangerous products, and similar information to public health authorities.
• Health Oversight: We may be required to disclose information to assist in investigations and audits, verify eligibility for government programs, and similar activities.
• Judicial and Administrative Proceedings: We may disclose information in response to an appropriate subpoena or court order.
• Law Enforcement Purposes: Subject to certain restrictions, we may disclose information required by law enforcement officials.

Confidential Communications:

You may ask us to communicate with you confidentially by, for example, sending notices to a special address.

Inspect and Obtain Copies:

In most cases, you have the right to review or request a copy of your health information. There will be a charge for the copies.

Amend Information:

If you believe that information in your record is incorrect, or if important information is missing, you have the right to request that we correct the existing information or add the missing information.

Accounting of Disclosures:

You may request a list of instances where we have disclosed health information about you for reasons other than treatment, payment, or health care operations.

Right to a Paper Copy of This Notice:

You are entitled to receive a paper copy of our notice of privacy practices. They are available at our office. The address is listed below.

Right to Provide an Authorization for Other Uses and Disclosures:

Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization provided may be revoked at any time in writing.

Complaints

If you believe your privacy rights have been violated, you may file a written complaint with our practice or with the Secretary of the Department of Health & Human Services.

Contact Person

If you have any questions, requests, or complaints, please contact:

Dermatology & Skin Laser Center
Attn: Office Manager
1340 Wonder World Drive, Suite 2301
San Marcos, TX 78666
(512) 392-1411