Privacy Practice
NOTICE OF PRIVACY PRACTICES
Effective Date: April 5, 2022.
“THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.”
This Notice of Privacy Practices explains how Dolls Plastic Surgery LLC uses and discloses medical information and how patients can access it. The policy is required under the Health Insurance Portability and Accountability Act (HIPAA).
The facility maintains Protected Health Information (PHI) including demographic data, health history, symptoms, examination results, diagnoses, and treatment plans. The organization commits to meeting HIPAA requirements and will notify patients promptly of any breaches.
1. Uses and Disclosures
For Treatment: “We will use and disclose your PHI to provide, coordinate, or manage your health care and any related services.”
For Payment: PHI is used to obtain payment for services and may be disclosed to other providers involved in care.
Operations: The facility may use PHI for “quality assessment and improvement activities, employee review activities, training programs” and related administrative functions.
Other Uses: Contact regarding surgery dates, treatment alternatives, health-related benefits, and fundraising activities.
2. Uses and Disclosures Beyond Treatment, Payment, and Health Care Operations Permitted Without Authorization
- When legally required by federal, state, or local law
- For public health activities including disease prevention and vital event reporting
- To report suspected abuse, neglect, or domestic violence
- For health oversight activities and audits
- In judicial and administrative proceedings
- For law enforcement purposes
- To coroners, funeral directors, and for organ donation
- For approved research purposes
- “In the Event of a Serious Threat to Health or Safety”
- For specified government functions
- For worker’s compensation compliance
3. Uses and Disclosures Permitted Without Authorization But With Opportunity to Object
The facility may disclose PHI to family members or close personal friends “if it is directly relevant to the person’s involvement in your surgery or payment related to your surgery.” Patients may object to these disclosures.
4. Uses and Disclosures Which You Authorize
“We will not disclose your health information other than with your written authorization” except as stated in the notice. Psychotherapy notes require written authorization, and marketing communications require authorization unless they are face-to-face or involve nominal promotional gifts.
5. Your Rights
Right to Inspect and Copy: “You may inspect and obtain a copy of your protected health information that is contained in a designated record set for as long as we maintain the protected health information.”
Exceptions include psychotherapy notes and information compiled for legal proceedings. Requests must be submitted in writing to the Privacy Officer. Fees may apply for copying and mailing costs.
Right to Request Restrictions: Patients may request limitations on uses and disclosures of PHI for treatment, payment, or operations. The facility is not required to agree unless the request pertains to health plan disclosures for items paid in full out-of-pocket.
Right to Confidential Communications: Patients may “request that we communicate with you in certain ways” through alternative means or locations by submitting written requests to the Privacy Officer.
Right to Request Amendments: Patients may request amendments to PHI in designated record sets by submitting written requests with supporting reasons to the Privacy Officer. If denied, patients may file statements of disagreement.
Right to Receive an Accounting: Patients may request accountings of certain PHI disclosures made for purposes other than treatment, payment, or operations. Written requests must specify the time period. The first accounting per 12-month period is provided free; subsequent requests may incur reasonable fees.
Right to Paper Copy: “Upon request, we will provide a separate paper copy of this notice even if you have already received a copy of the notice.”
HITECH Act Modifications:
- Right to notification of data breaches
- Right to request electronic copies of medical records
- Ability to instruct the facility not to share cash-paid treatment information with health plans
6. Our Duties
The facility is required to maintain PHI privacy and notify affected individuals following breaches of unsecured protected health information. The notice may be amended, with revisions posted to the website and available upon request.
7. Complaints
“Any individual, including you, has the right to express complaints to the Secretary of Health and Human Services and us if you believe that your privacy rights have been violated.” The facility encourages reporting concerns and prohibits retaliation for filing complaints.
8. Contact Person
Patients should contact the Privacy Officer regarding privacy matters:
18205 Biscayne Blvd, Suite 100, Aventura, FL 33160
305-995-0545
Contact Information
Dolls Plastic Surgery, LLC
info@dollsplasticsurgery.com
305-995-0545
18205 Biscayne Blvd STE 100 Aventura, FL 33160