Notice of Privacy Practices (HIPAA)

Our commitment

Federal law (HIPAA) requires us to protect the privacy of your protected health information, give you this notice of our legal duties and privacy practices, follow the notice currently in effect, and notify you if a breach affects your information.

How we may use and disclose your information without your authorization

• Treatment: to care for you and coordinate your care with other providers, hospitals, laboratories and surgical centers.
• Payment: to bill and collect from you, your health plan or a third party, including verifying coverage and obtaining prior authorizations.
• Health care operations: to run the practice, assess quality, train staff and complete audits.
• Business associates: with companies that provide services to us (billing, IT systems), who must sign a contract to protect your information.
• Reminders and follow-up: to remind you of appointments or give you information about your treatment.

We may also use or disclose it when the law requires or permits: public health, reporting abuse or domestic violence, health oversight, judicial proceedings, law enforcement, coroners and funeral directors, organ donation, approved research, to avert a serious threat to health or safety, specialized government functions and workers' compensation.

When we need your written authorization

We need your written authorization to use your information for marketing, to sell it, to use psychotherapy notes, or to publish photos or testimonials (including before-and-after photos). Any other use or disclosure not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

You can tell us whether you want us to share information with a family member or friend involved in your care or payment.

Your rights

• See or get a paper or electronic copy of your medical record. We may charge a reasonable, cost-based fee.
• Ask us to correct information you believe is incorrect or incomplete.
• Request confidential communications, for example at another phone number or address.
• Ask us to limit certain uses or disclosures. We are not required to agree to every request, but if you pay for a service out of pocket in full and ask us not to share that information with your health plan for payment or operations, we must agree unless the law requires us to share it.
• Get a list of the disclosures we have made in the last six years, with certain exceptions.
• Get a paper copy of this notice at any time.
• Choose a personal representative to act on your behalf.

Florida law

Where Florida law or other federal law gives greater protection (for example, for HIV, mental health or substance use treatment information), we will follow that protection.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Office for Civil Rights of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

• U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue S.W., Washington, D.C. 20201 · 1-877-696-6775 · www.hhs.gov/ocr/complaints

Changes to this notice

We may change this notice, and the changes will apply to all information we have about you. The current notice is available at the office and on this website.

Privacy officer contact

• Email: info@sflbariatrics.com
• Phone: +1 (520) 640-0892
• Address: 4600 Linton Blvd #310, Delray Beach, FL 33445