Privacy Policy

BRENTWOOD DERMATOLOGY

11980 SAN VICENTE BLVD. #120
BRENTWOOD, CA 90049

Notice Of Privacy Practices

Portability and Accountability As Required by the Privacy Regulations Created as a Result of the Health Insurance Act of 1996 (HIPAA)

This notice descibe how health information about you may be used and disclosed and how you can get access to this information. Please review it arefully.

OUR COMMITMENT TO YOUR PRIVACY

Our practice is dedicated to maintaining the privacy of your individually identifiable health information (IIHI). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning your IIHI. By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at the time.

We realize that these laws are complicated, but we must provide you with the following important information:

  • How we may use and disclose your IIHI.
  • Your privacy rights in your IIHI .
  • We may periodically send promotional emails about new products, special offers or other information which we think you may find interesting using the email address which you have provided.
  • Our obligations concerning the use and disclosure of your IIHI

The terms of this notice apply to all records containing your IIHI that are created or retained by our practice. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this notice will be effective for all of your records that our practice has created or maintained in the past, and for any of your records that we may create or maintain in the future. Our practice will post a copy of our current Notice in our offices in a visible location at all times, and you may request a copy of our most current Notice at any time

IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT: Jack Silvers, M.D. 11980 San Vicente Blvd. #120, Brentwood CA 90049 (310) 826-2051

USE AND DISCLOSURES OF HEALTH INFORMATION

Treatment:

Our practice may use or disclose your health information to a physician or other healthcare providers providing a service to you.

Payment:

Our practice may use and disclose your health information to obtain payments for services we provide to you.

Health Care Operations:

We may use and disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance.

Appointment Reminders:

Our practice may use your information to contact you and remind you of an appointment.

Release of Information to Family/Friend:

Our practice may disclose your health information to a family member, friend or other person to the extent necessary to help your healthcare or payment for your healthcare, but only if you agree that we may do so. Disclosures Required By Law: Our practice will use and disclose your health information when we are required to do so by federal, state or local law.

Disclosures Required By Law:

We may disclose your health information to appropriate authorities if we reasonably belive that you are a possible victim of abuse, neglect, or domestic violence .We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health and safety of others.

Abuse or Neglect:

Our practice may disclose your health information to federal officials for intelligence and national security activities authorized by law. We also may disclose your IIHI to federal officials in order to protect the President, other officials or foreign heads of state, or to conduct investigations.

National Security:

Our practice may use or disclose your health information to a physician or other healthcare providers providing a service to you.

Workers’ Compensation:

Our practice may release your health information for workers’ compensation and similar programs.

PATIENT RIGHTS

You have the following rights regarding the health information that we maintain about you:

Confidential Communications:

You have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make a written request to specifying the requested method of contact, or the location where you wish to be contacted. Our practice will accommodate reasonable requests. You do not need to give a reason for your request.

Requesting Restrictions:

You have the right to request a restriction in our use or disclosure of your IIHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your IIHI to only certain individuals involved in your care or the payment for your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you.

Inspection and Copies:

You have the right to inspect and obtain a copy of the IIHI that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to Brentwood Dermatology in order to inspect and/or obtain a copy of your IIHI. Our practice may charge a fee for the costs of copying, mailing, labor and supplies associated with your request. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. Another licensed health care professional chosen by us will conduct reviews.

Amendment:

You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing .We may deny your request under certain circumstances.

Accounting of Disclosures:

All of our patients have the right to request an “accounting of disclosures.” An “accounting of disclosures” is a list of certain non-routine disclosures our practice has made of your IIHI for non-treatment or operations purposes. Use of your IIHI as part of the routine patient care in our practice is not required to be documented. In order to obtain an accounting of disclosures, you must submit your request in writing. All requests for an “accounting of disclosures” must state a time period, which may not be longer than six (6) years from the date of disclosure and may not include dates before April 14, 2003. The first list you request within a 12-month period is free of charge, but our practice may charge you for additional lists within the same 12-month period.

Right to a Paper Copy of This Notice:

You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time.

Right to File a Complaint:

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact Jack Silvers, MD, (310) 826-2051. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

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 you provide to us regarding the use and disclosure of your IIHI may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your IIHI for the reasons described in the authorization. Please note, we are required to retain records of your care.