Associated Plastic Surgeons, P.C. is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. Protected health information is the information we create and obtain in providing our services to you.  Such information may include documenting your symptoms, examination, test results, diagnoses, treatment, and applying for future care or treatment.  It also includes billing documents for those services.

Examples of Uses and Disclosures of Your Health Information

Treatment. Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members. The office may leave messages for you regarding your treatment.  Our office also utilizes a computer phone system for appointment reminders.

Payment. Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.

Health care operations. Your health information may be used as necessary to support the day-to-day activities and management of Associated Plastic Surgeons, P.C. For example, information on the services you received may be used to support budgeting and financial reporting, activities to evaluate and promote quality, legal services and insurance.  We will share information about you with such insurers or other business associates as necessary to obtain these services.

Uses and Disclosures Other Than for Treatment, Payment, or Health Care Operations:

Business Associates:  We provide some services through contracts with business associates.  Examples include a transcription service and a computer software company.  When we use these services, we may disclose your health information to the business associate so that they can perform the function we have contracted with them to do.  To protect your health information, however, we require the business associate to appropriately safeguard your information.

Notification:  We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.

Communication with Family:  Unless you object, health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.

Research:  We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Marketing/continuity of care:  We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Food and Drug Administration:  We may disclose to the FDA health information relative to adverse effects/events with respect to food, drugs, supplements, product or product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Workers Compensation:  We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public Health:  As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Employers:  Except in cases involving workers’ compensation, disclosures to your employer will be made only if you execute a specific authorization for the release of that information to your employer.

Law Enforcement:  We may disclose your protected health information for law enforcement purposes as required by law, such as when required by a court order, or in cases involving felony prosecution, or to the extent an individual is in the custody of law enforcement.

Health Oversight:  Federal law allows us to release your protected health information to appropriate health oversight agencies or for health oversight activities.

Judicial/Administrative Proceedings:  We may disclose your protected health information in the course of any judicial or administrative proceeding as allowed or required by law, with your authorization, or as directed by a proper court order.

Individual Rights

You have certain rights under the federal privacy standards. These include:

• the right to request restrictions on the use and disclosure of your protected health information
• the right to receive confidential communications concerning your medical condition and treatment
• the right to inspect and copy your protected health information
• the right to amend or submit corrections to your protected health information
• the right to receive an accounting of how and to whom your protected health information has been disclosed
• the right to receive a printed copy of this notice

Associated Plastic Surgeons, P.C. Duties

We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices.

We also are required to abide by the privacy policies and practices that are outlined in this notice.

Right to Revise Privacy Practices

As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Whatever the reason for these revisions, we will provide you with a revised notice on your next office visit. The revised policies and practices will be applied to all protected health information that we maintain.

Requests to Inspect Protected Health Information

As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting the Receptionist or the Privacy Officer.

Complaints

If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:

Privacy Officer

Associated Plastic Surgeons, P.C.

11501 Granada Lane

Leawood, Kansas 66211

If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the same address.

You will not be penalized or otherwise retaliated against for filing a complaint.

Contact Person

The name and address of the person you can contact for further information concerning our privacy practices is:

Privacy Officer

Associated Plastic Surgeons, P.C.

11501 Granada Lane

Leawood, Kansas  66211

913-451-3722

Effective Date

This Notice is effective March 2, 2004.