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.
Purpose of This Notice
Premier Limb Lengthening is a HIPAA Covered Entity. This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information, which we call PHI, to carry out treatment, payment, and health care operations, and for other purposes permitted or required by law. It also describes your rights regarding your PHI and how you can exercise those rights.
This Notice applies to PHI created or received by Premier Limb Lengthening in connection with your care. It is separate from our website Privacy Policy, which is available at /privacy and governs website data that is not PHI. If there is any conflict between this Notice and our Privacy Policy with respect to PHI, this Notice controls.
Premier Limb Lengthening is a separate and independent practice from Premier Orthopaedic and Trauma Specialists. Dr. Hrayr Basmajian founded both practices, but Premier Limb Lengthening is its own practice. It is not a division, subsidiary, or part of Premier Orthopaedic and Trauma Specialists. References in this Notice to “we,” “us,” “our,” and “the practice” mean Premier Limb Lengthening.
Our Commitment to Your Privacy
We are required by law to maintain the privacy of your PHI, to provide you with this Notice describing our legal duties and privacy practices, and to follow the terms of this Notice while it is in effect. We are also required to notify you if a breach of your unsecured PHI occurs.
How We May Use and Disclose Your Health Information
The following categories describe ways we may use and disclose PHI without your written authorization. Not every possible use or disclosure in a category is listed, but all of the ways we are permitted to use and disclose PHI fall within one of these categories.
For Treatment
We may use and disclose your PHI to provide, coordinate, or manage your care and any related services. This includes communicating with other health care providers, imaging centers, physical therapists, and other professionals involved in your treatment or recovery.
For Payment
We may use and disclose your PHI to bill and collect payment for the treatment and services you receive, including verifying coverage, processing financing applications you choose to submit, and communicating with your financing partner about your account.
For Health Care Operations
We may use and disclose your PHI to run our practice, evaluate the quality of care we provide, train staff, conduct business planning, and carry out similar administrative activities.
Appointment Reminders and Treatment Options
We may use and disclose your PHI to contact you with appointment reminders, or with information about treatment alternatives or other health-related services that may interest you.
As Required by Law
We will disclose your PHI when required to do so by federal, state, or local law.
Public Health and Safety Activities
We may disclose your PHI to public health authorities for purposes such as preventing or controlling disease, reporting reactions to medications or product problems, and notifying a person who may have been exposed to a disease or may be at risk of spreading one.
Health Oversight Activities
We may disclose your PHI to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure actions.
Judicial and Administrative Proceedings
We may disclose your PHI in response to a court or administrative order, or in response to a subpoena, discovery request, or other lawful process, subject to the conditions required by law.
Law Enforcement
We may disclose your PHI to a law enforcement official for purposes such as responding to a court order, identifying a suspect or missing person, or reporting a crime.
To Avert a Serious Threat to Health or Safety
We may disclose your PHI when necessary to prevent a serious threat to your health or safety, or to the health or safety of the public or another person.
Organ and Tissue Donation
If you are an organ donor, we may disclose your PHI to organizations that handle organ procurement or transplantation.
Workers’ Compensation
We may disclose your PHI as authorized by, and to the extent necessary to comply with, workers’ compensation or similar programs that provide benefits for work-related injuries or illness.
Research
Under certain circumstances, and subject to the protections required by law, we may use or disclose your PHI for research purposes, such as when an Institutional Review Board has approved the research and reviewed the research proposal to weigh the research needs against the individual’s need for privacy.
Uses and Disclosures That Require Your Written Authorization
Other than the categories described above, we will not use or disclose your PHI without your written authorization. This includes, in particular:
- Most uses and disclosures of your PHI for marketing purposes.
- Any sale of your PHI.
- Any use or disclosure of psychotherapy notes, if applicable.
If you provide us with a written authorization, you may revoke it in writing at any time, except to the extent we have already acted in reliance on it.
Your Rights Regarding Your Health Information
You have the following rights regarding the PHI we maintain about you. To exercise any of these rights, please submit a written request to our Privacy Officer using the contact information at the end of this Notice. We may charge a reasonable, cost-based fee for certain requests, such as copies of records, as permitted by law.
Right to Inspect and Copy
You have the right to inspect and receive a copy of the PHI we maintain in your medical and billing records, with limited exceptions permitted by law. If we deny your request, we will tell you the reason in writing and explain any right you have to request a review of that decision.
Right to Request Amendment
You have the right to ask us to amend your PHI if you believe it is incorrect or incomplete. We may deny your request in certain circumstances permitted by law, and if we do, we will explain the reason in writing.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures of your PHI that we have made, other than disclosures for treatment, payment, health care operations, and certain other disclosures excluded by law.
Right to Request Restrictions
You have the right to ask us to restrict how we use or disclose your PHI for treatment, payment, or health care operations. We are not required to agree to a requested restriction, except that we must agree to a restriction on disclosure to a health plan if the disclosure relates solely to a service you have paid for out of pocket in full.
Right to Request Confidential Communications
You have the right to ask us to communicate with you about your PHI in a particular way or at a particular location, such as contacting you only at a specific phone number or address. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice at any time, even if you originally agreed to receive it electronically.
Right to Choose Someone to Act on Your Behalf
If you have given someone medical power of attorney, or if someone is your legal guardian, that person may exercise your rights and make choices about your PHI on your behalf. We will confirm that person’s authority before taking any action.
Right to Be Notified of a Breach
You have the right to be notified if a breach occurs that may have compromised the privacy or security of your unsecured PHI, as required by law.
Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer using the contact information below, or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
- Office for Civil Rights complaint portal: https://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html
Our Responsibilities
We are required by law to maintain the privacy of your PHI, to give you this Notice describing our legal duties and privacy practices, and to abide by the terms of this Notice currently in effect. We will not use or share your PHI other than as described here unless you tell us we can in writing, and if you change your mind, you may tell us in writing at any time.
Changes to This Notice
We reserve the right to change the terms of this Notice, and to make the revised Notice effective for PHI we already maintain as well as any PHI we receive in the future. When we make a material change, we will make the updated Notice available on our website at premierlimblengthening.com/notice-of-privacy-practices and, where required by law, at our office.
Contact Us and How to File a Complaint
If you have questions about this Notice, would like to exercise any of the rights described above, or would like to file a complaint, please contact our Privacy Officer.
Premier Limb Lengthening, Privacy Officer
- Mailing address: 400 N. Mountain Ave. Suite 305, Upland, CA 91786
- Phone: (951) 620-5663
- Email: privacy@premierlimblengthening.com
You will not be retaliated against for filing a complaint, whether with us or with the Office for Civil Rights.