NOTICE OF PRIVACY PRACTICES
Magic Body Sculpt LLC
Notice of Privacy Practices
This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Our Office use information about you for beauty treatment, to obtain payment for treatment, for administrative purposes, to evaluate the quality of treatment that you receive. Your health information is contained in a medical record that is the physical property of Magic Body Sculpt LLC.
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and controls your protected information. “Protected information” is information about you, including demographic information, that may identify you and that relates to your past, present, or future condition and related health care services.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices by accessing our website at www.magicbodysculpt2u.com, calling our office and requesting that a revised copy be sent to you in the mail, or asking for one at the time of your next appointment.
How Our Office May Use or Disclose Your Information
The following are examples of the types of uses and disclosures of your care information that our office is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office.
For Treatment. We may use and disclose your information to provide you with beauty treatment or services or to manage your health and any related services. For example, information obtained by a health care provider, such as a physician, nurse, or other person providing health services, to you, will record information in your record that is related to your treatment. This information is necessary for our staff to determine what treatment you should receive. Staff will also record actions taken by them in the course of your treatment and note how you respond to the actions.
For Payment. Our Office may use and disclose your information to others for purposes of receiving payment for treatment and services that you receive. For example, a bill may be sent to you or a third-party payer, such as an insurance company or financing plan. The information on the bill may contain information that identifies you, your treatment or supplies used in the course of treatment. This may also include certain activities that your insurance plan requires to be undertaken before it approves or pays for services we recommend for you such as; making a determination of eligibility or coverage for a financing plan, reviewing services provided to you for necessity, and undertaking utilization review activities. We may use and disclose health information about you in order to support the business activities of our Office. For example, your health information may be disclosed to members of staff, risk or quality improvement personnel, and others to:
• Evaluate the performance of our staff;
• Assess the quality of care and outcomes in your case and similar cases;
• Learn how to improve our facilities and services; and
• Determine how to continually improve the quality and effectiveness of the services we provide.
Appointments. Our Office may use your information to provide appointment reminders to you or information about treatment alternatives or other health-related benefits and services that may be of interest to you. In addition, when you arrive at our office, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your treatment and/or your appointment time. We may also call you by name in the waiting room when your member staffing is ready to see you.
Required by Law. Our Office may use and disclose information about you as required by law. For example, our Office may disclose information for the following purposes:
• For judicial and administrative proceedings pursuant to legal authority;
• To report information related to victims of abuse, neglect or domestic violence; and
• To assist law enforcement officials in their law enforcement duties.
Research. Our office may use your health information for research purposes when an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved the research.
Health and Safety. Your health information may be disclosed to avert a serious threat to the health or safety of you or any other person pursuant to applicable law. For example, we may disclose your health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post-marketing surveillance, as required.
Government Functions. Your information may be disclosed for specialized government functions such as protection of public officials or reporting to various branches of the armed services.
Business Associates. We will share your information with third-party “business associates” that perform various activities (e.g., billing, transcription services) for our office. Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected information.
Uses and Disclosures That We May Make Unless You Object
Other Uses. Other uses and disclosures will be made only with your written authorization unless otherwise permitted or required by law, and you may revoke the authorization except to the extent that our Office has acted in reliance on it.
Required Uses and Disclosures
Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. seq.
Your personal Information Rights
Although your health record is the physical property of our Office, the information belongs to you. Under the Federal Privacy Rules, 45 CFR Part 164,
We are required by the Federal Privacy Rules to:
• Maintain the privacy of protected personal information;
• Provide you with this notice of our legal duties and privacy practices with respect to your personal information;
• Abide by the terms of this notice;
• Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed;
• Accommodate reasonable requests you may make to communicate personal information for reasons other than those listed above and permitted under law.
We reserve the right to change our information practices and to make the new provisions effective for all protected information it maintains including personal information created or received prior to the effective date of any such revised notice. Should our protected information practices change, we will post it in our Office and/or on our website, and/or provide you a copy of the revised notice, upon request.
For More Information or to Report a Problem
If you have questions, you may contact the Privacy Officer at 3375 E. Russell Road Ste. 1E, Las Vegas, Nevada, 89120. Tel: 702-778-6623 E-mail: firstname.lastname@example.org.