NOTICE OF PRIVACY PRACTICES
The terms of this Notice of Privacy Practices apply to Jacksonville Cosmetic Surgery Center and are effective April 14, 2003. This organization and its employees will share individual patient health information as is necessary to provide quality health care and receive reimbursement for those services as permitted by law. This office is required by law to maintain the privacy of our patient's individual health information and to provide patients with notice of privacy practices with respect to your individual health information. We reserve the right to change the terms of this Notice of Privacy Practices as necessary.
Except as described below, this office will maintain the confidentiality of your individual health information. Your individual health information may be used and disclosed as customary and reasonable for purposes of treatment or services, payment, and health care operations and pursuant to a signed consent form permitting the use or disclosure. You have the right to revoke that authorization in writing unless any action has been taken in reliance on the authorization.
Treatment, Payment, and Health Care Operations. Except as otherwise provided, or with your signed consent, this office will use and disclose your individual health information as necessary for purposes of your treatment or services, payment, and as necessary and permitted by law, for our health care operations which include clinical improvement, professional peer review, business management, accreditation and licensing, etc..
Family and Friends. With your approval or based on our best professional judgment that you would not object, individual health information may be disclosed to designated family, friends, and others who are involved in your care or in payment of your care. If your are unavailable, incapacitated, or facing an emergency medical situation, and we determine that a limited disclosure may be in your best interest, we may share limited individual health information with such individuals without your approval.
Business Associates. At times it may be necessary for us to provide your individual health information to certain outside persons or organizations that assist us with our health care operations, such as Hospitals, Out patient surgery centers, Pathology and laboratories and Implant Companies, or for auditing, accreditation, collection and legal services, etc. These business associates are required to properly safeguard the privacy of your information.
Appointments and Services. This office may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits, product and services that may be of interest to you. You have the right to request and we will accommodate reasonable requests by you to receive communications regarding your individual health information from us by alternative means or at alternative locations. You may request such confidential communication in writing and my send your request to our office to the attention of Compliance Officer. You also have the right to request that we not send you any future marketing materials and we will use our best efforts to honor such request. You may send this request to our office, Att: Compliance Officer with your request to be removed from our marketing mailing lists or E-mail.
Special Situations: Other uses and disclosures of your individual health information, permitted or required by law, may be made without your consent or authorization.
• For any purpose required by law;
• For public health activities, such as required reporting of disease, injury, and birth and death, and for required public health investigations;
• As required by law if we suspect child abuse or neglect or if we believe you to be a victim of abuse, neglect, or domestic violence;
• To the Food and Drug Administration if necessary to report adverse events, product defects, or to participate in product recalls;
• To your employer or Worker's Compensation agency or similar program, when we have provided health care to you at the request of your employer or your WC agencies and if necessary for your WC benefit determination;
• If required by law to a government oversight agency conducting audits, investigations, or civil or criminal proceedings;
• If required to do so by a court or administrative ordered subpoena or discovery request;
• To law enforcement officials as required by law to report wounds and injuries and crimes;
• To coroners and/or funeral directors consistent with law;
• If necessary to arrange an organ or tissue donation from you or a transplant for you;
• If you are a member of the military as required by armed forces services; we may also release your individual health information if necessary for national security or intelligence activities.
1. Access to Individual Health Information. You have the right to copy and/or inspect much of the individual health information that we retain on your behalf. All requests for access must be made in writing and signed by you or your representative. We will charge you $1.00 per page up to 25 pages then $0.25 thereafter if you request a copy of the information. We will also charge $5.00 for postage and will charge for copying photographs or for preparing a summary of the requested information if you request such summary.
2. Amendments to Individual Health Information. You have the right to request in writing that individual health information that we maintain about you be amended or corrected. We are not obligated to make all requested amendments but will give each request careful consideration. All amendment requests, in order to be considered by us, must be in writing, signed by you or your representative, and must state the reasons for the amendment/correction request. If an amendment or corrections you request is made by us, we may also notify others who work with us and have copies of the uncorrected record if we believe that such notification is necessary. You may obtain an amendment request form from our office.
3. Accounting for Disclosures of Individual Health Information. You have the right to receive an accounting of certain disclosures made by us of your individual health information for purpose other than treatment, payment and health care operations after April 14, 2003. Requests must be made in writing and signed by you or your representative. Accounting request forms are available from our Compliance Officer. You will be charged for the costs of providing the list.
4. Restrictions and Use and Disclosures of Individual Health Information. You have the right to request restrictions on certain of our uses and disclosures of your individual health information. We are not required to agree to your restriction request but will attempt to accommodate reasonable requests when appropriate and we retain the right to terminate an agreed-to restriction if we believe such termination is appropriate. In the event of a termination by us, we will notify you of such termination. You also have the right to terminate, in writing or orally, any agreed-to restriction by sending such termination notice to our office.
If you believe your privacy rights have been violated, you can file a complaint to Jacksonville Cosmetic Surgery Center, Compliance Officer 820 Prudential Drive, Suite 702, Jacksonville, Florida 32207 or call (904) 399-5061. You may also file a complaint with the Secretary of the U.S. Department of Health And Human Services in Washington D.C. in writing within 180 days of a violation of your rights. There will be no retaliation for filing a complaint.
The information on this Website is provided “as is” for general information only. This information or any response to your E-mail questions are not intended to provide medical advice, and should not be relied upon as a substitute for face to face consultations with qualified health professionals who are familiar with your individual medical needs. Jacksonville Cosmetic Surgery Center makes no warranties of any kind regarding this Website or E-mail replies, including but not limited to any warranty of accuracy, completeness, currency, reliability, merchantability or fitness for a particular purpose, or any warranty that these pages, or the computer server which makes them available, are free of virus or other harmful elements, and such warranties are expressly disclaimed.
You acknowledge that the information, opinions and recommendations or result obtained in this Website or E-mail response, and general information may not necessarily apply to your situation or condition and the results of your surgery may be different.
You agree that you will hold harmless Jacksonville Cosmetic Surgery Center and its shareholders, officers, directors, physicians, employees, and independent contractors from all claims arising out of or related to your access or use of, or your inability to access or use, this Website or the information contained in this Website or other websites to which it is linked, including but not limited to claims that you have found something you have heard, viewed or downloaded from this Website or any other website to which it is linked to be obscene, offensive, defamatory, or infringing upon your intellectual property rights. In no event will Jacksonville Cosmetic Surgery Center or any of the information contributors to the Website be liable to you or anyone else for any decision made or action taken by you in reliance on such information or for any consequential, special or similar damages, even if Jacksonville Cosmetic Surgery Center has been advised of the possibility of such damages.
Jacksonville Cosmetic Surgery Center may provide links on the Website to other websites that are not under the control of Jacksonville Cosmetic Surgery Center. These links are provided for convenience or reference only and are not intended as an endorsement of the organization or individual operating the website or a warranty of any type regarding the website or the information on the website.
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