Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW THIS NOTICE CAREFULLY.

Uses and Disclosures: The reasons listed in this section do NOT require your authorization as indicated in the Health Insurance Portability Accountability Act of 1996 (HIPPA)

 

Treatment. Information regarding your health may be used by our staff members or disclosed to other health care professionals with the purpose of evaluating your health, diagnosing medical conditions, and providing treatment as necessary. For example, results of certain medical tests may remain in your medical record and be accessible by health professionals who provide future treatments or who are consulted by our staff.

 

Payment. Your health information may be used to seek payment from credit card companies or 3rd party financing companies that you have used to complete payments.

 

Health Care Operations. Information on your health may be used by the Cosmetic Plastic Surgery of Maryland staff to support management and day-to-day activities. For example, information regarding services you receive may be used by our staff to support budgeting or other financial reporting or to evaluate quality of operations.

 

Law Enforcement. In order to support government audits or inspections, facilitate law enforcement investigations, or to comply with government-mandated reporting, we may be required to disclose your health information to a law enforcement agency. This will be completed with your permission.

 

Public Health Reporting. In some instances, we may be required by law to disclose your health information to public health agencies. For example, we are required by law to report some communicable diseases to the state’s public health department.

 

Other Uses and Disclosures Require Your Authorization. Any disclosure of your health information or use of this information for purposes outside of those listed above require your specific written authorization and consent. In the even that you change your mind regarding authorized use of your information, you may revoke authorization in writing. However, understand that revoking authorization to use or share your information can not affect or undo any prior use or sharing of health information.

 

Appointment Reminders. Our staff must use your health information in order to notify you about upcoming appointments.

 

Information About Treatments. We may share or send information to you regarding treatment and management of your medical condition which may be of interest to you. In addition, we may send information describing health-related goods or services we believe may be of interest to you. Your health information may be used to send you this information.

 

Cosmetic Plastic Surgery of Maryland Duties

By law, Cosmetic Plastic Surgery of Maryland is required to maintain and protect the privacy of your health information and to provide you with this notice regarding our privacy practices. We are also required to abide by the following privacy practices.

 

Individual Rights

Federal privacy standards entitle you to certain rights. 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 review and copy your protected health information
  • The right to amend or submit corrections to your protected health information
  • The right to receive an account of how and to whom your protected health information has been disclosed
  • The right to receive a printed copy of this notice

 

Requests to Inspect Protected Health Information.

As permitted by federal regulation, we require that requests to inspect, copy, or disclose protected health information to yourself or another person be submitted in writing. To make such a request, a form to access your records may be obtained by contacting our Medical Records Department. To submit a complaint or comment regarding our privacy practices, please send a letter detailing your concerns to the contact listed below.

 

If you believe your right to privacy has been violated, you can call the matter to our attention by sending a letter describing your concerns to the contact listed below. No penalization or other retaliation will be faced as a result of filing such a complaint.

 

Contact Privacy Officer: Salman Ashruf, MD, FACS

7550 Teague Road, Suite 105

Hanover, MD 21076

 

Effective Date. This Notice is effective on or after April 14, 2020