HIPAA Privacy Policy

Who will follow this notice?

This notice describes the practices of PUR Skin Clinic Medical and the practices that will be followed by all of PUR Skin Clinic Medical workforce members who handle your medical information.

Our pledge regarding your protected health information

PUR Skin Clinic Medical understands that medical information about you and your health is personal. We are committed to protecting medical information about you. We maintain our records and conduct our treatment environment with a goal of providing the highest level of protection for your medical information, while still providing you with the highest level of medical care. This notice applies to all of the records of your medical care which are received or created by PUR Skin Clinic Medical.

Your other medical treatment providers (e.g., doctors, hospitals, home health agencies, etc.) may have different policies or notices regarding the use and disclosure of your medical information.

This notice will tell you about the ways in which PUR Skin Clinic Medical may use and disclose medical information about you. Your medical information, also referred to as protected health information (PHI), is that information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health information and related health care services.

In this notice, we also describe your rights and certain obligations PUR Skin Clinic Medical has regarding the use and disclosure of your protected health information. We are required by law to:

• Make sure that medical and other information that identifies you (protected health information) is kept private.
• Give you this notice of our legal duties and privacy practices with respect to protected health information about you.
• Follow the terms of the notice that is currently in effect.

Uses and disclosures for treatment, payment, and health care operations

By becoming a patient at PUR Skin Clinic Medical, you are giving consent for PUR Skin Clinic Medical to use your protected health information for certain activities, including treatment, payment, and other health care operations (“TPO”).

Treatment: We may use and disclose protected health information about you so that our medical professionals can treat you. For example, we may use your past medical information to diagnose your present condition or provide information to another doctor to whom we refer you for additional care.

Payment: We may use and disclose protected health information about you so that we may be paid for the medical treatment we provide. For example, we will submit protected health information about you to your insurance company in order to receive payment for services provided.

Health Care Operations: We may use and disclose protected health information about you for health care operations, such as evaluating how we can better meet your needs or providing protected health information to an auditor who reviews our books to ensure we can maintain our license.

Other uses and disclosures of your protected health information

The following uses of your protected health information may be made without additional authorization from you. (Not every use or disclosure is listed, but all uses and disclosures made by PUR Skin Clinic Medical are only those permitted under the law.)

• Licensure proceedings by the American Board of Plastic Surgery.
• Appointment reminders.
• Sharing with others involved in your healthcare.
• Emergency situations.
• Health-related benefits or services.
• Uses required by federal, state, or local law.
• Communicable disease reporting.
• Health oversight activities.
• Abuse or neglect reporting.
• FDA-related disclosures.
• Lawsuits and disputes.
• Law enforcement requests.
• Coroners, funeral directors, organ donation.
• Approved research.
• Criminal activity prevention.
• Workers’ Compensation.

Your rights regarding protected health information

• Right to inspect and copy: You may request to inspect or obtain copies of your records in writing.
• Right to request restrictions: You may request restrictions on use/disclosure of your PHI.
• Right to confidential communications: You may request communications through alternative means/locations.
• Right to amend: You may request corrections to your PHI if incomplete or inaccurate.
• Right to an accounting of disclosures: You may request a list of disclosures made outside of TPO.
• Right to a paper copy: You may request a paper copy of this notice at any time.

Changes to this notice

PUR Skin Clinic Medical reserves the right to change this notice. Revised notices apply to all PHI we maintain, past or future. The current notice will be posted on our website: www.www.purskinclinic.com.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the Office Manager at PUR Skin Clinic Medical, 307 Bell Street #104, Edmonds, WA 98020, or with the Secretary of the Department of Health and Human Services. Complaints must be in writing. You will not be penalized for filing a complaint.

Other uses of protected health information

Any other use or disclosure not covered by this notice or applicable law requires your written authorization. You may revoke authorization in writing at any time. Revocations do not apply to information already disclosed.

Questions?

If you have questions regarding this notice, please contact the Office Manager at PUR Skin Clinic Medical, 307 Bell Street #104, Edmonds, WA 98020, or call 425.678.2418.