Notice of Privacy Practices (HIPAA)

Effective Date: 10/22/2010

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED TO AGENCIES WE WORK WITH TO PROVIDE YOU YOUR MEDICAL NEEDS/SERVICE. PLEASE REVIEW IT CAREFULLY.

Our Pledge Regarding Your Protected Health Information

ARMEN VARTANY, M.D., F.A.C.S. and entire staff, 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 will tell you about the ways in which ARMEN VARTANY, M.D., F.A.C.S. and associated staff, may use and disclose medical information about you. Your medical information, also referred to as “protected health information,” is the 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.

Uses and Disclosures for Treatment, Payment and Health Care Operations

By becoming a patient of ARMEN VARTANY, M.D., F.A.C.S., you are giving consent for the use of your protected health information for certain activities, including treatment, payment, and other health care operations.

First off, we may use and disclose protected health information about you so that ARMEN VARTANY, M.D., F.A.C.S. and its medical professionals can treat you. We may also use and disclose protected health information about you so that we may be paid for the medical treatment we provide you. We will submit protected health information about you to your insurance company, if applicable, in order to receive payment for services we have provided to you. Cosmetic treatments are not billed to insurance.

Uses and Disclosures for Appointment Reminders

We may use and disclose your medical information to contact you as a reminder that you have an appointment at the office. If you request that such communications be made confidentially, please inform the office. An additional consent will be presented that specifically allows ARMEN VARTANY, M.D., F.A.C.S. to communicate via email and SMS messaging.

Uses and Disclosures to Others Involved in Your Health Care

We may disclose to a member of your family, a relative, a close friend, or any other person you identify, your protected health information that directly relates to that person’s involvement in your medical care. If you are unable to agree or object to this disclosure, we may disclose such information as necessary if we determine that it is in your best interests based on our professional judgment. We may also use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition, or death.

Uses and Disclosures in Emergency Situations

We may use or disclose your protected health information in an emergency treatment situation. If this happens, your physician will attempt to obtain your acknowledgment of this Notice as soon as reasonably practicable after the delivery of treatment.

Uses and Disclosures Required by Law

We will use or disclose protected health information about you when required to do so by federal, state, or local law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, if the law requires us to do so, of any such uses or disclosures. 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 law.

Disclosures to Law Enforcement

We may release protected health information if asked to do so by a law enforcement official, in response to a court order, subpoena, warrant, summons, or similar process. Other related disclosures may include disclosures relating to individuals who are Armed Forces personnel, to national security and intelligence agencies, as well as disclosures to authorized federal officials for the protection of the President of the United States or other authorized persons or foreign heads of state.

Disclosures for Financial Disputes

We may release protected health information about you in response to a financial dispute, a delinquent account, or in collection efforts. Any dispute cannot be properly addressed by ARMEN VARTANY, M.D., F.A.C.S., without the expressed waiver of your HIPAA Rights.

Disclosures for Workers’ Compensation

We may release protected health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Your Rights Regarding Protected Health Information About You.

Right to Confidential Communications. You also have the right to request to receive private health information communications (such as reminder calls/email/SMS messaging and promotional materials) by alternative means or at alternative locations. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of this Notice. You have the right to a paper copy of this Notice. You may ask us to give you a copy of this notice at any time.

Changes to This Notice

ARMEN VARTANY, M.D., F.A.C.S. reserves the right to change this notice. We reserve the right to make the revised or changed Notice effective for protected health information we already have about you, as well as any information we create or receive in the future.

Other Uses of Protected Health Information

Other uses and disclosures of your protected health information not covered by this notice or the laws that apply to ARMEN VARTANY, M.D., F.A.C.S. will be made only with your written permission (“authorization”). If you provide us permission to use or disclose protected health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose protected health information about you for the reasons covered by your authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the medical treatment or other services that we have provided to you.