THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Legal Duties
JLUXE Aesthetic Wellness is required by law to maintain the privacy and security of your Protected Health Information. We are required to give you this notice of our legal duties and privacy practices regarding your health information, and to follow the terms of the notice currently in effect.
If a breach occurs that may have compromised the privacy or security of your health information, we are required to notify you.
We may change the terms of this notice at any time. Any changes will apply to all health information we maintain. Revised notices will be posted in our office and on our website, and copies will be available upon request.
How We May Use and Disclose Your Health Information
Treatment. We use your health information to provide, coordinate, and manage your care. This includes sharing information with physicians, nurses, medical directors, or other providers involved in your treatment. For example, we may share your medical history with a supervising physician reviewing your treatment plan.
Payment. We use and disclose your health information to bill and collect payment for services. This may include verifying coverage, submitting claims, or working with payment processors and financing companies you choose to use.
Health Care Operations. We use your health information to run our practice and ensure quality care. This includes staff training, quality review, business planning, and evaluating the performance of our clinicians.
Business Associates. We contract with outside vendors who perform services on our behalf, such as electronic health record providers, billing services, and IT support. These vendors are required by written agreement to protect your health information.
Appointment Reminders and Follow-Up. We may contact you by phone, text, email, or mail to remind you of appointments, provide post-treatment instructions, or follow up on your care.
Treatment Alternatives and Health-Related Services. We may tell you about treatment options or services that may be of interest to you.
Marketing. We will not use or disclose your health information for marketing purposes without your written authorization. We will not sell your health information. We will not use your photographs, before-and-after images, or testimonials in advertising without your separate written authorization, which you may revoke at any time.
As Required by Law. We will disclose your health information when required by federal, state, or local law.
Public Health and Safety. We may disclose your health information to public health authorities, to report adverse events or product problems to the FDA, to report suspected abuse or neglect, or to prevent a serious threat to health or safety.
Health Oversight, Legal Proceedings, and Law Enforcement. We may disclose your health information to health oversight agencies for audits and investigations, in response to a court order or lawful subpoena, or to law enforcement as permitted by law.
Workers’ Compensation, Coroners, and Organ Donation. We may disclose your health information as authorized by workers’ compensation laws, to coroners or medical examiners, or to organ procurement organizations.
Persons Involved in Your Care. Unless you object, we may share relevant information with a family member, friend, or other person you have identified as involved in your care or payment for your care.
Uses and Disclosures That Require Your Written Authorization
Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and any sale of your health information require your written authorization. Any other use or disclosure not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.
Your Rights Regarding Your Health Information
Right to Inspect and Copy. You have the right to inspect and receive a copy of your health information, including an electronic copy if we maintain it electronically. Submit a written request to our Privacy Officer using the contact information below. We will respond within 30 days. We may charge a reasonable, cost-based fee for copies. In limited circumstances we may deny your request, and you may have the denial reviewed.
Right to Request an Amendment. If you believe information in your record is incorrect or incomplete, you may request an amendment. Submit your request in writing to our Privacy Officer and include the reason for the request. We may deny your request if the information was not created by us, is not part of the records we maintain, or is accurate and complete. If we deny your request, you may submit a statement of disagreement that will be added to your record.
Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we have made of your health information in the six years prior to your request. This does not include disclosures for treatment, payment, health care operations, or disclosures you authorized. Submit your request in writing to our Privacy Officer. The first accounting in any 12-month period is free.
Right to Request Restrictions. You have the right to request restrictions on how we use or disclose your health information for treatment, payment, or operations, or to persons involved in your care. We are not required to agree to most requests. However, if you pay in full out of pocket for a service and ask us not to disclose that information to your health plan, we must honor that request. Submit your request in writing to our Privacy Officer.
Right to Request Confidential Communications. You have the right to ask that we contact you in a specific way or at a specific location, such as by mail to a different address. Submit your request in writing to our Privacy Officer. We will accommodate reasonable requests and will not ask you to explain why.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice at any time, even if you agreed to receive it electronically. Ask at our front desk or contact our Privacy Officer.
Right to Be Notified of a Breach. You have the right to be notified if a breach occurs that may have compromised the privacy or security of your health information.
How to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with us. Submit your complaint in writing to:
Privacy Officer
JLUXE Aesthetic Wellness
jen@jluxeaesthetic.com
(440) 295-5866
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at 200 Independence Avenue SW, Washington, D.C. 20201, by calling 1-800-368-1019, or at www.hhs.gov/ocr/privacy/hipaa/complaints.
We will not retaliate against you for filing a complaint.
Contact
Questions about this notice or our privacy practices can be directed to our Privacy Officer at jen@jluxeaesthetic.com or (440) 295-5866.
