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Privacy Policy

Privacy Policy

It is going to talk about the ways in which your medical information can be used and disclosed by us. Also, know how to get access to this information.

Go through the privacy policy carefully. Always know that the privacy of your information is of supreme importance to us.

Our Legal Duty

Both the federal and the state laws inform us to maintain the safety of your protected medical information. It is also imperative for us to make you aware of the notice regarding our privacy practice, legal duties, and your rights to your protected medical information. The privacy policy described in the notice is followed while it is in effect. The notice is applicable from April 14, 2003, and shall remain in effect until replaced by us.

We hold the right to make changes in our privacy practices and term of this notice at any time. Special emphasis is to be placed to make sure that the changes made are permissible by the law. We also have the right to make changes in our privacy practices and the new terms of our notice that is effective for all medical health-related information.

You can get a copy of the privacy policy (or any other related notice) at any time. All you gotta do is just let us know. For more information regarding privacy practices or any additional copies of this notice, feel free to contact us using the information provided at the end of this notice.

Uses and Disclosures of Protected Health Information

We will disclose and use your protected health information about the treatment, health care operations, payment, etc. Some examples of the types of disclosures and uses of your protected health information are being given below. Going through them will give you a clear idea about the topic.

  • Treatment:

    Your protected health information can be used by us to coordinate, provide or manage your health care and related services. The personal credentials enable us to handcraft a treatment plan that perfectly suits your needs. We also use health-related information to manage or coordinate your health care with a third party. For example, we would disclose your health information to a health agency that provides quality care to you. The physicians treating you can also get the information from us.

    To add on, we disclose information to a physician or health care providers from time to time, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician

  • Payment:The protected health information can also be shared to get payment from your health care services. This can include the activities that your health insurance plan might execute before the payment or approval for health care services. It is advisable to determine the coverage or eligibility for insurance benefits. Make sure to review the services provided to you for protected health necessity, and also undertake the utilization of review activities. For example, it can be necessary to obtain approval for a hospital stay. In that case, we will share the health information with the hospital.
  • Health Care Operations:

    Your protected health information can be disclosed (if needed) to conduct certain operational and business activities. These activities include employee review activities, quality assessment activities, licensing, training of students, and conducting other business activities. You need to realize that the activities are not just confined to the mentioned areas.

    For example, you will be asked to sign your name on a sign-in sheet at the registration desk. Next, we may call you by name when your turn to see the doctor arrives. We can disclose or use the protected health information (if required) to get in touch with you via mail or telephone to inform you about the appointment.

    We will also share your protected health information with “third party” business associates that perform several activities i.e transcription and billing services for the practice. When an arrangement between our office and a business associate involves the disclosure or use of your protected health information, we will have a written contract that consists of terms and conditions that will ensure the privacy of your protected health information.

    The protected health information can be used or disclosed, if necessary, to make you aware of the treatment alternatives or other health-related benefits and services that can be of great help. Your protected health information can also be utilized for marketing activities. For example, your address or name can be used to send you a newsletter about the services or practices we have to offer. We can also send you information about services and products that we believe can be of benefit to you. In case you do not need anything, contact us to not send these materials to you.

    Disclosures and use of information based on your written authorization: Other disclosures or uses of your protected health information can only be made with your authorization unless otherwise required or permitted by law as described in the section below.

    You can give us written authorization to use or disclose your protected health information for any need. You might revoke the authorization any time you want by giving it to us in writing. Just know that revocation will never have an impact on the use or disclosure permitted by your authorization while it was in effect. We will never disclose your health care information as described in the notice without your written authorization.

  • Others Involved in Your Health Care: If there is no objection, we can disclose the protected health information to one of your friends, family members, relatives, close friend, or any other person that you identify. If you do not agree with the disclosure of the personal information, it can be disclosed by us at a time if we determine that it is in your best interest on the basis of our professional judgment. We may disclose or use the information to notify a personal representative, family member, acquaintance, or any other person who is responsible for taking care of your general condition, location, or death.
  • Marketing: We may also use your protected health information to get in touch with you about the treatment alternatives that can be of use to you. We can also protect your personal health information from a business associate who can help you in these activities. If the information is not provided to you by a general newsletter or in person or is for services or products of nominal value. You can opt-out of receiving any such information by just saying it to us via contact information.
  • Research; Death; Organ Donation: We can use or disclose your protected health information for research purposes in certain circumstances. We may also disclose the protected health information of a deceased person to a coroner, protected health examiner, funeral director, or organ procurement organization for certain purposes.
  • Public Health and Safety: We can use the protected health information to an extent in order to situations that can be a threat to your safety or public health. Your information can also be disclosed to a government agency that is authorized to supervise the health care system or government programs or its contractors, and to the public health authorities for public health reasons.
  • Health Oversight: Your health information can be disclosed to a health oversight agency for activities that are authorized by audits, law, inspections, and investigations. These agencies can seek information that includes government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.
  • Abuse or Neglect: The protected health information can be shared with a public health authority that is authorized by law to receive reports of child abuse or neglect. To add on, we can disclose your protected health information if we feel that you have been subjected to abuse, neglect, or violence to the governmental entity or agency authorized to receive such information. In that case, consistent disclosure will be made to comply with the applicable federal and state laws.
  • Food and Drug Administration: We can also share the protected health information to a company or person needed by the Food and Drug Administration to report in case of adverse events, product problems, or defects, to track products, biologic product deviations, to allow product recalls, to make replacements or repairs or to conduct marketing surveillance (if required).
  • Criminal Activity: In order to comply with the applicable state or federal laws, we might have to disclose the protected health information. It will be done if we believe that the disclosure is necessary to reduce or prevent a critical threat to the safety of the public or person. We can also disclose the protected health information if it is necessary for the authorities that enforce the law to apprehend an individual.
  • Required by Law: We may disclose or use the protected health information when it is necessary to do so because of the law. For example, we might need to disclose your protected health information to the U.S. Department of Health and Human Services based on the request for purpose of determining if we are in compliance with the federal privacy laws. When authorized by worker’s compensation or similar laws, we might need to disclose your protected health information.
  • Process and Proceedings: We might need to disclose your protected health information in response to an administrative order, court, discovery request, or other lawful processes, subpoena under certain criteria. In some situations, such as a warrant or grand jury subpoena, court order, we might need to disclose the protected health information to the enforcement officials.
  • Law Enforcement: It might be necessary for you to disclose the protected information of a fugitive, material witness, suspect, missing person, or crime. We may disclose the protected health information of an inmate or other person in lawful custody to a law enforcement official or correctional institution under certain circumstances. It can also be done to assist law enforcement officials to arrest an individual who has confessed to his/her participation in a crime.

Patient Rights

Access: You have the right to both get and look at the protected health information with limited exceptions. For that, you need to contact the listed person to obtain access to your protected health information. You can also request access to your protected health information. You may also request access by sending us a letter to the address at the end of this notice. If you request copies, we will charge you $25.00 for each page or$10.00 per hour to locate and copy your protected health information, and postage if you want the copies mailed to you. If you prefer, we will prepare a summary or an explanation of your protected health information for a fee. Contact us using the information listed at the end of this notice for a full explanation of our fee structure.

Restriction Requests: You have the right to receive a list of instances in which we or our business associates disclosed your protected health information for purposes other than treatment, payment, health care operations, and certain other activities after April 14, 2003. After April 14, 2009, the accounting will be provided for the past six(6) years. We will provide you with the date on which we made the disclosure, the name of the person or entity to whom we disclosed your protected health information, a description of the protected health information we disclosed, the reason for the disclosure, and certain other information. If you request this list more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests. Contact us using the information listed at the end of this notice for a full explanation of our fee structure.

Confidential Communication: You have the right to request that we communicate with you in confidence about your protected health information by alternative means or to an alternative location. You must make your request in writing. We must accommodate your request if it is reasonable, specifies the alternative means or location, and continues to permit us to bill and collect payment from you.

Amendment: You have the right to request that we amend your protected health information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request if we did not create the information you want to be amended or for certain other reasons. If we deny your request, we will provide you a written explanation. You may respond with a statement of disagreement to be appended to the information you wanted to be amended. If we accept your request to amend the information, we will make reasonable efforts to inform others, including people or entities you name, of the amendment and to include the changes in any future disclosures of that information.

Electronic Notice: If you receive this notice on our website or by electronic mail (e-mail), you are entitled to receive this notice in written form. Please contact us using the information listed at the end of this notice to obtain this notice in written form.

Questions and Complaints

If you want more information about our privacy practices or have questions or concerns, please contact us using the information below. If you believe that we may have violated your privacy rights, or you disagree with a decision we made about access to your protected health information or in response to a request you made, you may complain to us using the contact information below. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request.
We support your right to protect the privacy of your protected health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services

Name of Contact Person: Dr. Sam Harouni, DDS

Telephone: 310-929-9128

Address: 350 S Beverly Dr #160b, Beverly Hills, CA 90212, United States

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