Privacy Policy
Here's some information on how we treat the information
you give us.
Your e-mail address
We only collect and hold your e-mail address in order to
send you information you have requested. You can unsubscribe
any time for any reason. We never rent e-mail lists. We
don't share your name with any outside entity.
What we send
You will only get e-mails from Rewind Cosmetic Dermatology
and only if you have given us your email address voluntarily.
If you are a Rewind Cosmetic Dermatology client, you may
receive special offers when we launch new services or products.
Unsubscribing
To unsubscribe from our mailing list, simply choose the
Unsubscribe link on any newsletter and you will be instantly
removed.
Questions?
If you have any questions regarding this policy or any other
general site use concerns, please contact us here or call
480.421.2121.
Thank you!
Notice of Privacy Practices (HIPAA)
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. If you have
any questions about this Notice of Privacy Practices please
contact our office:
This Notice of Privacy Practices describes how Elisa Mashal,
MD may use and disclose your protected health information
(PHI) to carry out treatment, payment or health care operations
and for other purposes that are permitted or required by
law. It also describes your rights to access and control
your protected health information. "Protected Health
Information" is information about you, including demographic
information, that may identify you and that relates to your
past, present or future physical or mental health or condition
and related health care services.
We are required to abide by the terms of this Notice of
Privacy Practices. We may change the terms of our notice,
at any time. The new notice will be effective for all protected
health information that Elisa Mashal, MD maintains at that
time. Upon your request, Elisa Mashal, MD will provide you
with any revised Notice of Privacy Practices by calling
the practice and requesting that a revised copy be sent
to you in the mail or asking for one at the time of your
next appointment.
I. Uses and Disclosures of Protected
Health Information
Uses and Disclosures of Protected Health Information Based
Upon Your Written Consent
You will be asked by Elisa Mashal, MD to sign a consent
form. Once you have consented to use and disclosure of your
protected health information for treatment, payment and
health care operations by signing the consent form, Elisa
Mashal , MD will use or disclose your protected health information
as described in this Section. Your protected health information
may be used and disclosed by Elisa Mashal, MD, the office
staff and others outside of our office that are involved
in your care and treatment for the purpose of providing
medical care services to you.
Treatment: We will use and disclose your protected health
information to provide, coordinate or manage your medical
care and any related services. This includes the coordination
or management of your medical care with a third party that
has already obtained your permission to have access to your
protected health information. In addition, Elisa Mashal
, MD may disclose your protected health information to another
physician or health care provider (e.g., a specialist or
laboratory) who, at the request of Elisa Mashal, MD, becomes
involved in your care by providing assistance with your
medical care diagnosis or treatment to Elisa Mashal, MD.
Healthcare Operations: We may call you by name in the waiting
room when Elisa Mashal, MD is ready to see you. We may use
or disclose your protected health information, as necessary,
to contact you to remind you of your appointment.
We will share your protected health information with third
party "business associates" that perform various
activities for the practice. Whenever an arrangement between
our office and a business associate involves the use or
disclosure of your protected health information, Elisa Mashal,
MD will l have a written contract that contains terms that
will protect the privacy of your protected health information.
Uses and Disclosures of Protected Health Information Based
upon Your Written Authorization
Other uses and disclosures of your protected health information
will be made only with your written authorization, unless
otherwise permitted or required by law as described below.
You may revoke this authorization, at any time, in writing,
except to the extent that, Elisa Mashal MD or the practice
has taken an action in reliance on the use or disclosure
indicated in the authorization.
Other Permitted and Required Uses and Disclosures That
May Be Made With Your Consent, Authorization or Opportunity
to Object
We may use and disclose your protected health information
in the following instances. You have the opportunity to
agree or object to the use or disclosure of all or part
of your protected health information. If you are not present
or able to agree or object to the use or disclosure of the
protected health information, then Elisa Mashal, MD may,
using professional judgment, determine whether the disclosure
is in your best interest. In this case, only the protected
health information that is relevant to your medical care
will be disclosed.
Others Involved in Your Healthcare:
Unless you object, Elisa Mashal, MD 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 such a disclosure,
Elisa Mashal, MD may disclose such information as necessary
if it determines that it is in your best interest based
on its professional judgment. We may 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.
Emergencies:
We may use or disclose your protected health information
in an emergency treatment situation. If this happens, Elisa
Mashal , MD will try to obtain your consent as soon as reasonably
practicable after the delivery of treatment. If Elisa
Mashal, MD is required by law to treat you and it has attempted
to obtain your consent but is unable to obtain your consent,
it may still use or disclose your protected health information
to treat you.
Communication Barriers:
We may use and disclose your protected health information
if Elisa Mashal, MD attempts to obtain consent from you
but is unable to do so due to substantial communication
barriers and it determines, using professional judgment,
that you intend to consent to use or disclosure under the
circumstances.
Other Permitted and Required Uses and Disclosures That
May Be Made Without Your Consent, Authorization or Opportunity
to Object
We may use or disclose your protected health information
in the following situations without your consent or authorization.
These situations include:
- Required By Law: We may use or disclose your protected health information to the extent that law requires the use or disclosure. 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, as required by law, of any such uses or disclosures.
- Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability. We may also disclose your protected health information, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.
- Health Oversight: Elisa Mashal, MD may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations and inspections. Oversight agencies seeking this information include government agencies that oversee the medical care system, government benefit programs, other government regulatory programs and civil rights laws.
- Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, Elisa Mashal, MD may disclose your protected health information if it believes that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
- Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.
- Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), in certain conditions in response to a subpoena, discovery request or other lawful process.
- Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include:
- legal processes and otherwise required by law;
- limited information requests for identification and location purposes;
- pertaining to victims of a crime;
- suspicion that death has occurred as a result of criminal conduct;
- in the event that a crime occurs on the premises of the practice;
- medical emergency (not on Elisa Mashal, MD practice's premises) and it is likely that a crime has occurred.
- Coroners: Elisa Mashal, MD may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law.
- Criminal Activity: Consistent with the applicable federal and state laws, Elisa Mashal, MD may disclose your protected health information, if it believes that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. Elisa Mashal, MD may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.
- Military Activity and National Security: When the appropriate conditions apply, Elisa Mashal, MD may use or disclose protected health information of individuals who are Armed Forces personnel:
for activities deemed necessary by appropriate military command authorities; for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits;
to foreign military authority if you are a member of that foreign military services. Elisa Mashal, MD may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
- Workers' Compensation: Elisa Mashal, MD may disclose your protected health information as authorized to comply with workers' compensation laws and other similar legally established programs.
- Required Uses and Disclosures: Under the law, Elisa Mashal, MD 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 requirements of HIPAA Privacy Rule under§164.500 of the HIPAA Privacy Rule.
II. Your Rights
The following is a statement of your rights with respect
to your protected health information and a brief description
of how you may exercise these rights.
You have the right to inspect and copy your protected health
information. This means you may inspect and obtain a copy
of protected health information about you that is contained
in a designated record set for as long as Elisa Mashal,
MD maintain the protected health information. A "designated
record set" contains medical and billing records and
any other records that Elisa Mashal, MD and the practice
use for making decisions about you.
Under federal law, however, you may not inspect or copy
the following records:
- information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding;
- protected health information that is subject to law that prohibits access to protected health information.
Depending on the circumstances, a decision to deny access
may be reviewable. In some circumstances, you may have a
right to have this decision reviewed. Please contact our
Privacy Official if you have questions about access to your
medical record.
You have the right to request a restriction of your protected
health information. This means you may ask us not to use
or disclose any part of your protected health information
for the purposes of treatment, payment or healthcare operations.
You may also request that any part of your protected health
information not be disclosed to family members or friends
who may be involved in your care or for notification purposes
as described in this Notice of Privacy Practices. Your request
must state the specific restriction requested and to whom
you want the restriction to apply.
Elisa Mashal, MD is not required to agree to a restriction
that you may request. If it believes it is in your best
interest to permit use and disclosure of your protected
health information, your protected health information will
not be restricted. If Elisa Mashal, MD does agree to the
requested restriction, it may not use or disclose your protected
health information in violation of that restriction unless
it is needed to provide emergency treatment. With this in
mind, please discuss any restriction you wish to request
with Elisa Mashal, MD You may request a restriction by contacting
our Privacy Official.
You have the right to request to receive confidential communications
from us by alternative means or at an alternative location.
We will accommodate reasonable requests. We may also condition
this accommodation by asking you for information as to how
payment will be handled or specification of an alternative
address or other method of contact. We will not request
an explanation from you as to the basis for the request.
Please make this request in writing to our Privacy Official.
You may have the right to request Elisa Mashal, MD to amend
your protected health information. This means you may request
an amendment of protected health information about you in
a designated record set for as long as Elisa Mashal, MD
maintains this information. In certain cases, it may deny
your request for an amendment. If Elisa Mashal, MD denies
your request for amendment, you have the right to file a
statement of disagreement with us and it may prepare a rebuttal
to your statement and it will provide you with a copy of
any such rebuttal. Please contact our Privacy Official to
determine if you have questions about amending your medical
record.
You have the right to receive an accounting of certain
disclosures Elisa Mashal, MD has made, if any, of your protected
health information. This right applies to disclosures for
purposes other than treatment, payment or healthcare operations
as described in this Notice of Privacy Practices. It excludes
disclosures Elisa Mashal, MD may have made to you, to family
members or friends involved in your care or for notification
purposes. You have the right to receive specific information
regarding these disclosures that occurred after September
1,2006. You may request a shorter timeframe. The right to
receive this information is subject to certain exceptions,
restrictions and limitations.
You have the right to obtain a paper copy of this notice
from us, upon request, even if you have agreed to accept
this notice electronically.
3. Complaints
You may complain to us or to the Secretary of Health and
Human Services if you believe your privacy rights have been
violated by us. You may file a complaint with us by notifying
our office manager of your complaint. We will not retaliate
against you for filing a complaint.
4. Effectiveness
This notice was published and becomes effective on May 1,
2007
Patient Privacy
Elisa Mashal, M.D. is aware of the privacy needs for
well-known individuals and media personalities. Special
entrance to the office assures anonymity and protection
from undesired attention. Our staff is well-trained to ensure
the discretionary requirements of any patient visiting our
office.against you for filing a complaint.
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