PRIVACY PRACTICES

NOTICE OF PRIVACY PRACTICES
(Please refer to §164.520 of the Federal Register
for HIPAA Rules and Regulations for all required elements.)

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.

“Advanced Cosmetic Laser Center” may use your health information, information that constitutes protected health information as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. Advanced Cosmetic Laser Center has established policies to guard against unnecessary disclosure of your health information.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED:

To Provide Treatment. Advanced Cosmetic Laser Center may use your health information to coordinate care within Advanced Cosmetic Laser Center and with others involved in your care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. Advanced Cosmetic Laser Center also may disclose your health care information to individuals outside of Advanced Cosmetic Laser Center involved in your care including family members, pharmacists, suppliers of medical equipment, or other health care professionals.

To Obtain Payment. Advanced Cosmetic Laser Center may include your health information in invoices to collect payment from third parties for the care you receive from Advanced Cosmetic Laser Center. For example, Advanced Cosmetic Laser Center may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or Advanced Cosmetic Laser Center. Advanced Cosmetic Laser Center also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for health care that will be provided to you.

To Conduct Health Care Operations. Advanced Cosmetic Laser Center may use and disclose health information for its own operations in order to facilitate the function of Advanced Cosmetic Laser Center and as necessary to provide quality care to all of Advanced Cosmetic Laser Center‘s patients. Health care operations includes such activities as:

- Quality assessment and improvement activities.

- Activities designed to improve health or reduce health care costs.

- Protocol development, case management and care coordination.

-- Contacting Advanced Cosmetic Laser Centers and patients with information about treatment alternatives and other related functions that do not include treatment.

-- Professional review and performance evaluation.

-- Training programs including those in which students, trainees or practitioners in health care learn under supervision.

-- Training of non-health care professionals.

-- Accreditation, certification, licensing or credentialing activities.

-- Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs.

-- Business planning and development including cost management and planning related analyses and formulary development.

-- Business management and general administrative activities of Advanced Cosmetic Laser Center.

For example Advanced Cosmetic Laser Center may use your health information to evaluate its staff performance, combine your health information with other Advanced Cosmetic Laser Center patients in evaluating how to more effectively serve all Advanced Cosmetic Laser Center patients, disclose your health information to Advanced Cosmetic Laser Center staff and contracted personnel for training purposes, use your health information to contact you as a reminder regarding a visit to you, or contact you as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).

For Appoinent Reminders. Advanced Cosmetic Laser Center may use and disclose your health information to contact you as a reminder that you have an appoinent for a doctor’s office visit.

For Treatment Alternatives. Advanced Cosmetic Laser Center may use and disclose your health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY ALSO BE USED AND DISCLOSED

When Legally Required. Advanced Cosmetic Laser Center will disclose your health information when it is required to do so by any Federal, State or local law.

When There Are Risks to Public Health. Advanced Cosmetic Laser Center may disclose your health information for public activities and purposes in order to:

- Prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions.

- Report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration.

- Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.

- Notify an employer about an individual who is a member of the workforce as legally required.

To Report Abuse, Neglect Or Domestic Violence. Advanced Cosmetic Laser Center is allowed to notify government authorities if Advanced Cosmetic Laser Center believes a patient is the victim of abuse, neglect or domestic violence. Advanced Cosmetic Laser Center will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.

To Conduct Health Oversight Activities. Advanced Cosmetic Laser Center may disclose your health information to a health oversight Advanced Cosmetic Laser Center for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. Advanced Cosmetic Laser Center, however, may not disclose your health information if you are the subject of an investigation and your health information is not directly related to your receipt of health care or public benefits.

In Connection With Judicial And Administrative Proceedings. Advanced Cosmetic Laser Center may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when Advanced Cosmetic Laser Center makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information. [Some States require a court order for the release of any confidential medical information and may be more protective than the Federal requirements.]