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| Privacy |
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| Examples of Disclosure for Treatment, Payment, and Health Operations |
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| 1. We will use your health information for treatment: For example : Information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. Dr. Behmand will document in your record his expectations of the members of your health care team. Members of your health care team will then record the actions they took and their observations, such that Dr. Behmand will know how you are responding to treatment. 2. We will use your health information for payment: For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used. 3.) We will use your health information for regular health operations: A.) Quality Assurance: Members of our medical staff, the risk or quality improvement manager may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service we provide. B.) Business Associates: There are some services provided in our organization through contacts with Business Associates. Examples include diagnostic services, certain laboratory tests, and therapy sessions and when these services are contracted, we may disclose your health information to our Business Associates so that it can perform the job we have asked it to do and bill you or your third- party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information. C.) Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition. D.) Communication with family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care. E.) Marketing: Unless specifically notified to the contrary by you, we may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and devices that may be of interest to you. F.) Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement. G.) Workers compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law. H.) Public health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability. I.) Correctional institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals. J.) Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority, or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public. |
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| Effective Date: 01/09/05 Version Number: 03 |
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| 1776 Ygnacio Valley Rd, Suite 108 Walnut Creek, California 94598 Tel: (925) 939-9200 |


| 1776 Ygnacio Valley Rd, Suite 108, Walnut Creek, California 94598 Telephone: (925) 939-9200 Facsimile: (925) 939-9205 Home/Cosmetic Surgery For Women/Cosmetic Surgery For Men/Plastic Surgery After Massive Weight Loss/Thermage®/Botox®/Skin Care/Injectable Skin Fillers/The Office Privacy/Contact Us/Sitemap |