Newport Beach Plastic Surgeon | Orange County: 949.574.0574

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Call for a Consultation: 949-574-0574
female plastic surgeon newport beach orange county
☏ Call for a Consultation: 949-574-0574

female plastic surgeon newport beach orange county
Board Certified American Board of Plastic Surgery
Plastic & Reconstructive Surgeon

American Society of Plastic Surgeons
American Society for Aesthetic Surgery
Fellow American College of Surgeons
California Society of Plastic Surgeons
International Society of Aesthetic Plastic Surgery
American Board of Plastic Surgery ABMS MOC
American Society of Plastic Surgeons
American Society for Aesthetic Surgery
Fellow American College of Surgeons
California Society of Plastic Surgeons
International Society of Aesthetic Plastic Surgery
American Board of Plastic Surgery ABMS MOC

PATIENTS RIGHTS UNDER HIPPA


Dr. Amy T. Bandy, Medical Corporation - Notice of Privacy Practices
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 please
contact: our Privacy Contact who is Robyn Coit
This Notice of Privacy Practices describes how we may use and
disclose your protected health information 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 we
maintain at that time. Upon your request, we will provide you with any
revised Notice of Privacy Practices by accessing our website, calling
the surgery center and requesting that a revised copy be sent to you in
the mail or asking for one at the time of your next appointment.


1. Uses and Disclosures of Protected Health Information
Uses and Disclosures of Protected Health Information Based Upon Your Written Consent


You will be asked by your physician 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, your physician will use or disclose your
protected health information as described in this Section 1. Your
protected health information may be used and disclosed by your
physician, our office staff and others outside of our office that are
involved in your care and treatment for the purpose of providing health
care services to you. Your protected health information may also be
used and disclosed to pay your health care bills and to support the
operation of the physicians practice.
Following are examples of the types of uses and disclosures of your
protected health care information that the physicians office is
permitted to make once you have signed our consent form. These examples
are not meant to be exhaustive, but to describe the types of uses and
disclosures that may be made by our office once you have provided
consent.


Treatment: We will use and disclose your protected
health information to provide, coordinate, or manage your health care
and any related services. This includes the coordination or management
of your health care with a third party that has already obtained your
permission to have access to your protected health information. For
example, we would disclose your protected health information, as
necessary, to a home health agency that provides care to you. We will
also disclose protected health information to other physicians who may
be treating you when we have the necessary permission from you to
disclose your protected health information. For example, your protected
health information may be provided to a physician to whom you have been
referred to ensure that the physician has the necessary information to
diagnose or treat you.


In addition, we may disclose your protected health information from
time-to-time to another physician or health care provider (e.g.
specialists, nurses, pharmacy or laboratory technicians, home health
care or recovery care post operatively) who, at the request of your
physician, becomes involved in your care by providing assistance to
your physician with your health care diagnosis or treatment, or to
coordinate different aspects of your health care.


Payment: Your protected health information will be
used, as needed, to obtain payment for your health care services. This
may include certain activities that your health insurance plan may
undertake before it approves or pays for the health care services we
recommend for you such as; making a determination of eligibility or
coverage for insurance benefits, reviewing services provided to you for
medical necessity, and undertaking utilization review activities. For
example, obtaining approval for a hospital stay may require that your
relevant protected health information be disclosed to the health plan
to obtain approval for the hospital admission.


Healthcare Operations: We may use or disclose,
as-needed, your protected health information in order to support the
business activities of your physicians practice. These activities
include, but are not limited to, quality assessment activities,
employee review activities, peer review, training of medical students,
licensing, marketing and fundraising activities, and conducting or
arranging for other business activities.


For example, we may disclose your protected health information to
medical school students that see patients at our office. In addition,
we may use a sign-in sheet at the registration desk where you will be
asked to sign your name and indicate your physician. We may also call
you by name in the waiting room when your physician 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 may disclose your information to friends or family members who are directly involved in your medical care.
We will share your protected health information with third party
“business associates� that perform various activities (e.g.,
billing, transcription services) for the practice. Whenever an
arrangement between our office and a business associate involves the
use or disclosure of your protected health information, we will have a
written contract that contains terms that will protect the privacy of
your protected health information.


We may use or disclose your protected health information, as
necessary, to provide you with information about treatment alternatives
or other health-related benefits and services that may be of interest
to you. We may also use and disclose your protected health information
for other marketing activities. For example, your name and address may
be used to send you a newsletter about our practice and the services we
offer. We may also send you information about products or services that
we believe may be beneficial to you. You may contact our Privacy
Contact to request that these materials not be sent to you.


We may use or disclose your demographic information and the dates
that you received treatment from your physician, as necessary, in order
to contact you for fundraising activities supported by our office. If
you do not want to receive these materials, please contact our Privacy
Contact and request that these fundraising materials not be sent to
you.
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 your
physician or the physicians 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 your physician
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 health care will be disclosed.


Facility Directories: Unless you object, we will
use and disclose in our facility directory your name, the location at
which you are receiving care, your condition (in general terms), and
your religious affiliation. All of this information, except religious
affiliation, will be disclosed to people that ask for you by name.
Members of the clergy will be told your religious affiliation.


Others Involved in Your Healthcare: Unless you
object, we 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
health care. If you are unable to agree or object to such a disclosure,
we may disclose such information as necessary if we determine that it
is in your best interest based on our 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. Finally, we may use or disclose your protected health
information to an authorized public or private entity to assist in
disaster relief efforts and to coordinate uses and disclosures to
family or other individuals involved in your health care.


Emergencies: We may use or disclose your protected
health information in an emergency treatment situation. If this
happens, your physician shall try to obtain your consent as soon as
reasonably practicable after the delivery of treatment. If your
physician or another physician in the practice is required by law to
treat you and the physician has attempted to obtain your consent but is
unable to obtain your consent, he or she may still use or disclose your
protected health information to treat you.


Communication Barriers: We may use and disclose
your protected health information if your physician or another
physician in the practice attempts to obtain consent from you but is
unable to do so due to substantial communication barriers and the
physician 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 the use or disclosure
is required by law. 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.


Communicable Diseases: We may disclose your
protected health information, if authorized by law, to a person who may
have been exposed to a communicable disease or may otherwise be at risk
of contracting or spreading the disease or condition.


Health Oversight: We 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 health 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, we may
disclose your protected health information if we believe 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
(1) legal processes and otherwise required by law, (2) limited
information requests for identification and location purposes, (3)
pertaining to victims of a crime, (4) suspicion that death has occurred
as a result of criminal conduct, (5) in the event that a crime occurs
on the premises of the practice, and (6) medical emergency (not on the
Practice’s premises) and it is likely that a crime has occurred.


Coroners, Funeral Directors, and Organ Donation:
We 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. We may also disclose protected health information to a funeral
director, as authorized by law, in order to permit the funeral director
to carry out their duties. We may disclose such information in
reasonable anticipation of death. Protected health information may be
used and disclosed for cadaveric organ, eye or tissue donation
purposes.


Research: We may disclose your protected health
information to researchers when their research has been approved by an
institutional review board that has reviewed the research proposal and
established protocols to ensure the privacy of your protected health
information.


Criminal Activity: Consistent with applicable
federal and state laws, we may disclose your protected health
information, if we believe 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. We 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, we may use or disclose protected health
information of individuals who are Armed Forces personnel (1) for
activities deemed necessary by appropriate military command
authorities; (2) for the purpose of a determination by the Department
of Veterans Affairs of your eligibility for benefits, or (3) to foreign
military authority if you are a member of that foreign military
services. We 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: Your protected health
information may be disclosed by us as authorized to comply with
workers™ compensation laws and other similar legally-established
programs.


Inmates: We may use or disclose your protected
health information if you are an inmate of a correctional facility and
your physician created or received your protected health information in
the course of providing care to you.


Required Uses and Disclosures: Under the law, we
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 Section 164.500 et. seq.


2. Your Rights


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 we maintain the protected health information. A
“designated record set contains medical and billing records and any
other records that your physician and the practice uses for making
decisions about you.


Under federal law, however, you may not inspect or copy the
following records; psychotherapy notes; information compiled in
reasonable anticipation of, or use in, a civil, criminal, or
administrative action or proceeding, and 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 Contact 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.


Your physician is not required to agree to a restriction that you
may request. If physician 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 your physician
does agree to the requested restriction, we 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 your physician.
You may request a restriction by contacting our center and asking for
the Privacy Contact person, and putting your request in writing. Your
request will be reviewed by your physician and will be evaluated and an
answer given to your upon your request, within 30 days.


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 Contact.


You may have the right to have your physician 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 we maintain this
information. In certain cases, we may deny your request for an
amendment. If we deny your request for amendment, you have the right to
file a statement of disagreement with us and we may prepare a rebuttal
to your statement and will provide you with a copy of any such
rebuttal. Please contact our Privacy Contact to determine if you have
questions about amending your medical record.


You have the right to receive an accounting of certain disclosures we have 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 we may have made to you, for a
facility directory, 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 April 14,
2003. 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 privacy contact of
your complaint. We will not retaliate against you for filing a
complaint.


You may contact our office at (949) 574-0574 or (310) 375-9604 for further information about the complaint process.


This notice was published and becomes effective on January 4, 2003.