HIPAA Privacy Statement
Shikara Facial Plastic Surgery
Dr. Meryam Shikara, MD
Effective Date: [Insert Date]
Please Read Carefully – Important Information About Your Privacy
Who is covered by this notice: This notice applies to our medical facility and any programs associated with Shikara Facial Plastic Surgery.
Our commitment to your privacy: We understand that your medical information is personal, and we are dedicated to safeguarding it. We create and maintain records of the care and services you receive at our facility, which are necessary for providing quality care and ensuring legal compliance. This notice applies to all of your medical records.
We are obligated by law to:
Maintain the privacy of your Protected Health Information (PHI)
Provide you with this notice about our legal duties and privacy practices
Follow the terms of the notice currently in effect
Description of privacy practices: This Notice of Privacy Practices outlines how we may use and disclose your protected health information for treatment, payment, healthcare operations, and other purposes permitted or required by law. "Protected Health Information" refers to information that identifies you and relates to your physical or mental health, including past, present, or future care.
Changes to this notice: We reserve the right to modify this notice. Any changes will apply to both existing and future medical information. The current notice will be made available at our facility and on our website: https://www.drshikara.com. You will also receive a copy of the current notice during your visit for treatment.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our facility or directly with the U.S. Department of Health and Human Services, Office for Civil Rights, located at 200 Independence Avenue, S.W., Washington D.C. 20201. Toll-Free: (877) 696-6775. You can also visit www.hhs.gov/ocr/privacy/hipaa/complaints/ for more information.
To file a complaint with our facility, please submit a written complaint within 180 days of the suspected violation to info@drshikara.com. Include as much detail as possible about the incident.
Use and Disclosure of Your Medical Information
Treatment
We may use and disclose your protected health information to provide, coordinate, or manage your healthcare. This includes sharing information with other healthcare providers involved in your care. We may also disclose your information to external parties involved in your medical care or related services. In some cases, we will obtain your authorization before disclosing your information. Only the minimum necessary information will be shared.
Communication with Family
When involving your family or personal friends in your care, we may disclose relevant health information to them. In emergency situations, or when you are unable to object, we may disclose your information in your best interest. After an emergency, you will be informed of the disclosure and given the opportunity to object to further disclosures.
Healthcare Operations
We may use your medical information to support quality assessment, improvement activities, and operational purposes that do not involve treatment. This includes activities such as provider evaluation, educational purposes, accreditation, and business planning and development.
Payment
We may use and disclose your medical information to bill for services rendered and collect payment from you, insurance companies, or third parties. This may involve sharing information with your health plan to facilitate payment or prior approval.
Business Associates
We may engage business associates to provide specific services. To ensure your privacy, we require them to safeguard your information in accordance with the law.
Appointment Reminders
We may contact you to remind you of upcoming appointments or reschedule missed appointments.
Treatment Aftercare
We may use and disclose your medical information to assess your satisfaction, recommend aftercare options, and inform you about health-related benefits or services we offer.
Legal Requirements
We will disclose your information when required by federal, state, or local law.
Public Health Risks
We may disclose your medical information for public health activities, including disease control, reporting child abuse, medication reactions, notifying exposed individuals, or reporting domestic violence.
Health Oversight Activities
We may disclose your medical information to health oversight agencies authorized by law for audits, investigations, inspections, and licensure purposes.
Lawsuits and Disputes
In legal proceedings, we may disclose your medical information in response to a court order or lawful process.
Law Enforcement
We may release your medical information to law enforcement officials under certain circumstances, such as court orders, subpoenas, reporting criminal conduct, or emergencies related to crime or safety.
Correctional Institutions
If you are an inmate, we may disclose your protected health information to correctional institutions or law enforcement officials for healthcare purposes, safety, or security.
Medical Examiners
We may release your medical information to medical examiners for identification purposes or determining the cause of death.
National Security and Intelligence Activities
In compliance with the law, we may release your medical information to authorized federal officials for national security and intelligence activities.
Your Rights Regarding Your Medical Information
Right to Inspect and Copy
You have the right to review and receive a copy of your medical information maintained by our facility. To request access, submit a written request to info@drshikara.com. We may charge a reasonable fee for copying and associated supplies.
Right to Amend
If you believe your medical information is incorrect or incomplete, you may request an amendment. Your request must be in writing, explain the reason, and be submitted to info@drshikara.com. We may deny your request in certain circumstances.
Right to an Accounting of Disclosures
You have the right to request a list of disclosures we have made of your medical information. Requests should be in writing, specifying the desired time period, and sent to info@drshikara.com. Additional requests may incur a fee.
Right to Request Confidential Communications
You have the right to request confidential communication regarding your medical matters. Submit your request in writing to info@drshikara.com, specifying the desired communication method.
Breach Notification
In the event of a breach of your unsecured Protected Health Information, we will notify you as required by law.
Right to Request Restrictions
You have the right to request restrictions on the use or disclosure of your medical information for treatment, payment, or healthcare operations. We are not obligated to agree to your request, except in specific circumstances. Submit written requests to info@drshikara.com.
Right to a Copy of This Notice
You have the right to request a paper copy of this notice at any time. To obtain a copy, submit your request in writing to info@drshikara.com.
Contact Information
Shikara Facial Plastic Surgery
110 E 60th St # 908
New York, NY 10022
Phone: (332) 291-7001
Email: info@drshikara.com
For questions about this HIPAA Privacy Statement or to exercise any of your rights, please contact us using the information above. We will not retaliate against you for filing a complaint about our privacy practices.