Privacy Policy

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.

Beverly Hills Hearing Center (TM) is committed to protecting your health information. This Notice of Privacy Practices (“Notice”) is provided pursuant to the Health Insurance Portability and

Accountability Act of 1996 (“HIPAA”) as revised in the 2013 HIPAA Omnibus Rule . This

Notice describes how we may use and disclose your protected health information to carry out treatment, payment or audiological/health care operations and for other purposes that are permitted or required by law. This Notice also describes your rights and our duties with respect to your protected health information.

“Protected health information” is information about you that may identify you and that relates to your past, present or future physical or mental health/condition and related audiological/health care services. We must follow the privacy practices that are described in this Notice while it is in effect. If you have any questions about this Notice, please contact our Privacy Officer, Bonnie Baehr, at (310) 276-8585 or bbaehr@beverlyhillshearing.com.

HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION

The following categories describe the different ways that we may use and disclose your protected health information. These examples are not meant to be exhaustive, but to illustrate the types of uses and disclosures that may be made.

We may use and disclose your protected health information to provide, coordinate, or manage your audiological treatment and any related services. We may also disclose your protected health information to other third party providers involved in your audiological/health care. For example, your protected health information may be provided to a physician or other audiological/health care provider (e.g. a specialist or laboratory) to whom you have been referred to ensure that the physician or other audiological/health care provider has the necessary information to diagnose or We may use and disclose your protected health information so that the treatment and health care services you receive may be billed to you, your insurance company, a government program, ort hird party payors. This may include certain activities that your health insurance plan may undertake before it approves or pays for the audiological/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, we may provide your health plan with medical information about theaudiological/health care services Beverly  Hills Hearing Center rendered to you for

3. Audiological/Health Care OperationsWe may use and disclose your protected health information for audiological/health care operation purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care and for our operation and management purposes. For example, we may use your protected health information to review the quality of the treatment and services you receive and to evaluate the performance of our team members in caring for you. We also may disclose information to audiologists, physicians, nurses, technicians, medical students, and other personnel for educational and learning purposes.

4. Treatment Communications

We may provide treatment communications concerning treatment alternatives or other health

related products or services.  For communications for which we or a business associate may

receive financial remuneration in exchange  for making the communication, we must obtain

written authorization unless the communication is made face-to-face and/or involving

promotional gifts of nominal value. If you do not wish to receive these communications please submit a written request to our Privacy Officer, Bonnie Baehr, Beverly Hills Hearing Center (TM) , 9100 Wilshire Blvd #310 E, Beverly Hills, CA 90212.

5. Fundraising Activities

We may use or disclose your demographic information and dates of services provided to you, as necessary, in order to contact you for fundraising activities supported by Beverly Hills Hearing Center (TM). You have the right to opt out of receiving fundraising communications. If you do not want to receive these materials, please submit a written request to our Privacy Officer, Bonnie Baehr, Beverly Hills Hearing Center (TM), 9100 Wilshire Blvd #310 E, Beverly Hills, CA 90212.

6. 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. Also, for example, if you are brought into this office and are unable to communicate normally with your clinician for some reason, we may find it is in your best interest to give your hearing instrument and other supplies to the friend or relative who brought you in for treatment. We may also use and disclose protected health information to notify such persons of your location, general condition, or death. We also may coordinate with disaster relief agencies to make this type of notification.  We also may use professional judgment and our experience with common practice  to make reasonable decisions  about your best interests in allowing a person to act on your behalf to pick up your hearing instruments, supplies, records, or other things that contain protected health information about you.

7. 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.

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.

We may disclose your protected  health information to our business associates that perform

functions on our behalf or provide us with services if the information is necessary for such

functions or services. To protect your health information, however, we require the business

associate to appropriately safeguard your information.

10. 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.

We may disclose your 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 audiological/health care

system, government benefit programs, other government regulatory programs and civil rights

We may disclose your protected health information to a public health authority that is authorized

by law to receive reports of 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.

13. 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 by law.

We may disclose your 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), and in certain conditions in response to a subpoena,

discovery request or other lawful process.

We may disclose your protected health information, so long as applicable legal requirements are

met, for law enforcement purposes.

16. Coroners, Funeral Directors, and Organ Donation

We may disclose your 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 your protected health information

to a funeral director, as authorized by law, in order to permit the funeral director to carry out its

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.

17. 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.

18. Serious Threat to Health or Safety

Consistent with applicable federal and state  laws, we may disclose your protected health

information to prevent or lessen a serious threat to your health and safety or to the health and

safety of another person or the public.

19. Military Activity and National Security

If you are involved with military, national security or intelligence activities or if you are in law

enforcement custody, we may disclose your protected health information to authorized officials

so they may carry out their legal duties under the law.

20. Workers’ Compensation

We may disclose your protected health information as authorized for workers’ compensation or

other similar programs that provide benefits for a work-related illness.

21. For Data Breach Notification Purposes

We may use or disclose your protected health information to provide legally required notices of

unauthorized access to or disclosure of your health information.

22. Required Uses and Disclosures

Under the law, we must make disclosures to you and when required by the Secretary of the

U.S. Department of Health and Human Services to investigate or determine our compliance with

the requirements of Section 164.500 et. Seq.

SPECIAL PROTECTIONS FOR HIV,  ALCOHOL AND SUBSTANCE ABUSE,

MENTAL HEALTH AND GENETIC INFORMATION

Certain federal and state laws may require special privacy protections that restrict the use and

disclosure of certain health information, including HIV-related information, alcohol and

substance abuse information, mental health information, and genetic information. Some parts of

this Notice may not apply to these types of information.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION BASED

UPON YOUR WRITTEN AUTHORIZATION

The following uses and disclosures will be made only with your written authorization:

1. Uses and disclosures of protected health information for marketing purposes for which we or a

business associate may receive remuneration; and

2. Disclosures that constitute a sale of protected health information.

Other uses and disclosures of your protected health information not described in this Notice will

be made only with your written authorization, unless otherwise  permitted or required by law.

You may revoke this authorization, at any time, in writing, except to the extent that Beverly Hills

Hearing Center has taken an action in reliance on the use or  disclosure indicated in the

authorization. Additionally, if a use or disclosure of protected health information described

above in this Notice is prohibited or materially limited by other laws that apply to use, it is our

intent to meet the requirements of the more stringent law.

YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION

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.

1. Right to be Notified if there is a Breach of Your Protected Health information

You have the right to be notified upon a breach of any of your unsecured protected health

2. Right to Inspect and Copy

You may inspect and obtain a copy of your protected health information that is contained in your

medical and billing records and any other records that Beverly Hills Hearing Center  uses for

making decisions about you. To inspect and copy your medical information, you must submit a

written request to our Privacy Officer, Bonnie Baehr, Beverly Hills Hearing Center, 9100

Wilshire Blvd #310 E, Beverly Hills, CA 90212. If you request a copy of your information, we

may charge you a reasonable fee for the costs of copying, mailing or other costs incurred by us in

complying with you request. Under federal law, 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, we may deny your request to  inspect and/or copy  your protected health

information. A decision to deny access may be reviewable. Please contact our Privacy Officer,

Bonnie Baehr, at (310) 276-8585 or bbaehr@beverlyhillshearing.com if you have questions

about access to your medical record.

3. Right to Request Restrictions

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. To request a

restriction on who may have access to your protected health information, you must submit a

written request to our Privacy Officer, Bonnie Baehr, Beverly Hills Hearing Center, 9100

Wilshire Blvd #310 E, Beverly Hills, CA 90212. Your request must state the specific restriction

requested and to whom you want the restriction to apply. Beverly Hills Hearing Center is not

required to agree to a restriction that you may request, unless you are asking us to restrict the use

and disclosure of your protected health information to a health plan for payment or

audiological/health care operation purposes and such information you wish to restrict pertains

solely to a audiological/health care item or service for which you have paid us “out-of-pocket” in

full. If we believe it is in your best interest to permit the use and disclosure of your protected

health information, your protected health information will not be restricted. If we do 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.

4. Right to Request Confidential Communication

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. You must request

this by submitting a written request to our Privacy Officer, Bonnie Baehr, Beverly Hills Hearing

Center, 9100 Wilshire Blvd #310 E, Beverly Hills, CA 90212.

5. Right to Request Amendment

You may request an amendment of your protected health information contained in your medical

and billing records and any other records that Beverly Hills Hearing Center  uses for making

decisions about you, for as long as we maintain the protected health information. You must

request for an amendment by submitting a written request to our Privacy Officer, Bonnie Baehr,

Beverly Hills Hearing Center, 9100 Wilshire Blvd #310 E, Beverly Hills, CA 90212, and provide

the reason(s) that support your request. In certain cases, we may deny your request for an

amendment. If we deny your request for an 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.

6. Right to an Accounting of Disclosures

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. It excludes disclosures we may

have made to you, for a resident directory, to family members or friends involved in your care, or

for notification purposes. The right to receive this information is subject to certain exceptions,

restrictions and limitations. Additionally, limitations are different for electronic health records.

You must request for an accounting of disclosures by submitting a written request to our Privacy

Officer, Bonnie Baehr, Beverly Hills Hearing Center, 9100 Wilshire Blvd #310 E, Beverly Hills,

CA 90212, and provide the reason(s) that support your request.

7. Right to Obtain a Paper Copy of this Notice

You have the right to receive a paper copy of this Notice even if you have agreed to receive this

notice electronically. You may ask us to give you a copy of this notice at any time. To obtain a

paper copy of this Notice, you can contact our Privacy Officer, Bonnie Baehr, at (310) 276-8585

or bbaehr@beverlyhillshearing.com. You may also obtain a copy of this Notice at

www.beverlyhillshearing.com.

COMPLAINTS OR QUESTIONS

If you believe your privacy rights have been violated, you may file a complaint with us or with

the Secretary of the U.S. Department of Health and Human Services. If you have a question

about this Notice or wish to file a complaint with us, please contact our Privacy Officer, Bonnie

Baehr, at (310) 276-8585 or bbaehr@beverlyhillshearing.com or the Corporate Privacy Officer at

the address listed below. All complaints must  be submitted in writing. Beverly Hills Hearing

Center will not retaliate against you for filing a complaint.

CHANGES TO THIS NOTICE

We reserve the right to change this Notice at any time. The new Notice will be effective for all

health information we already have about you as well as any information we receive in the

future. You can also obtain a revised Notice at www.beverlyhillshearing.com or by contacting

our Privacy Officer, Bonnie Baehr, Beverly Hills Hearing Center, 9100 Wilshire Blvd #310 E,

Beverly Hills, CA 90212.

Beverly Hills Hearing Center

Attn: Corporate Privacy Officer

This Notice is effective as of April, 2013.

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