THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

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Body Art Rejuvenation LLC (“Body Art Rejuvenation,” “we,” “our,” or “the Practice”) is committed to protecting the privacy and confidentiality of your medical and health information.

Protected health information (“PHI”) is individually identifiable health information about you, including demographic information, that relates to your past, present, or future physical or mental health condition, healthcare services provided to you, or payment for healthcare services.

Body Art Rejuvenation is a self-pay healthcare practice. This Notice describes our privacy practices under the Health Insurance Portability and Accountability Act (“HIPAA”), when applicable, and other applicable federal and Florida laws.

Where an applicable Florida law provides greater privacy protection or places greater restrictions on the use or disclosure of health information than federal law, we will follow the applicable more protective requirement.

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WHO FOLLOWS THIS NOTICE

This Notice applies to Body Art Rejuvenation LLC and, as applicable, to:

• Healthcare providers furnishing services through the Practice;

• Employees and other members of our workforce;

• Medical oversight personnel participating in Practice operations;

• Authorized personnel who use the Practice's records or systems to provide or support patient care; and

• Other persons or organizations acting on our behalf when applicable law permits them to use or receive PHI.

These persons may use or share health information as permitted by law for treatment, payment, healthcare operations, and the other purposes described in this Notice.

 

An independently operated healthcare provider or organization that maintains separate medical records and its own privacy practices may be subject to its own Notice of Privacy Practices.

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YOUR RIGHTS

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities.

 

Get an Electronic or Paper Copy of Your Medical Record

You may ask to inspect or receive an electronic or paper copy of your medical record and other health information that we maintain about you.

We will provide access within the period required by applicable law.

We may charge a reasonable, cost-based fee or other fee permitted by applicable law for copies, supplies, postage, or an agreed-upon summary or explanation.

 

In certain limited circumstances permitted by law, we may deny access to all or part of the requested information. When required, we will explain the reason for the denial and any available right to have the decision reviewed.

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Ask Us to Correct or Amend Your Medical Record

You may ask us to correct or amend health information about you that you believe is inaccurate or incomplete.

We may deny your request under circumstances permitted by law, including when the information is accurate and complete, was not created by us, is not part of the information subject to amendment, or is otherwise not subject to amendment under applicable law.

 

If we deny your request, we will provide an explanation as required by law.

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Request Confidential Communications

You may ask us to contact you about health matters in a specific way or at a specific location. For example, you may ask us to contact you only at a particular telephone number, email address, or mailing address.

We will accommodate reasonable requests as required by applicable law. You are responsible for providing accurate contact information and notifying us when your contact instructions change.

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Ask Us to Limit What We Use or Share

You may ask us not to use or disclose certain PHI for treatment, payment, or healthcare operations.

We are generally not required to agree to every requested restriction. If we agree to a restriction, we will follow it except when disclosure is necessary for emergency treatment or another exception permitted or required by law applies.

When applicable, if you pay for a healthcare service or item completely out-of-pocket and request that we not disclose information concerning that service or item to a health plan for purposes of payment or healthcare operations, we will honor that request unless disclosure is otherwise required by law.

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Receive an Accounting of Certain Disclosures

You may request an accounting of certain disclosures of your PHI that we made during the six years before the date of your request, or another period required by applicable law.

The accounting does not include every disclosure. For example, certain disclosures for treatment, payment, or healthcare operations; disclosures made directly to you; disclosures made pursuant to your authorization; and other disclosures excluded by law generally do not have to be included.

 

We will provide one accounting during a 12-month period without charge. We may charge a reasonable, cost-based fee for additional accountings requested during the same 12-month period after informing you of the cost and giving you an opportunity to withdraw or modify your request.

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Receive a Copy of This Notice

You may request a paper copy of this Notice at any time, even if you previously agreed to receive the Notice electronically.

The current Notice will also be available through our website and at our Practice.

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Choose Someone to Act for You

If another person is legally authorized to act as your personal representative, that person may exercise your privacy rights and make choices concerning your PHI to the extent permitted by law.

We may verify the person's authority before recognizing the individual as your personal representative.

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Receive Notice of Certain Breaches

We will notify you as required by applicable law if a breach occurs that may have compromised the privacy or security of your unsecured PHI.

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File a Privacy Complaint

• You may file a complaint if you believe your privacy rights have been violated.

• You may complain directly to Body Art Rejuvenation using the contact information provided at the end of this Notice.

• When HIPAA applies, you may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.

• We will not retaliate against you, deny treatment to you, or treat you differently because you exercised a privacy right or filed a good-faith privacy complaint.

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YOUR CHOICES

For certain health information, you may tell us your preferences about what we share.

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Family Members, Friends, Caregivers, and Others Involved in Your Care

Unless you object, and when otherwise permitted by law, we may share information relevant to your healthcare or payment for your healthcare with a family member, friend, caregiver, personal representative, or another person involved in your care.

If you are unable to communicate your preference, we may use professional judgment to determine whether a limited disclosure is in your best interest and is permitted by law.

We will disclose only the information reasonably relevant to that person's involvement in your care or payment for your care.

We may also use or disclose information, when permitted by law, to notify or assist in notifying a person responsible for your care regarding your location, general condition, or death.

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HOW WE TYPICALLY USE AND DISCLOSE YOUR HEALTH INFORMATION

We may use or disclose your PHI for the purposes described below without your written authorization when permitted or required by applicable law.

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Treatment

We may use and disclose your PHI to evaluate, coordinate, manage, and provide your healthcare and related services.

For example, a treating provider may review your:

• Medical history;

• Medications;

• Allergies;

• Treatment photographs;

• Laboratory results;

• Prior procedures;

• Consultation information; or

• Other information relevant to your care.

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When permitted by law, we may share relevant health information with another physician, healthcare provider, laboratory, pharmacy, specialist, or other person involved in your treatment.

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Payment

We may use and disclose PHI as necessary to collect and process payment for healthcare services provided by Body Art Rejuvenation.

Body Art Rejuvenation is a self-pay healthcare practice.

Payment-related activities may include:

• Providing information about charges;

• Processing patient payments;

• Processing credit or debit card transactions;

• Coordinating with payment processors;

• Coordinating with financing or payment providers selected by the patient;

• Maintaining billing and transaction records;

• Processing refunds;

• Addressing payment disputes or chargebacks; and

• Performing other payment-related activities permitted by law.

 

f a health plan, insurer, or another third-party payer becomes involved in payment for a patient's services, we may use or disclose PHI for payment purposes when permitted or required by law.

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Healthcare Operations

We may use and disclose PHI as necessary to operate the Practice and improve the quality, safety, effectiveness, and administration of our healthcare services.

Healthcare operations may include:

• Quality assessment and improvement;

• Patient-safety activities;

• Provider review and credentialing;

• Workforce training;

• Compliance and regulatory activities;

• Medical-record review;

• Business planning and management;

• Auditing and accounting;

• Legal services;

• Appointment and scheduling management;

• Customer service;

• Information-technology and cybersecurity support;

• Fraud prevention;

• Practice administration; and

• Vendor and service-provider management.

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When a third-party service provider qualifies as a HIPAA business associate, we will require appropriate contractual protections for PHI as required by law.

 

Appointment, Treatment, and Care Communications

We may use your health information to contact you regarding:

• Appointments and scheduling;

• Appointment reminders;

• Treatment instructions;

• Follow-up care;

• Laboratory matters;

• Prescription matters;

• Product recalls;

• Patient-safety information;

• Treatment alternatives; and

• Other health-related services relevant to your care.

You may request reasonable alternative methods of communication as described elsewhere in this Notice.

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Telehealth

When Body Art Rejuvenation provides telehealth services, we may use and disclose PHI as necessary to provide, coordinate, document, and support those healthcare services.

Telehealth encounters will be documented in the patient's medical record in accordance with applicable legal and professional requirements.

Electronic information associated with telehealth services will be protected in accordance with applicable privacy and security requirements.

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MARKETING, PHOTOGRAPHS, TESTIMONIALS, AND PROMOTIONAL USES

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Marketing

We will obtain your written authorization before using or disclosing PHI for marketing when authorization is required by federal or Florida law.

Certain communications permitted by law may not constitute marketing or may not require a separate marketing authorization. These may include certain treatment-related communications, communications concerning treatment alternatives or health-related services, certain face-to-face communications, and other communications specifically permitted by law.

 

Nothing in this Notice authorizes us to disclose your PHI to another company for that company's independent marketing purposes without the authorization required by law. You may opt out of promotional communications when an opt-out right applies.

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Photographs, Videos, Testimonials, and Social Media

We will obtain a separate written authorization when required by law before using identifiable patient photographs, videos, testimonials, treatment stories, medical information, or other identifiable patient information for advertising, social media, website content, promotional materials, or similar marketing purposes.

Receiving healthcare services from Body Art Rejuvenation is not conditioned upon signing a marketing, testimonial, photography, or social-media authorization except where otherwise expressly permitted by law.

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An authorization for promotional use is separate from consent for photographs, videos, or other information that may be medically necessary to document your treatment.

You may revoke a marketing or promotional authorization in writing, subject to applicable law and except to the extent that we have already taken action in reliance upon the authorization.

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Revocation does not require us to destroy information that must be retained as part of your medical record or otherwise retained under applicable law.

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Sale of Protected Health Information

Body Art Rejuvenation does not sell protected health information.

We will not disclose PHI in exchange for payment or other remuneration when the disclosure constitutes a sale of PHI under applicable law unless we first obtain a valid written authorization or a legal exception applies.

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When an authorization is legally required for a disclosure involving remuneration, the authorization will contain any disclosure concerning that remuneration required by law.

 

OTHER USES AND DISCLOSURES PERMITTED OR REQUIRED BY LAW

Subject to applicable legal conditions and limitations, we may use or disclose PHI without your written authorization for purposes including:

• When required by federal, state, or local law;

• Public-health activities;

• Preventing or controlling disease or injury;

• Reporting certain adverse events, product defects, or product recalls;

• Reporting suspected abuse, neglect, exploitation, or domestic violence when permitted or required by law;

• Health-oversight activities;

• Professional licensing or regulatory activities;

• Certain judicial and administrative proceedings;

• Certain lawful law-enforcement purposes;

• Coroners, medical examiners, and funeral directors;

• Organ or tissue donation;

• Workers' compensation matters;

• Research when applicable legal requirements have been satisfied;

• Certain military and veterans' activities;

• National-security and protective-service activities permitted by law;

• Certain correctional institution or law-enforcement custodial situations;

• Preventing or reducing a serious and imminent threat to health or safety when disclosure is permitted by law; and

• Disclosures to government agencies, including the U.S. Department of Health and Human Services, when required to determine compliance with applicable privacy requirements.

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We will comply with all conditions imposed by applicable law before making such disclosures.

Where Florida law provides greater protection or places greater restrictions on disclosure, we will follow the applicable Florida requirement.

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SUBSTANCE USE DISORDER RECORDS SUBJECT TO 42 C.F.R. PART 2

Body Art Rejuvenation does not operate a substance-use-disorder treatment program and does not routinely create or maintain patient records subject to 42 C.F.R. Part 2.

However, to the extent that Body Art Rejuvenation ever receives, creates, or maintains patient records that are subject to 42 C.F.R. Part 2, those records will receive the additional protections required by applicable federal law.

Part 2-protected records will not be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against you except as permitted by applicable law, including pursuant to appropriate written consent or an applicable court order and legal process where required.

Nothing in this section means that Body Art Rejuvenation provides substance-use-disorder diagnosis or treatment services.

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USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION

Uses and disclosures of PHI that are not otherwise permitted or required by law or described in this Notice generally require your written authorization.

Written authorization may be required for:

• Certain marketing uses and disclosures;

• A sale of PHI;

• Certain uses or disclosures of psychotherapy notes, if applicable;

• Identifiable photographs or videos used for advertising;

• Testimonials containing identifiable patient information;

• Certain social-media or website uses involving identifiable patient information; and

• Other uses or disclosures not otherwise permitted by law.

If you provide a written authorization, you may revoke that authorization in writing at any time, except to the extent that we have already taken action in reliance upon it or applicable law provides otherwise.

 

ELECTRONIC COMMUNICATIONS

Email, text messaging, electronic messaging, and similar communications may involve privacy and security risks.

We use reasonable administrative, physical, and technical safeguards appropriate to the communication method and applicable legal requirements.

You may ask us to communicate with you through a reasonable alternative method or at an alternative location.

General email, website forms, ordinary text messages, or general chat functions should not be used for emergency medical concerns.

If you are experiencing a medical emergency, call 911 or seek appropriate emergency medical care.

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OUR RESPONSIBILITIES

Body Art Rejuvenation is committed to protecting the privacy and security of health information entrusted to the Practice.

To the extent required by applicable law, we will:

• Maintain the privacy and security of PHI;

• Use appropriate administrative, physical, and technical safeguards;

• Maintain privacy and security policies and procedures;

• Train appropriate workforce members regarding their privacy responsibilities;

• Limit access to PHI based upon legitimate job responsibilities and applicable legal requirements;

• Require appropriate protections from business associates when required;

• Maintain records of disclosures when required;

• Notify affected individuals of breaches when notification is legally required;

• Follow the duties and privacy practices described in the Notice currently in effect;

• Provide a copy of this Notice upon request; and

• Refrain from retaliating against individuals for exercising their privacy rights or filing a complaint.

We will not use or disclose your PHI other than as described in this Notice unless you authorize us in writing or another use or disclosure is permitted or required by law.

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CHANGES TO THIS NOTICE

We may change the terms of this Notice and our privacy practices as permitted by law. Changes may apply to all PHI we maintain, including information created or received before the change. When a change requires revision of this Notice, we will revise the Notice as required by applicable law. The current Notice will be available upon request, at our office, and on our website.

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Questions and Complaints

Contact:

Rolando Pol, Manager and Privacy Contact
Body Art Rejuvenation LLC
13550 SW 88 Street, Suite 130 Miami, Florida 33186

Email: corp@bodyartrejuvenation.com
Telephone: 786-654-7575

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