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.
Last updated: [DATE TO BE CONFIRMED] · Oak Brook Hair Transplant, 2425 W. 22nd Street, Suite 205C, Oak Brook, IL 60523 · 630-974-1400
[REVIEW REQUIRED] This document is a draft prepared for review by the practice’s legal counsel or compliance officer. Placeholders marked in brackets must be completed before publication. A HIPAA Notice of Privacy Practices has content mandated by 45 CFR 164.520 and must be reviewed by the practice’s counsel or compliance officer, with an effective date and named Privacy Officer inserted, before going live.
Our commitment
Oak Brook Hair Transplant is required by law to maintain the privacy of your protected health information (PHI), to give you this notice of our legal duties and privacy practices regarding your PHI, and to follow the terms of the notice currently in effect.
This notice applies to all records of your care generated by this practice.
How we may use and disclose your health information without your authorization
For treatment. We may use your PHI to provide, coordinate or manage your care, including consultation, examination, procedures and follow-up, and to share it with other providers involved in your treatment.
For payment. We may use and disclose PHI so that treatment you receive may be billed and payment collected, including from you or a third party where applicable.
For health care operations. Including quality assessment, staff training and review, business planning, and administrative activities.
As required by law. Including public health activities, reporting of abuse or neglect, health oversight activities, judicial and administrative proceedings, law enforcement requests, coroners and medical examiners, organ donation, workers’ compensation, and to avert a serious threat to health or safety.
Appointment reminders and related communications. We may contact you to remind you of an appointment or to discuss treatment alternatives or health-related benefits.
Uses and disclosures that require your written authorization
Photographs and images. Clinical photography is used for your medical record. Any use of your photographs for marketing, on this website, on social media, or in any other public setting requires your separate, specific, written authorization, which you may refuse and may revoke in writing at any time.
Marketing communications and any sale of PHI require your written authorization.
Where you provide authorization, you may revoke it in writing at any time, except to the extent we have already acted in reliance on it.
Your rights regarding your health information
Right to inspect and copy. You may inspect and obtain a copy of your PHI, including an electronic copy where we maintain it electronically. We may charge a reasonable, cost-based fee.
Right to request an amendment. If you believe information in your record is incorrect or incomplete you may request an amendment. We may deny the request in certain circumstances and will explain why in writing.
Right to an accounting of disclosures. You may request a list of certain disclosures we have made of your PHI.
Right to request restrictions. You may request a restriction on how we use or disclose your PHI. We are not required to agree in most cases. We must agree to a request not to disclose PHI to a health plan for a service you paid for in full out of pocket.
Right to request confidential communications. You may ask us to contact you at an alternative address or by an alternative means.
Right to notification of a breach. You will be notified of any breach of your unsecured PHI as required by law.
Right to a paper copy of this notice on request, even if you agreed to receive it electronically.
Changes to this notice
We reserve the right to change this notice and to make the revised notice effective for PHI we already hold as well as any information we receive in future. The current notice will be posted in the practice and on this website, showing its effective date.
How to raise a concern or complain
If you believe your privacy rights have been violated you may complain to the practice, or to the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalised or retaliated against for filing a complaint.
Practice contact: [PRIVACY OFFICER NAME AND TITLE TO BE CONFIRMED], Oak Brook Hair Transplant, 2425 W. 22nd Street, Suite 205C, Oak Brook, IL 60523. Telephone 630-974-1400. Email info@oakbrookhair.com.
Office for Civil Rights: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Washington, D.C. 20201, or via hhs.gov/ocr/complaints.
Questions about this document: info@oakbrookhair.com or 630-974-1400.