Effective Date: 05/29/2023

This Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

OUR COMMITMENT TO YOUR PRIVACY

Our practice is dedicated to maintaining the privacy of your protected health information (PHI). We are required by law to maintain the confidentiality of your PHI and provide you with this Notice of our legal duties and privacy practices.

The terms of this Notice of Privacy Practices (“Notice”) apply to BodyLuxe PLLC, its affiliates and employees.

OUR RESPONSIBILITIES

1. We are required by law to maintain the privacy and security of your protected health information.

2. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

3. We must follow the duties and privacy practices described in this notice and give you a copy of it.

4. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

5. We are required to inform you that there may be a provision of Illinois state law that relates to the privacy of your health information that may be more stringent than a standard or requirement under Federal Health Insurance Portability Act (HIPAA).

YOUR RIGHTS

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

1. Access to Your PHI: You have the right to inspect and get copies of your PHI, with some exceptions. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Under federal law, however, you may not inspect or copy the following records: information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health/personal information that is subject to law that prohibits access to protected health/personal information.

2. Amendment: You have the right to request an amendment of PHI about you in a designated record set for as long as we maintain this information. We may say “no” to your request, but we’ll tell you why in writing within 60 days.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.

3. Disclosure Accounting: You have the right to receive an accounting of certain disclosures we have made, if any, of your PHI.

4. Restrictions: You have the right to request a restriction of your PHI. You can ask us not to use or share certain health information for treatment, payment, or our operations. You may ask us not to use or disclose any part of your protected health/personal information 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. We are not required to agree to your request, and we may say “no” if it would affect your care.

5. Confidential Communication: You have the right to request to receive confidential communications from us by alternative means or at an alternative location.

6. Get a paper copy of this privacy notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.

7. Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

You can file a complaint if you feel your rights are violated.

HOW WE MAY USE AND DISCLOSE YOUR PHI

We typically use or disclose your health information in the following ways:

1. Treatment: Your PHI may be used and disclosed by those who are involved in your care for the purpose of providing, coordinating, or managing your healthcare treatment and related services. We may disclose your PHI to designated family, friends and others who are involved in your care or in payment of your care in order to facilitate that person’s involvement in caring for you or paying for your care. If you are unavailable, incapacitated, or facing an emergency medical situation and we determine that a limited disclosure may be in your best interest, we may share limited protected health information with such individuals without your approval.  We may also disclose limited protected health information to a public or private entity that is authorized to assist in disaster relief efforts in order for that entity to locate a family member or other persons that may be involved in some aspect of caring for you.

2. Billing and Payment: We may use or disclose your PHI, as needed, to obtain payment for your health care services.

3. Healthcare Operations and Business Management: We may use or disclose your PHI to support our business activities. These activities include, but are not limited to quality assessment, employee review, training of medical students, licensing, accreditation, and conducting or arranging for other business activities.

4. Business Associates: Certain aspects and components of our services are performed through contracts with outside persons or organizations, such as auditing, accreditation, outcomes data collection, legal services, etc. At times it may be necessary for us to provide your PHI to one or more of these outside persons or organizations who assist us with our health care operations. In all cases, we require these associates to safeguard the privacy of your information appropriately.

5. Public Health Reporting and Compliance with Health Oversight Agencies: Your PHI may be disclosed to public health agencies as required by law. We can share health information about you for certain situations such as preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety.

6. Professional peer review purposes, and improving clinical treatment and patient care

7. Research: In limited circumstances, we may use and disclose your protected health information for research purposes. In all cases where your specific authorization is not obtained, your privacy will be protected by strict confidentiality requirements applied by an Institutional Review Board which oversees the research or by representations of the researchers that limit their use and disclosure of your information.

8. Comply with the law, address workers’ compensation, law enforcement, and other government requests

9. Respond to lawsuits and legal actions in response to a court or administrative order, or in response to a subpoena.

APPOINTMENTS AND SERVICES

We may provide appointment updates or information about your treatment or other health-related benefits and services that may be of interest to you. You have the right to request and will accommodate reasonable requests by you to receive communications regarding your PHI from us by alternative means or at alternative locations. For instance, if you wish appointment reminders not to be left on voice mail or sent to a particular address, we will accommodate reasonable requests.  With such requests, you must provide an appropriate alternative address or method of contact. You also have the right to request that we not send you any future marketing materials and we will use our best efforts to honor such request. You must make such requests in writing, including your name and address, and send such writing to the Privacy Office at the address below or online at https://farrugia.com/contact-us/.

YOUR CHOICES

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to share information with your family, close friends, or others involved in your care. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. We will never sell your information. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

CHANGES TO THIS NOTICE

We reserve the right to change this Notice and to make the revised Notice effective for all health information we already have about you as well as any information we receive in the future. The new notice will be available upon request and we will post a copy of the current Notice in our office and on our website.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. You will not be penalized or otherwise retaliated against for filing a complaint.

CONTACT US

For further information about the matter covered by this Notice, or to make a complaint, please contact our Privacy Officer at: (312) 999-5505 or fill in the online form at https://bodyluxe.com/contact-us. You may also write to us at BodyLuxe PLLC, 875 N Michigan Ave, Suite 3620, Chicago IL 60611.