Legal
Notice of Privacy Practices
Millard Premier Medicine & Aesthetics is committed to protecting your health information. Please review this notice carefully.
This Patient Notice of Privacy Practices describes how medical information about you may be used and disclosed, your patient rights, and how to report a complaint or concern. Please review carefully.
Effective Date: January 23, 2023 · Most Recent Revision Date: January 23, 2023
The terms of this Patient Notice of Privacy Practices (Notice) apply to Millard Premier Medicine & Aesthetics, its affiliates, and its staff. Millard Premier Medicine & Aesthetics may share protected health information (PHI) of patients as necessary to carry out treatment, payment, and health care operations as permitted by law. Questions or concerns about this Notice should be directed to the Compliance Office at (866) 339-2333.
Our Legal Duty
Millard Premier Medicine & Aesthetics is committed to and required by federal and state law to maintain the privacy of our patients’ health information, called protected health information (PHI), and to provide patients with notice of our legal obligations and privacy practices with respect to PHI. We are required to comply with the terms of this Notice for as long as it remains in effect. We reserve the right to make changes to our Notice as permitted by applicable law. If changes are made to the Notice, the new terms are effective for all health information maintained, created, and/or received by us prior to the date changes were made. The most recent version of this Notice is always available on our website. We are also required to notify you in the event of a breach of your unsecured PHI.
We respect our legal obligation to keep PHI that identifies you private. We will not use or disclose your health information without your written authorization, except as described in this Notice and permitted by law.
Our Pledge to You
We understand that your PHI is private and personal, and we are committed to its protection. This Notice applies to all the records of your care at Millard Premier Medicine & Aesthetics. We are required by law to:
- Keep your protected health information private during your lifetime and for 50 years following your death.
- Provide you with this Notice describing our legal duties and privacy practices for your protected health information.
- Notify you as outlined in state and federal law if a breach of your unsecured protected health information has occurred.
- Follow the terms of the Notice that is currently in effect.
Understanding What Comprises Your Health Information
Each time you use our services, a health record of the service(s) conducted and the associated result(s) is created. The health record also includes the personal information you provided upon registration.
Uses and Disclosures Permitted by Law Without Your Written Authorization
The following describes how we may use and disclose your health information without written authorization from you.
Treatment
Under HIPAA, we may use or disclose your PHI for treatment purposes, which may include disclosure of your medical information to physicians, nurses, medical students, pharmacies, and other healthcare professionals who provide you with healthcare services and/or are involved in the coordination of your care. Unless it is an emergency situation as defined by HIPAA, we will not share your PHI with any health care professional without your express written authorization unless required to do so by law.
Payment
Under HIPAA, we may use or disclose your PHI for the purposes of obtaining payment for the provided services. If insurance becomes involved in your services, we will share your health information with your insurance payer to determine coverage and obtain payment or reimbursement.
Health Care Operations
Under HIPAA, we may use or disclose your PHI for healthcare operations, which means the management and operation of our clinic and any laboratory services. For example, we may use your PHI to conduct quality and accuracy testing, obtain/maintain accreditations, provide training to our staff, manage disease, meet public health reporting requirements, etc.
Business Associates
Certain aspects of our services are performed through contracts with “business associates” outside of our company, such as auditing, accreditation, outcomes data collection, and legal services. Whenever an arrangement involves the use or disclosure of your PHI, we will have a written contract containing terms that protect the privacy of your PHI.
Communication with Family and Others
Unless you expressly object, we may, in emergent situations, disclose relevant PHI to a family member, friend, or other person involved in your care. We may be required by state or federal law to disclose the PHI of minors to their legal guardians or parents.
Appointment Reminders
We may contact you via text, email, and/or mail to remind you of scheduled appointments, provide information about your treatment, or inform you it is time to make a routine appointment. You have the right to request communications by alternative means.
Health-Related Products and Services
We may use or disclose your PHI, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. We provide an opportunity during registration for you to opt out of receiving this type of communication.
Research
In limited circumstances, PHI about you may be disclosed to researchers preparing to conduct a research project. For actual research studies, we would obtain your specific authorization if information that directly identifies you is disclosed, except where an Institutional Review Board grants a waiver as permitted under federal guidelines.
Organ Donation
Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
Incidental Uses and Disclosures
There are certain incidental uses or disclosures of your health information that may occur while we are providing services. We will make reasonable efforts to limit these incidental uses and disclosures.
Uses and Disclosures Required by Law
The following describes situations where we may be required to use and disclose your health information to meet legal requirements.
As Required by Law
We will use or disclose your health information as required by federal, state, or local law.
Public Health Activities
We may disclose health information about you for public health activities, including disclosures to prevent or control disease, injury, or disability; reporting to authorities authorized to receive reports of abuse and neglect; FDA-regulated reporting; and notifying a person who may have been exposed to a disease.
Law Enforcement
We may disclose your health information for law enforcement purposes including in response to a subpoena or court order; if we believe it is evidence of criminal conduct on our premises; to identify or locate a suspect or missing person; or to report a crime.
Threats to Health or Safety
Under certain circumstances, we may use or disclose your health information if we believe it is necessary to avert or lessen a serious and imminent threat to health and safety.
Health Oversight Activities
We may disclose health information for health oversight activities authorized by law, such as audits, investigations, inspections, and licensure activities.
Specialized Government Functions
We may disclose your information for national security and intelligence activities authorized by law, or for protective services of the president; or, if you are a military member, to the military under limited circumstances.
Funeral Directors, Medical Examiners, and Coroners
We may disclose your health information to funeral directors, medical examiners, and coroners consistent with applicable law to carry out their duties.
Lawsuits and Administrative Proceedings
We may release your health information in response to a court or administrative order, or in response to a subpoena or other discovery request, but only if efforts have been made to tell you about the request or to obtain an order protecting the requested information.
Workers' Compensation
We may disclose health information to the extent authorized and necessary to comply with laws relating to workers’ compensation or other similar programs established by law.
Correctional Institutions
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your health information to the correctional institution as necessary for your health or the health and safety of other individuals.
Disaster Relief Purposes
We may use or share your PHI with public or private disaster relief organizations, like the American Red Cross, so that your family can be told of your location and condition in case of disaster or emergency.
Uses and Disclosures That Require Your Written Authorization
Apart from what we say in this Notice, we will not use or share your PHI unless we obtain your written authorization. If you give us written authorization to use or disclose your PHI, you may revoke that permission in writing at any time. The following uses and disclosures will only be made with your written authorization:
- Uses and disclosures permitted by law not listed above
- Marketing as defined by HIPAA and this Notice
- Sale of Health Information: Disclosures that constitute a sale of your health information
- Sensitive Medical Information: Uses or disclosures of sensitive PHI such as mental health, diseases that may result in social stigma, substance abuse, or genetic testing information, when required by federal and state laws
Your Rights Regarding PHI
HIPAA provides you with a set of patient rights regarding your PHI. To exercise any of these rights, please submit a request in writing, signed by you or your legal representative, to:
5062 S 155th St, Omaha, NE 68137
Phone: (866) 339-2333 — request the Compliance Office
Right to Request a Copy of this Notice
You have the right to request a paper copy of this Notice in writing. You can also access the Notice on our website.
Right to See and Access Your Health Information
You may request to copy and/or inspect much of the PHI that we retain on your behalf. For PHI that we maintain in any electronic form, you may request a copy in a reasonable electronic format. You may be charged a reasonable copy fee and your request will be completed according to Nebraska Statute.
Right to Request an Amendment or Correction
You may request that your health information be amended if you feel that the information is not correct. We are not obligated to make requested amendments, but we will give each request careful consideration. If we deny your request, we will notify you in writing.
Right to an Accounting of Disclosures
For purposes other than treatment, payment, or health care operations, you have the right to request an accounting of certain disclosures of your health information. Your request must state a time period that may not be longer than six years.
Right to Request Restrictions on Use and Disclosure
You may request restrictions on how your health information is used for treatment, payment, or health care operations, or disclosed to certain family members or others involved in your care. We will consider your request, but are not required to agree to it in most circumstances.
Right to Request Confidential Communications
You may request that we communicate with you in a certain way or at a certain location. When submitting your request, please explain how or where you wish to be contacted. We will accommodate reasonable requests.
Changes to This Notice
We reserve the right to change this Notice as our privacy practices change and to make the new provisions effective for all health information we maintain. We will post a current Notice in patient registration areas and on our website.
For More Information or to Report a Problem
If you have questions or would like additional information, you may contact the Compliance Department at the phone number and address listed above.
If you believe your privacy rights have been violated, you may file a complaint with the Compliance Department via the previously provided phone number and/or address, or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.