DR. MACRENE ALEXIADES MD PHD FAAD
DERMATOLOGY & LASER SURGERY
955 PARK AVE, NEW YORK, NY 10028
382 MONTAUK HWY, WAINSCOTT, NY 11975
(212) 570-2067 EMAIL@NYDERM.ORG
HIPAA PRIVACY NOTICE
Notice of Privacy Practices
Dr. Macrene Alexiades MD PhD PLLC
955 Park Avenue, New York, NY 10021
382 Montauk Highway, Wainscott, NY 11975
EFFECTIVE DATE: JANUARY 1, 2024 · 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.
We are required by law to maintain the privacy of your protected health information, to provide you with notice of our legal duties and privacy practices with respect to that information, and to notify you if a breach of your unsecured protected health information occurs. We are required to abide by the terms of this Notice while it is in effect.
SECTION I
How We May Use and Disclose Your Health Information
The following describes the ways we may use and disclose health information that identifies you. Not every use or disclosure will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories below.
For Treatment. We may use and disclose your health information to provide, coordinate, or manage your medical treatment. For example, we may disclose your health information to physicians, nurses, technicians, or other personnel who are involved in your care.
For Payment. We may use and disclose your health information to obtain payment for the health care services we provide. For example, we may contact your health insurer to confirm your coverage or to request payment for treatments provided.
For Health Care Operations. We may use and disclose your health information for our health care operations. This includes activities such as reviewing the quality of care we provide, staff training, and certain administrative and business functions necessary to run our practice.
As Required By Law. We will disclose your health information when required to do so by federal, state, or local law.
Public Health Activities. We may disclose your health information to public health authorities for activities such as preventing or controlling disease, reporting adverse reactions to medications, or reporting suspected abuse or neglect.
Health Oversight Activities. We may disclose your health information to a health oversight agency for activities authorized by law, such as audits, inspections, and investigations.
Judicial and Administrative Proceedings. We may disclose your health information in response to a court or administrative order, subpoena, or other lawful process.
Law Enforcement. We may release health information for law enforcement purposes as required by law or in response to a valid subpoena or court order.
Serious Threats to Health or Safety. We may use and disclose your health information when necessary to prevent a serious and imminent threat to your health or safety or the health or safety of the public or another person.
Research. Under certain circumstances, we may use or disclose your health information for research purposes, subject to applicable privacy protections.
Business Associates. We may disclose your health information to our business associates who perform functions or services on our behalf, provided they agree in writing to protect the privacy of your information.
SECTION II
Uses and Disclosures Requiring Your Authorization
Other uses and disclosures of your health information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you provide authorization, you may revoke it at any time by submitting a written request to our Privacy Officer. The following require your written authorization:
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Most uses and disclosures of psychotherapy notes
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Uses and disclosures of your health information for marketing purposes
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Disclosures that constitute the sale of your health information
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Other uses and disclosures not otherwise permitted by law
SECTION III
Your Rights Regarding Your Health Information
You have the following rights regarding your health information. To exercise these rights, please submit a written request to our Privacy Officer at the contact information listed below.
Right to Inspect and Copy. You have the right to inspect and copy your health information that may be used to make decisions about your care, including medical and billing records. We may charge a reasonable fee for copies.
Right to Amend. If you believe the health information we have about you is incorrect or incomplete, you may request that we amend it. We may deny your request under certain circumstances.
Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we have made of your health information in the six years prior to the date of your request.
Right to Request Restrictions. You have the right to request restrictions on how we use or disclose your health information. We are not required to agree to your request, except we must agree to restrict disclosure of your health information to a health plan if the disclosure is for payment or health care operations and the information pertains solely to a service for which you have paid us in full out of pocket.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice at any time, even if you have agreed to receive this Notice electronically. Please contact our office to request a copy.
Right to Be Notified of a Breach. You have the right to be notified in the event that we (or a business associate) discover a breach of your unsecured protected health information.
SECTION IV
Our Duties
We are required by law to maintain the privacy of your health information and to provide you with this Notice of our legal duties and privacy practices. We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all health information we maintain. Revised Notices will be available upon request and posted in our offices and on our website.
SECTION V
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with us, contact our Privacy Officer using the information below. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Complaints to the Department of Health and Human Services may be submitted to:
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Office for Civil Rights, U.S. Department of Health & Human Services
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200 Independence Avenue, S.W., Washington, D.C. 20201
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Toll-free: 1-877-696-6775 · TDD: 1-800-537-7697
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CONTACT
Privacy Officer Contact Information
DR. MACRENE ALEXIADES MD PHD PLLC — PRIVACY OFFICER
New York Office
955 Park Avenue, New York, NY 10021
Hamptons Office
382 Montauk Highway, Wainscott, NY 11975
For privacy-related inquiries, please contact our office by phone or in writing. Contact details are available at each location.
DR. MACRENE ALEXIADES MD PHD PLLC · NOTICE OF PRIVACY PRACTICES · EFFECTIVE JANUARY 1, 2024
THIS NOTICE IS PROVIDED IN COMPLIANCE WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA)