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.

This Notice of Privacy Practices (“Notice”) describes how Platinum Sculpt may use and disclose your Protected Health Information (“PHI”) and how you can access that information. We are required by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) to maintain the privacy and security of your PHI and to provide you with this Notice.

PHI is individually identifiable health information that relates to your past, present, or future physical or mental health condition, the care you receive, or payment for that care.

Our Responsibilities

We are required by law to:

• Maintain the privacy and security of your PHI
• Provide you with this Notice of our legal duties and privacy practices
• Notify you following a breach of unsecured PHI as required by law
• Follow the terms of the Notice currently in effect

How We May Use and Disclose Your PHI (Without Your Written Authorization)

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your care and related services. For example, we may share PHI with other healthcare professionals involved in your treatment.

Payment

We may use and disclose your PHI to bill and receive payment for services. For example, we may provide information to your insurer or payment processor as needed to process payment.

Health Care Operations

We may use and disclose your PHI for practice operations such as quality assessment, improving services, staff training, credentialing, licensing, auditing, and compliance.

Appointment Reminders and Communications

We may contact you about appointments and services (for example, reminders by phone, text, email, or mail). You may request confidential communications (see “Your Rights”).

Individuals Involved in Your Care

We may disclose PHI to a family member, friend, or someone else involved in your care or payment for your care, unless you object or we learn that you object.

Business Associates

We may share PHI with third-party service providers who help operate our practice (for example, scheduling platforms, IT providers, billing support). These “business associates” must protect your PHI and can only use or disclose it as permitted by law and our agreements.

As Required by Law / Public Health & Safety

We may disclose PHI when required by federal, state, or local law, or for certain public health and safety purposes (for example, reporting suspected abuse/neglect, certain public health reporting, or preventing a serious threat to health or safety), as permitted or required by law.

Law Enforcement, Legal Proceedings, and Other Government Requests

We may disclose PHI in response to a court order, subpoena, warrant, or other lawful process, as permitted or required by law.

Research

In limited circumstances, we may use or disclose PHI for research purposes in compliance with HIPAA and other applicable requirements.

Uses and Disclosures That Require Your Written Authorization

We will obtain your written authorization for uses and disclosures not described in this Notice, unless permitted or required by law. You may revoke your authorization in writing at any time, except to the extent we have already relied on it.

Marketing: We will not use or disclose your PHI for marketing purposes in a way that requires authorization without first obtaining your written authorization.
Sale of PHI: We do not sell PHI. If that ever changes, we will obtain authorization as required.

Your Rights Regarding Your PHI

You have the right to:

Get an Electronic or Paper Copy of Your Records

You may request to inspect or receive a copy of your medical and billing records and other PHI we maintain about you. We will provide a copy or summary, usually within 30 days, and may charge a reasonable cost-based fee.

Ask Us to Correct Your Records

You may request an amendment if you believe your PHI is incorrect or incomplete. We may deny your request in certain circumstances, but we will provide an explanation in writing.

Request Confidential Communications

You may request that we contact you in a specific way (for example, only at work, only by mail, or at a specific phone number). We will accommodate reasonable requests.

Ask Us to Limit What We Use or Share

You may request restrictions on certain uses or disclosures. We are not required to agree to all requests; however:

• If you pay for a service in full out-of-pocket, you may request that we not share PHI about that service with your health plan for payment or operations purposes, and we will comply unless a law requires us to share it.

Get a List of Certain Disclosures

You may request an accounting (list) of certain disclosures we have made of your PHI, typically for the prior six years (excluding disclosures for treatment, payment, and operations, and certain other exceptions).

Get a Copy of This Notice

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

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us and/or with the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights. We will not retaliate against you for filing a complaint.

To file a complaint with us or ask questions about this Notice, contact:

Platinum Sculpt — Privacy Officer
1945 Scottsville Rd, Suite A1
Bowling Green, KY 42104
Phone: (270) 714-9964
Email: info@platinumsculpt.com

To file a complaint with HHS:
You can submit a complaint to HHS Office for Civil Rights using the HHS OCR Complaint Portal.

Changes to This Notice

We reserve the right to change this Notice and make the revised Notice effective for all PHI we maintain. Updated Notices will be posted on our website and will be available upon request.

Website Privacy

For information about privacy practices related to our website (cookies, analytics, website forms), please review our Privacy Policy.