Effective Date: October 15, 2024
This notice explains how your medical information may be used, disclosed, and how you can access this information. Please review it carefully
Protected Health Information (PHI)
At Dr. George Mutafyan’s office, your privacy is of utmost importance. We are committed to safeguarding the privacy of your health information, referred to as Protected Health Information (PHI). This protection is mandated by the Health Insurance Portability and Accountability Act (HIPAA) and other applicable federal and state privacy laws.
Who Follows This Notice?
This Notice applies to all employees, staff, volunteers, and healthcare providers at our practice who have agreed to abide by these privacy practices. It includes any healthcare providers involved in your care who follow this Notice when handling your PHI.
How We May Use and Disclose Your PHI
We may use and disclose your health information for various reasons. These include:
- For Treatment: We may share your PHI with healthcare professionals involved in your care to ensure you receive appropriate treatment. For example, your doctor may need to consult with another specialist or lab technician about your health status.
- For Payment: We may use or disclose your PHI to bill and collect payment for the treatment and services provided to you. For example, we may send your insurer details about a surgery to process the claim.
- For Healthcare Operations: Your PHI may be used for operational purposes, such as quality improvement and staff training, to ensure that we provide the best possible care.
Special Uses of Your PHI
We may also use your PHI in the following ways:
- Appointment Reminders: We may contact you to remind you of upcoming appointments or provide information about treatment options.
- Health Information: We may use your information to inform you about potential treatments, health benefits, or services that might interest you.
Your Authorization May Be Required
In some instances, your specific authorization is required for us to use or disclose your PHI. This includes situations such as the use or disclosure of psychotherapy notes, for marketing purposes, or any situation involving the sale of your PHI. You have the right to revoke your authorization at any time.
Certain Uses and Disclosures of Your PHI Required or Permitted by Law
We are sometimes required or permitted by law to disclose your PHI without your authorization in situations such as:
- Public Health Reporting:
Reporting certain diseases or reactions to medications. - Abuse and Neglect Reporting:
Reporting any suspected child or elder abuse, neglect, or domestic violence. - Compliance with Laws:
Disclosing your PHI when required by federal, state, or local laws, such as for judicial or administrative proceedings, law enforcement purposes, or to avert a threat to health or safety. - Organ Donation:
If you are an organ donor, we may disclose PHI to support organ or tissue donation and transplantation.
Your Rights Regarding Your PHI
You have several rights when it comes to your PHI:
- Right to Request Restrictions:
You can request limits on how we use or disclose your PHI, particularly with regard to payments or health operations. We are not required to agree to all requests, but we will comply when possible. - Right to Confidential Communications:
You may request that we communicate with you in a specific way or at a certain location, such as by mail or email. - Right to Revoke Authorization:
You can revoke your authorization at any time, but it won’t affect disclosures that have already occurred with your prior consent. - Right to Access and Copy:
You have the right to inspect and obtain a copy of your PHI, including electronic records. A fee may apply for copies. - Right to Amend:
If you feel your records are incorrect, you may request an amendment. We will review and decide whether to amend your information. - Right to an Accounting of Disclosures:
You have the right to request a list of disclosures we have made of your PHI, except for those made for treatment, payment, or healthcare operations. - Right to Notification of a Breach:
You will be notified in the event that we or one of our business associates experience a breach of your unsecured PHI. - Right to a Paper Copy:
Even if you’ve agreed to receive this notice electronically, you are entitled to a paper copy upon request.
What to Do If You Have a Complaint
If you believe your privacy rights have been violated, you can file a complaint with our office or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
- To file a complaint with us:
Contact the Privacy Officer at:
Dr. George Mutafyan, MD
1510 S Central Avenue, Suite 200
Glendale, CA 91205
Phone: (818) 247-2000
Email: hello@GeorgeMutafyanMD.com - To file a complaint with the U.S. Department of Health and Human Services:
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Changes to Our Privacy Practices
We reserve the right to change our privacy practices and this Notice at any time. The revised Notice will be effective for all PHI that we maintain. We will post the current version in our office and on our website, and provide it upon request.
This HIPAA notice is designed to inform you of your privacy rights and how we protect your health information. We are dedicated to maintaining the confidentiality of your health information and ensuring it is used appropriately.
Effective Date: October 15, 2024
