Notice of Privacy Practices

Our commitment

Bariatric Surgeons of Kentuckiana and David R. Geller, MD are required by law to maintain the privacy of your protected health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.

How we may use and disclose your health information

We may use and disclose your health information without your written authorization for the following purposes:

• Treatment. To provide, coordinate, or manage your care — for example, sharing information with the hospital where your surgery is performed, your anesthesiologist, your primary care physician, a dietitian, or a laboratory.
• Payment. To bill and collect payment from you, your insurance plan, or another payer, including verifying coverage and obtaining prior authorization.
• Health care operations. For quality assessment, staff review, training, licensing, business planning, and administration of the practice.
• Appointment reminders and follow-up, including reminders sent by telephone, text message, email, or through the patient portal.
• Treatment alternatives and health-related benefits we believe may be of interest to you.
• Individuals involved in your care. With your agreement, or where you do not object, we may share information relevant to your care with a family member, friend, or other person you identify.
• As required by law, including public health activities, reporting of abuse or neglect, health oversight activities, judicial and administrative proceedings, law enforcement requests, coroners and funeral directors, organ donation, workers' compensation, and to avert a serious threat to health or safety.

Uses that always require your written authorization

Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and any sale of your protected health information require your written authorization. Other uses not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

Your rights regarding your health information

• Inspect and copy. You may request access to your medical and billing records, and request an electronic copy where we maintain them electronically. We may charge a reasonable, cost-based fee.
• Amend. You may request an amendment if you believe information is incorrect or incomplete. We may deny the request in certain circumstances and will explain why in writing.
• An accounting of disclosures. You may request a list of certain disclosures we have made of your health information.
• Request restrictions. You may ask us to limit how we use or disclose your information. We are not required to agree, except that we must agree to a request not to disclose information to your health plan where you have paid for the service in full out of pocket.
• Confidential communications. You may ask us to contact you in a specific way or at a specific address.
• A paper copy of this notice, on request, even if you have agreed to receive it electronically.
• Notification of a breach of unsecured protected health information.

To exercise any of these rights, contact the office in writing at the address below.

Our duties

We are required by law to maintain the privacy of your health information and to notify you following a breach of unsecured protected health information. We reserve the right to change this notice and to make the revised notice effective for information we already hold as well as information we receive in the future. A current copy will always be posted on this website and available at the office.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the practice at the address below, or with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, D.C. 20201, by calling 1-877-696-6775, or online at hhs.gov/ocr/complaints. You will not be penalized or retaliated against for filing a complaint.

Contact

Privacy Officer
Bariatric Surgeons of Kentuckiana
2401 Terra Crossing Boulevard, Suite 375
Louisville, Kentucky 40245
(502) 893-7151

A printed copy of this notice is available at the office on request.