NOTICE OF PRIVACY PRACTICES

Effective Date: January 1, 2025 | Version 1.0

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.

1. Who we are

Mesobar, P.C. is a professional medical corporation located at 9615 Brighton Way, Suite 400, Beverly Hills, CA 90210. We provide cosmetic and elective medical services.

This notice describes how we may use and disclose your protected health information and your rights regarding that information.

2. How we may use and disclose health information

We may use or disclose your protected health information in the following ways without your written authorization:

Treatment: To provide, coordinate, or manage your care and related services. This includes consultations with other healthcare providers about your treatment.

Payment: To bill and collect payment for services. This includes sharing information with your insurance company if applicable.

Healthcare operations: For administrative, quality improvement, and business functions. This helps us maintain high standards of care and service.

As required by law: To comply with federal, state, or local law when such use or disclosure is required.

Public health and safety: To report communicable diseases, adverse reactions, or to prevent serious threats to health or safety.

Law enforcement and legal proceedings: As required by a court order, subpoena, or law enforcement request within legal parameters.

Business associates: To contractors or vendors who provide services on our behalf such as billing or IT support. These partners are bound by HIPAA agreements to protect your information.

3. Uses requiring your authorization

We will not use or disclose your protected health information for purposes not listed above without your written authorization. This includes most marketing communications, any sale of health information, and psychotherapy notes if applicable.

You may revoke your authorization in writing at any time. Once revoked, we will stop using your information for that purpose going forward.

4. Your rights under HIPAA

You have the right to access your health records. You may request a copy in paper or electronic format.

You have the right to amend your records if you believe information is inaccurate or incomplete. Submit your request in writing with supporting information.

You have the right to request an accounting of certain disclosures we have made of your health information. This does not include disclosures for treatment, payment, or healthcare operations.

5. Additional privacy rights

You may request restrictions on how we use or disclose your health information for treatment, payment, or healthcare operations. We will consider your request but are not required to agree.

You may request confidential communications by alternative means or locations. For example, you can ask that we contact you only at work or by mail.

You have the right to receive this notice in paper or electronic form upon request.

6. Filing complaints

If you believe your privacy rights have been violated, you may file a complaint with us 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 our Privacy Officer using the information provided below. All complaints must be submitted in writing.

7. Our responsibilities

We are required by law to maintain the privacy and security of your protected health information. We will notify you promptly if a breach occurs that may have compromised your information.

We must follow the duties and privacy practices described in this notice and provide you with a copy upon request.

We may change this notice at any time. The revised notice will apply to all information we maintain. The updated notice will be posted on mesobar.com and available in our office.

8. Contact information

For questions, requests, or complaints about this notice, please contact:

Privacy Officer

Mesobar, P.C.

9615 Brighton Way, Suite 400

Beverly Hills, CA 90210

info@mesobar.com

(310) 902-7074

9. Government complaints

You may also file a complaint directly with:

U.S. Department of Health and Human Services

Office for Civil Rights

200 Independence Avenue, S.W.

Washington, D.C. 20201

(877) 696-6775