HIPAA Privacy Notice

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.

Our Commitment to Your Privacy

Dr. Tomur Plastic Surgery is dedicated to maintaining the privacy of your protected health information (PHI). We are required by law to maintain the confidentiality of your health information. This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment, or healthcare operations, and for other purposes permitted or required by law. It also describes your rights regarding your protected health information.

How We May Use and Disclose Your Protected Health Information

Treatment

We may use and disclose your protected health information to provide, coordinate, or manage your healthcare and related services. This includes coordinating or managing your healthcare with other providers. For example, we may disclose your protected health information to another physician who may be treating you or to whom you have been referred to ensure they have the necessary information to diagnose or treat you.

Payment

We may use and disclose your protected health information to obtain payment for services we provide to you. For example, we may need to give your health insurance plan information about your procedure so they will pay us or reimburse you for the treatment. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

Healthcare Operations

We may use and disclose your protected health information for healthcare operations. These uses and disclosures are necessary to run our practice and make sure all of our patients receive quality care. For example, we may use your health information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine health information about many patients to decide what additional services we should offer, what services are not needed, and whether certain new treatments are effective.

Appointment Reminders, Treatment Alternatives, and Health-Related Benefits

We may use and disclose your protected health information to contact you to remind you of an appointment, to tell you about treatment alternatives, or health-related benefits or services that may be of interest to you.

Individuals Involved in Your Care or Payment for Your Care

We may release your protected health information to a friend or family member who is involved in your medical care or who helps pay for your care. We may also disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care about your location, general condition, or in the event of your death.

Research

Under certain circumstances, we may use and disclose your protected health information for research purposes. All research projects are subject to a special approval process, and we will obtain your written authorization if the researcher will have access to your name, address, or other information that reveals who you are.

As Required By Law

We will disclose your protected health information when required to do so by federal, state, or local law. This may include reporting suspected abuse, neglect, or domestic violence, responding to court or administrative orders, or responding to law enforcement requests.

To Avert a Serious Threat to Health or Safety

We may use and disclose your protected health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.

Health Oversight Activities

We may disclose your protected health information to a health oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and licensure.

Your Rights Regarding Your Protected Health Information

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your protected health information that may be used to make decisions about your care, including medical and billing records. To inspect and copy your protected health information, you must submit your request in writing to our Privacy Officer. We may charge a fee for the costs of copying, mailing, or other supplies associated with your request.

Right to Amend

If you feel that the protected health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to our Privacy Officer. You must provide a reason that supports your request.

Right to an Accounting of Disclosures

You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of your protected health information for purposes other than treatment, payment, healthcare operations, or certain other permitted purposes. To request this list, you must submit your request in writing to our Privacy Officer.

Right to Request Restrictions

You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment, payment, or healthcare operations. You also have the right to request a limit on the information we disclose to someone involved in your care or the payment for your care. We are not required to agree to your request, except in certain limited circumstances. To request restrictions, you must make your request in writing to our Privacy Officer.

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. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to our Privacy Officer.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy.

Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for protected health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our office and on our website. The notice will contain the effective date on the first page.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact our Privacy Officer. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Contact Information

For more information about our privacy practices or to file a complaint, please contact:

Privacy Officer
Dr. Tomur Plastic Surgery
6901 Snider Plaza
Suite #120
Dallas, TX 75205
Phone: (214) 965-9885
Email: office@drtomur.com

This statement was last updated on June 1, 2025.