Justin Saliman MD
Notice of Privacy Practices
Effective Date: 01/01/2024

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 Responsibilities

We are required by law to maintain the privacy and security of your protected health information (PHI). We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this notice and give you a copy of it. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

How We May Use and Disclose Your Health Information

• For Treatment: We may use your health information to provide you with medical treatment or services. We may disclose your health information to doctors, nurses, technicians, or other clinic personnel who are involved in your care.
• For Payment: We may use and disclose your health information to obtain payment for the services we provide to you. For example, we may share your information with your health insurance plan to receive reimbursement for your care.
• For Healthcare Operations: We may use and disclose your health information for operations necessary to run our clinic and ensure that all of our patients receive quality care. For example, we may use health information to review the performance of our staff in caring for you.
• Other Uses and Disclosures: We may also use or disclose your health information in the following situations:
  • To remind you of appointments.
  • To inform you of treatment alternatives or health-related benefits and services.
  • To inform family members or other individuals involved in your care, unless you object.
  • For public health and safety reasons, as required by law.
  • For research purposes, under certain conditions.

Your Rights Regarding Your Health Information

• Inspect and Copy: You have the right to inspect and receive a copy of your health information, with some exceptions.
• Request an Amendment: If you feel that health information we have about you is incorrect or incomplete, you may request an amendment. We may deny your request, but we will tell you why in writing within 60 days.
• Request Restrictions: You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
• Request Confidential Communications: You can request that we contact you in a specific way (for example, home or office phone) or send mail to a different address.
• Get a List of Those With Whom We’ve Shared Information: You have the right to get a list of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• Receive a Copy of This Notice: You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
• Choose Someone to Act for You: If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

Changes to This Notice

We reserve the right to change this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

Contact Information

If you have any questions about this notice or want to exercise one of your rights, please contact us:

Justin Saliman MD
Address: 8436 West 3rd St. #800 Los Angeles CA 90048
Phone: 310-703-5819
Email: patients@justinsalimanmd.com
Website: justinsalimanmd.com

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:
Sheila Pineda
8436 West 3rd St. #800 Los Angeles CA 90048
310-703-5819