HIPAA Notice of Privacy Practices
Effective Date: 5/12/25
Clinic Name: Yoko Suzuki MD ("YokoMD")
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.
This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment, or health care operations and for other purposes permitted or required by law. It also describes your rights to access and control your protected health information.
We are required by law to maintain the privacy of your PHI and to provide you with this Notice of our legal duties and privacy practices. We may change the terms of this Notice at any time. A current version will always be available upon request or through our website.
1. Uses and Disclosures of Protected Health Information
Treatment: Your PHI may be used and disclosed by physicians, staff, and others involved in your care for the purpose of providing, coordinating, or managing your healthcare services. For example, PHI may be shared with a referred specialist or laboratory.
Payment: We may use and disclose PHI to obtain payment for services provided, including insurance verification, billing, and eligibility checks.
Healthcare Operations: We may use and disclose PHI to support our business operations, such as quality assessment, staff evaluations, licensing, training, and administrative activities.
Business Associates: We may share PHI with third-party vendors that assist in operations (e.g., billing services), under contracts that protect your privacy.
Health-Related Benefits and Services: We may contact you with treatment options or other health-related benefits and services that may interest you. You may opt out by contacting our Privacy Officer.
2. Other Uses and Disclosures Without Authorization
We may disclose PHI without your authorization in the following situations:
When required by law
For public health purposes (e.g., disease prevention)
To report abuse, neglect, or domestic violence
To health oversight agencies (e.g., audits or inspections)
In response to legal proceedings or law enforcement
To coroners, funeral directors, and organ donation organizations
For research (with proper approvals)
To prevent serious threats to health or safety
For military or national security purposes
For workers' compensation claims
To correctional institutions (if you are an inmate)
3. Uses and Disclosures That Require Your Authorization
Any other uses and disclosures not described in this Notice will be made only with your written authorization. You may revoke an authorization in writing at any time.
4. Your Rights Regarding Protected Health Information
Access: You have the right to inspect and copy your medical records, with some exceptions. A reasonable fee may apply.
Amendments: You may request that we amend your PHI if you believe it is inaccurate or incomplete. We may deny the request under certain circumstances.
Restrictions: You may request restrictions on the use or disclosure of your PHI. We are not required to agree, except in certain cases involving payment disclosures to health plans.
Confidential Communications: You may request that we communicate with you using alternative methods or locations.
Accounting of Disclosures: You may request a list of certain disclosures we have made of your PHI, excluding those made for treatment, payment, operations, or as authorized by you.
Copy of This Notice: You have the right to request a paper or electronic copy of this Notice at any time.
5. Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of Health and Human Services. We will not retaliate against you for filing a complaint.
To file a complaint or for more information:
Privacy Officer
Yoko Suzuki MD ("YokoMD")
333 S Arroyo Parkway, 3rd FL, Pasadena CA 91105
+1 (213) 328-0027
info@yokomd.com
We are committed to protecting your privacy and ensuring the confidentiality of your health information.