OFFICE POLICIES  

Payment & Billing

We accept cash, MasterCard, Visa, Discover & AMEX for your convenience. We do not accept checks.

Office Hours

Dr. Bogle's office hours are from 9AM to 4PM, Monday through Friday.

Accessibility Policy

The Laser and Cosmetic Surgery Center of Houston, P.A. is committed to complying with the requirements of the Web Content Accessibility Guidelines within reason. Our efforts are ongoing as changes are made to meet the guidelines over time. If you have questions or concerns about the accessibility of this site or need assistance with content, please contact us at 713-622-1720 or 3700 Buffalo Speedway, Suite 700, Houston, TX 77098. If you do have an accessibility issue, specify the web page and nature of the problem. We will make reasonable efforts to make that page accessible.

Notice of Privacy Practices

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.

EFFECTIVE JULY 9, 2013

This Notice of Privacy Practices (the “Notice”) tells you about the ways we may use and disclose your protected health information (“medical information”) and your rights and obligations regarding the use and disclosure of your medical information. This Notice applies to the Laser and Cosmetic Surgery Center of Houston, P.A., including its providers and employees (the “Practice”).

This notice applies to all of the records of your care generated by the practice, whether made by the practice or an associated facility.

This notice describes our practice’s policies, which extend to:

• Any health care professional authorized to enter information into your chart (including physicians, assistants, nurses, etc.);
• All areas of the practice (front desk, administration, billing and collection, etc.);
• All employees, staff and other personnel that work for or with our practice;
• Our business associates (including a billing service, or facilities to which we refer patients), on-call physicians, and so on.

The Practice provides this Notice to comply with the Privacy Regulations issued by the Department of Health and Human Services in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

OUR THOUGHTS ABOUT YOUR PROTECTED HEALTH INFORMATION:

We understand that your medical information is personal to you, and we are committed to protecting the information about you. As our patient, we create paper and electronic medical records about your health, our care for you, and the services and/or items we provide to you as our patient. We need this record to provide for your care and to comply with certain legal requirements. We are required by law to:

• Make sure that the protected health information about you is kept private;
• Provide you with Notice of our Privacy Practices and your legal rights with respect to protected health information about you
• Follow the conditions of the Notice that is currently in effect.

OUR OBLIGATIONS. We are required by law to:

• Maintain the privacy of your medical information, to the extent required by state and federal law;
• Give you the Notice explaining our legal duties and privacy practices with respect to medical information about you;
• Notify affected individuals following a breach of unsecured medical information under federal law
• Follow the terms of the version of the Notice that is currently in effect

HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU.

The following categories describe different ways that we typically use and disclose medical information. These categories are intended to be general descriptions only, and not a list of every instance in which we may use or disclose your medical information. Please understand that for these categories, the law generally does not require us to get your authorization in order for us to use or disclose your medical information.

Medical Treatment. We may use and disclose medical information about you to provide you with health care treatment and related services, including coordinating and managing your health care. We may disclose medical information about you to physicians, nurses, and other health care providers and personnel who are providing or involved in providing health care to you (both within and outside the Practice). For example, should your care require referral to or treatment by another physician of a specialty outside the Practice, we may provide that physician with your medical information in order to aid the physician in his or her treatment of you.

Medical Treatment. We may use and disclose medical information about you to provide you with health care treatment and related services, including coordinating and managing your health care. We may disclose medical information about you to physicians, nurses, and other health care providers and personnel who are providing or involved in providing health care to you (both within and outside the Practice). For example, should your care require referral to or treatment by another physician of a specialty outside the Practice, we may provide that physician with your medical information in order to aid the physician in his or her treatment of you.

Payment. Our practice may use and disclose medical information about you in order to bill and collect from you, an insurance company, or a third party for the health care services we provide. This may also include disclosure of medical information to obtain prior authorization for treatment and procedures from your insurance plan. For example, we may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. If, however, you pay for an item or service in full, out of pocket and request that we not disclose to your health plan the medical information solely relating to that item of service.

Operational Uses. We may use and disclose medical information about you so that we can run our Practice more efficiently and make sure that all of our patients receive quality care. These uses and disclosures are necessary to operate and manage our practice and to promote quality care. For example, we may need to use or disclose your medical information in order to assess the quality of care you receive or to conduct certain cost management, business management, administrative, or quality improvement activities or to provide information to our insurance carriers.

Quality Assurance. We may need to use or disclose your medical information for our internal processes to assess and facilitate the provision of quality care to our patients.

Utilization Review. We may need to use or disclose your medical information to perform a review of the services we provide in order to evaluate whether that the appropriate level of services is received, depending on condition and diagnosis.

Credentialing and Peer Review. We may need to use or disclose your medical information in order for us to review the credentials, qualifications and actions of our health care providers.

Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that we believe may be of interest to you.

Appointment and Patient Recall Reminders. We may use and disclose medical information to contact you as a reminder that you have an appointment for medical care with the Practice or that you are due to receive periodic care from the Practice or to provide other information. This contact may be by phone, in writing, e-mail, or otherwise and may involve the leaving an e-mail, a message on an answering machines, or otherwise which could (potentially) be picked up by others. We may use and disclose medical information to tell you about health-related benefits or services that we believe may be of interest to you.

Business Associates. There are some services (such as billing or legal services) that may be provided to or on behalf of our Practice through contracts with business associates. When these services are contracted, we may disclose your medical information to our business associate so that they can perform the job we have asked them to do. To protect your medial information, however, we require the business associate to appropriately safeguard your information.

Individuals Involved in Your Care or Payment of Your Care. We may disclose medical information about you to a friend or family member who is involved in your health care, as well as to someone who helps pay for your care, but we will do so only as allowed by state or federal law (with an opportunity for you to agree or object when required under the law), or in accordance with your prior authorization.

Required by Law. We will disclose medical information about you when required to do so by federal, state, or local law or regulations.

To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent or decrease a serious an imminent threat of injury to your physical, mental or emotional health or safety or the physical safety of another person. Such disclosure would only be to medical or law enforcement personnel.

Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

Research. We may use or disclose your medical information for research purposes in certain situations. Texas law permits us to disclose your medical information without your written authorization to qualified personnel for research, but the personnel may not directly or indirectly identify a patient in any report of the research or otherwise disclose identity in any manner. Additionally, a special approval process will be used for research purposes, when required by state or federal law. For example, we may use or disclose your information to an Institutional Review Board or other authorized privacy board to obtain a waiver of authorization under HIPAA. Additionally, we may use or disclose your medical information for research purposes if your authorization has been obtained when required by law, or if the information we provide to researchers is “de-identified.”

Military or Veterans. If you are a member of the armed forces, we may use and disclose medical information about you as required by the appropriate military authorities.

Workers’ Compensation. We may disclose medical information about you for your workers' compensation or similar program. These programs provide benefits for work-related injuries. For example, if you have injuries that resulted from your employment, workers’

Public Health Risks. We may disclose medical information about you to public health authorities for public health activities. As ageneral rule, we are required by law to disclose certain types of information to public health authorities, such as the Texas Department ofState health Services. The types of information generally include information used:

• To prevent or control disease, injury or disability (including the reporting of a particular disease or injury
• To report births and deaths
• To report suspected child abuse or neglect.
• To report reactions to medications or problems with products, medical devices and supplies.
• To notify people of recalls of products they may be using.
• To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
• To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domesticviolence. We will only make this disclosure if you agree or when required or authorized by law.
• To provide information about certain medical devices.
• To assist in public health investigations, surveillance, or interventions.

Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. Theseoversight activities include audits, civil, administrative, or criminal investigations and proceedings, inspections, licensure anddisciplinary actions, and other activities necessary for the government to monitor the health care system, certain governmental benefitprograms, certain entities subject to government regulations which relate to health information, and compliance with civil rights laws.

Legal Matters. If you are involved in a lawsuit or a legal dispute, we may disclose medical information about you in response to a courtor administrative order, subpoena, discovery request, or other lawful process. In addition to lawsuits, there may be other legalproceedings for which we may be required or authorized to use or disclose your medical information, such as investigations of healthcare providers, competency hearings on individuals, or claims over the payment of fees for medical services.

Law Enforcement, National Security and Intelligence Activities. In certain circumstances, we may disclose your medical informationif we are asked to do so by law enforcement officials, or if we are required by law to do so. We may disclose your medical informationto law enforcement personnel, if necessary to prevent or decrease a serious and imminent threat of injury to your physical, mental oremotional health or safety or the physical safety of another person. We may disclose medical information about you to authorizedfederal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to acourt or administrative order. This is particularly true if you make your health an issue. We may also disclose medical information aboutyou in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute. We shall attempt inthese cases to tell you about the request so that you may obtain an order protecting the information requested if you so desire. We mayalso use such information to defend ourselves or any member of our practice in any actual or threatened action.

Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. Thismay be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical informationabout patients to funeral home directors as necessary to carry out their duties.

Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose medicalinformation about you to the health care personnel of a correctional institution as necessary for the institution to provide you with healthcare treatment.

Marketing Health-Related Services: We will not use your health information for marketing communications without your writtenauthorization.

Electronic Disclosures of Medical Information. Under Texas law, we are required to provide notice to you if your medicalinformation is subject to electronic disclosure. This Notice serves as general notice that we may disclose your medical informationelectronically for treatment, payment, or health care operations or as otherwise authorized or required by state or federal law.

OTHER USES OF MEDICAL INFORMATION

There are times we may need or want to use or disclose your medical information for reasons other than those listed above, but to do so we will need your prior authorization. If you provide us with written authorization to use or disclose your medical information for such other purposes, you may revoke that authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your medical information for the reasons covered by your written authorization. You understand that we are unable to take back any uses or disclosures we have already made in reliance upon your authorization, and that we are required to retain our records of the care that we provided to you.

YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU.

Federal and state laws provide you with certain rights regarding the medical information we have about you. The following is a summary of those rights.

Right to Inspect and Copy. Under most circumstances, you have the right to inspect and/or copy your medical information that wehave in our possession, which generally includes your medical and billing records. To inspect or copy your medical information, youmust submit your request to do so in writing to the Practice’s HIPAA Officer. If you request a copy of your information, we may chargea fee for the costs of copying, mailing, or certain supplies associated with your request. The fee we may charge will be the amountallowed by state law. If your requested medical information is maintained in an electronic format (e.g., as part of an electronic medicalrecord, electronic billing record, or other group of records maintained by the Practice that is used to make decisions about you) and yourequest an electronic copy of this information, then we will provide you with the requested medical information in the electronic formand format requested, if it is readily producible in that form and format. If it is not readily producible in the requested electronic formand format, we will provide access in a readable electronic form and format as agreed to by the Practice and you. In certain verylimited circumstances allowed by law, we may deny your request to review or copy your medical information. We will give you anysuch denial in writing. If you are denied access to medical information, you may request that the denial be reviewed. Another licensedhealth care professional chosen by the Practice will review your request and the denial. The person conducting the review will not be theperson who denied your request. We will abide by the outcome of the review.

Right to Amend. If you feel that the medical information we have about you in your record is incorrect or incomplete, you may ask usto amend the information. You have the right to request an amendment for as long as the information is kept by the Practice. To requestan amendment, your request must be submitted in writing and submitted to the Practice’s HIPAA Officer. In your request, you mustprovide a reason as to why you want this amendment. If we accept your request, we will notify you in writing. We may deny yourrequest for an amendment if it is not in writing or does not include a reason to support the request. If we deny your request, we willnotify you of that denial in writing. In addition, we may deny your request if you ask us to amend information that:

• Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
• Is not part of the medical information kept by or for the Practice;
• Is not part of the information which you would be permitted to inspect and copy; or
• Is inaccurate and incomplete.

Right to an Accounting of Disclosures. You have the right to request an "accounting of disclosures” of your medical information. Thisis a list of the disclosures we have made for up to six years prior to the date of your request of your medical information, but does notinclude disclosures for Treatment, Payment or Health Care Operations or disclosures made pursuant to your specific authorization, orcertain other disclosures. If you make disclosures through an electronic health records (HER) system, you may have an additional rightto an accounting of disclosures for Treatment, Payment or Health Care Operation. Please contact the Practice’s HIPAA Officer for moreinformation regarding whether we have implemented an HER and effective date, if any, of any additional right to an accounting ofdisclosures made through an HER for the purpose of Treatment, Payment or Health Care Operations. To request this list, you mustsubmit your request in writing to the Practice’s HIPAA Officer. Your request must state a time period, which may not be longer than sixyears (or longer than three years for Treatment, Payment, and Health Care Operations disclosures made through an EHR, if applicable) and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a twelve-month period will be free. For additional lists, we may charge you a reasonablefee for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request atthat time before any costs are incurred.

Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or discloseabout you for treatment, payment or health care operations. You also have the right to request a restriction or limitation on the medicalinformation we disclose about you to someone who is involved in your care or the payment for your care, like a family member orfriend. We are not required to agree to your request for a restriction or limitation. If we do agree, we will comply with your requestunless the information is needed to provide emergency treatment. In addition, there are certain situations where we won’t be able toagree to your request, such as when we are required by law to use or disclose your medical information. To request restrictions, youmust make your request in writing to the Practice’s HIPAA Officer. In your request, you must specifically tell us what information youwant to limit, whether you want us to limit our use, disclosure, or both, and to whom you want the limits to apply (e.g. disclosures toyour children, parents, spouse, etc.). As stated above, in most instances we do not have to agree to your request for restrictions ondisclosures that are otherwise allowed. However, if you pay or another person (other than a health plan) pays on your behalf for an itemor service in full, out of pocket, and you request that we not disclose the medical information relating solely to that item or service to ahealth plan for the purpose for the purposes of payment or health care operations, then we will be obligated to abide by that request forrestriction unless the disclosure is otherwise required by law. You should be aware that such restrictions may have unintendedconsequences, particularly if other providers need to know that information (such as a pharmacy filling a prescription). It will be your obligation to notify any such other providers of this restriction. Additionally, such a restriction may impact your health plan’s decision to pay for related care that you may not want to pay for out of pocket (and which would not be subject to the restriction).

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 home, not a work or, conversely, only at work and not at home. To request confidential communications, you must make your request in writing to the Practice’s HIPAA Officer. We will not ask the reason for your request, and we will use our best efforts to accommodate all reasonable requests, but there are some requests with which we will not be able to comply. Your request must specify how and where you wish to be contacted.

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. To obtain a copy of this Notice, you must make a request in writing to the Practice’s HIPAA Officer.

Right to Breach Notification. In certain instances, we may be obligated to notify you (and potentially other parties) if we become aware that your medical information has been improperly disclosed or otherwise subject to a “breach” as defined in and/or required by HIPAA and applicable state law.

CHANGES TO THIS NOTICE

We reserve the right to change this Notice at any time, along with our privacy policies and practices. We reserve the right to make the revised or changed Notice effective for medical information we already have about you as well, as any information we may receive in the future. We will post a copy of current notice, along with an announcement that changes have been made, as applicable, in our office. When changes have been made to the Notice, you may obtain a revised copy by sending a letter to the Practice’s HIPAA Officer or by asking the office receptionist for a current copy of the Notice.

COMPLAINTS

If you believe your privacy rights as described in this Notice have been violated, you may file a complaint with the Practice or with the Secretary of the Department of Health and Human Services. To file a complaint you may either call or send a written letter. The Practice will not retaliate against any individual who files a complaint. In addition, if you have any questions about this Notice, please contact the Practice’s HIPAA Officer.

You can download our Privacy Practices by clicking the link below

Notice of Privacy Practices.pdf

Note: This file is in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.