Accurate Aesthetics Plastic Surgery

Katherine D. Hein, M.D., P.C.


This notice describes how information about you may be used and disclosed and how you can obtain access to this information. Please review it carefully.

Understanding Your Health Record/Information
Each time you visit this office a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and plan for future care. This information, often referred to as your health or medical record, serves as a:

  • basis for planning your care and treatment
  • means of communication among the many health professionals who contribute to your care
  • legal document describing the care you received
  • means by which you or a third-party payer can verify that services billed were actually provided
  • a source of information for public health officials charged with improving the health of the nation

Understanding what is in your record and how your health information is used helps you to ensure its accuracy; be aware of who, what, when, where, and why others may access your health information; make better, more informed decisions when authorizing disclosures.

Your Health Information Rights
Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to:

  • request in writing a restriction on certain uses and disclosure of your information
  • obtain a paper copy of the notice of privacy practices upon request
  • inspect and obtain a copy of your health record upon written request
  • amend your health record
  • request in writing an account of disclosures of your health information
  • request in writing that communications of your health information by alternative means or at alternative locations
  • revoke your authorization to use or disclose health information except to the extent that action has already been taken up until the office has received written notification of such revocation

Our Responsibilities
This organization is required to:

  • maintain the privacy of your health information
  • abide by the terms of this notice
  • notify you if we are unable to agree to a requested restriction
  • accommodate reasonable requests you may have to communicate health information by alternative means or alternative locations
  • maintain de-identification practices which eliminate certain pieces of personal identification information from records that are electronically transmitted, while keeping the minimum information necessary in order to effectively communicate
  • mitigate, to the extent practicable, any harmful effect that is known to the practice of a use or disclosure of confidential information in violation of its policies and procedures or the requirements of the rule or of any of its business associates

We reserve the right to change our practices and to make the new provisions effective for all protected health information that we maintain. Should our privacy practices change dramatically we will notify you accordingly.

For More Information or to Report a Problem
If you have any questions and/or would like additional information, you may contact the privacy policy officer, Lisa Shumski, at (781) 263-0011. If you believe that your privacy rights have been violated, you may file a complaint with the privacy policy officer or the Office of Civil Rights. There will be no retaliation for filing a complaint.

Examples of Disclosures for Treatment, Payment and Health Operations
We will use your health information for treatment.
For example: Information obtained by the physician or physician assistant will be recorded in your chart and used to determine the course of treatment that should work best for you.
We will use your health information for payment.
For example: A bill may be sent to you or a third-party payer which may include information that identifies you, as well as your diagnosis, treatment, procedures, and supplies used.
We will use your health information for regular health operations.
For example: Medical professionals may use information in your chart to assess the care and outcomes in your case and others like it in order to continually improve the quality of the healthcare we provide.

Other Permitted or Required Uses and Disclosures
Business associates: There are some services provided in this practice through contacts with business associates. Examples include hospital-based procedures and all services provided at the hospitals with which this practice is affiliated including MetroWest Medical Center-Framingham Union Campus and Leonard Morse Campus, and Milford-Whitinsville Regional Hospital. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them to do and bill you or your third-party payer for services rendered. In order to protect your health information, however, we require that these business associates appropriately safeguard your information.

Notification: We may use or disclose information regarding your location and general condition to a family member, personal representative, or another person responsible for your care.
Communication with family: Medical professionals may disclose to a family member, close friend or any other person whom you identify, health information relevant to that person’s involvement in your care or payment related to your care.

Research: This practice may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Funeral directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.
Food and Drug Administration (FDA): We may disclose health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Workers’ compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Correctional institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof, health information necessary for your health and the health and safety of other individuals.

Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena or court order.

Federal law makes provision for your health information to be released to an appropriate health oversight agency, public heath authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public.

Effective Date: April 14, 2003