Notice of Privacy Practices

4100 Birch St., Suite 200
Newport Beach, CA 92660
Phone: 949-880-8057

Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Commitment to Protecting Your Privacy

Revive Regenerative Medical Group understands that medical information about you and your health is personal. We are committed to protecting your medical information.

This Notice of Privacy Practices describes how we may use and disclose your protected health information and your rights regarding that information.

We are required by law to:

• Maintain the privacy of protected health information
• Provide you with notice of our legal duties and privacy practices
• Follow the terms of this notice currently in effect

How We May Use and Disclose Medical Information

Treatment

We may use your medical information to provide treatment or services. Information may be shared between physicians, nurses, technicians, and other healthcare professionals involved in your care.

Payment

We may use and disclose your medical information so that the treatment and services you receive can be billed and payment collected from you, an insurance company, or another third party.

Healthcare Operations

We may use and disclose medical information for healthcare operations. These activities include quality improvement, training, licensing, certification, and other administrative functions required to operate our medical practice.

Situations Where Disclosure May Be Required

Federal or state law may require that we disclose medical information about you in certain circumstances. Examples may include:

• Public health reporting
• Legal proceedings or court orders
• Law enforcement requests
• Government regulatory oversight
• Situations necessary to prevent serious threats to health or safety

Your Rights Regarding Medical Information

You have certain rights regarding your protected health information.

These rights include the ability to:

• Request access to your medical records
• Request corrections to your medical records
• Request confidential communication methods
• Request restrictions on certain uses or disclosures of your health information
• Receive an accounting of certain disclosures of your protected health information

To exercise these rights, please contact Revive Regenerative Medical Group.

Our Responsibilities

Revive Regenerative Medical Group is required by law to maintain the privacy of protected health information.

We must:

• Protect your medical information
• Provide you with this Notice of Privacy Practices
• Follow the terms of this notice currently in effect
• Notify affected individuals if a breach of protected health information occurs

We reserve the right to change the terms of this notice and make the revised notice effective for all protected health information we maintain.

Electronic Communications

Revive Regenerative Medical Group may communicate with patients through phone calls, text messages, or email for purposes such as:

• Appointment reminders
• Scheduling
• Treatment instructions
• Follow-up care
• Billing notifications

While reasonable safeguards are used, electronic communication may not always be completely secure.

By providing contact information to Revive Regenerative Medical Group, you acknowledge and accept potential privacy risks associated with electronic communications unless you request alternative communication methods in writing.

Questions or Complaints

If you have questions about this notice, your privacy rights, or believe your privacy rights have been violated, please contact:

Revive Regenerative Medical Group
4100 Birch St., Suite 200
Newport Beach, CA 92660
949-880-8057

You may also file a complaint with the U.S. Department of Health and Human Services. Filing a complaint will not affect the care you receive from Revive Regenerative Medical Group.