Skin Cancer Specialists, P.C.

Notice on Privacy of Health Information Practices



This notice will tell you about the ways in which Skin Cancer Specialists, P.C. (“Skin Cancer Specialists”) may use and disclose medical information about you. We will also describe your rights and certain obligations we have regarding the use and disclosure of medical information.   The terms “information, “health information” or “medical information” in this notice include any information that we maintain that reasonably can be used to identify you and that relates to your physical or mental health condition, the provision of health care to you, or the payment for your health care.

We are required by law to:

  • Make sure medical information that identifies you is kept private;
  • Give you this notice of our legal duties and privacy practices  with  respect  to  medical information about you; and
  • Follow the terms of the notice that is currently in effect.

We have the right to change our privacy practices and the terms of this notice.  If we make a material change to our privacy practices, we will provide you with a revised notice at your first visit after the revision or electronically as permitted by applicable law.   In all cases, we will post the revised notice on our website     We  reserve  the right to make any revised or changed notice effective for information we already have and for information that we receive in the future.


How we may use and disclose your medical information:

Each time you visit Skin Cancer Specialists P.C., a record of your visit is made.   Typically, this record contains your symptoms, examination and test results, diagnoses,  treatment,  and a  plan  for future  care  or treatment.  This information, often referred to as your health or medical record and containing your health information, may be used and disclosed in different ways. For each category of uses or disclosures, we will explain what we mean and try to give some examples. Not every use or disclosure in a category will  be  listed.  However,  all  of  the  ways  we  are permitted to use and disclose information will fall within one of these categories.

  1. Treatment.  We may use and disclose medical information in the course of providing, coordinating or  managing  your  medical  treatment,  including  the disclosure of medical information for treatment activities of another health care provider.  We may use your medical information to treat you.  For example, we  may  ask  you  to  have  laboratory  tests  (such  as blood or urine tests), and we may use the results to help us reach a diagnosis.  We might use your medical information in order to write a prescription for you, or we might disclose your medical information to a pharmacy  when  we  order  a  prescription  for  you. Many of the people who work at Skin Cancer Specialists – including, but not limited to, doctors, nurses, technicians, students and trainees (both health professional and administrative) – may use or disclose your medical information in order to treat you or to assist others who may assist in your care, such as your spouse, children or parents.   Finally, we may also disclose your medical information to other health care providers for purposes related to your treatment.
  1. Payment.  We may use and disclose your medical information so that the treatment and services you receive at Skin Cancer Specialists, P.C.  may be billed and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about a procedure you received at Skin Cancer Specialists, P.C.  so your health plan will pay Skin Cancer Specialists, P.C.  or reimburse  you.  We  also  may  tell  your  health  plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
  1. Health  Care  Operations.    We  may  use  and disclose your medical information as part of our operations. These operations include, but are not limited to, quality assessment and improvement of our services and treatment, provider training, underwriting activities, compliance and risk management activities, planning and development, management and administration, and disclosures to doctors, nurses, technicians, students, trainees, attorneys, consultants, accountants   and   others   for   review   and   learning purpose.      We   may   also   disclose   your   medical information to other health providers and health plans for certain of their health care operations, provided that those other plans or providers have, or had in the past, a relationship with you.
  1. Appointment Reminders.  We may use and disclose your medical information to contact you and remind you of an appointment.  For example, we may contact  the  home  telephone  number,  mobile telephone, or business telephone number you provide to us on your patient information form and leave a message on your answering machine reminding you of an upcoming appointment in our office. We may also use   texting   as   a   way   of   reminding   you   about upcoming appointments.  In addition, we also utilize a 3rd party vendor for notifications.
  1. Treatment Options.   We may use and disclose your medical information to tell you about or recommend possible treatment options or alternatives that our staff have determined to possibly be of benefit to you.
  1. Health-Related Benefits and Services.  We may use and disclose your medical information to inform you of health-related benefits or services that may be of interest to you.
  1. Individuals Involved in Your Care.  We may release your medical information to a friend or family member  who  is  actively  involved  in  your  medical care.   We also may release medical information to someone who helps pay for your care.  This would be the minimum information necessary to facilitate payment.
  1. Participation in an Organized Health Care Arrangement. To the extent Skin Cancer Specialists, P.C. participates in an organized health care arrangement pertaining to you, we may disclose your medical information to other covered entities that participate in such arrangement.
  1. Business  associates.   During   the   course   of providing  treatment  to  you,  obtaining  payment  for your care and conducting normal practice operations, Skin Cancer Specialists, P.C. works with business partners. For example, Skin Cancer Specialists, P.C. works  with  computer  software  and  hardware companies   and   credit   card   processing   services. Though  every  reasonable  attempt  will  be  made  by Skin Cancer Specialists, P.C. to limit access by business associates to patient information, it is impossible to prevent all such access. Therefore, Skin Cancer  Specialists,  P.C.  requires  all  business associates to enter into contractual agreements that require these business associates to limit their access to patient information to that which is necessary or unavoidable. Furthermore, our contracts with business associates require that all access to patient information that does occur will be managed according to strict principles of confidentiality and privacy. These business associates are required to follow the same privacy   laws   as   Skin   Cancer   Specialists,   P.C., including protecting your information and taking appropriate measures in the event of a breach of your medical information.
  1. Marketing activities. We may use your PHI to send you marketing materials. We may not sell your PHI without your written authorization. However, we may communicate with you about some products or services related to your treatment, case management, care coordination, alternative treatments, therapies, healthcare providers or care settings without your permission. Marketing activities do not include a communication made   to   you   to   provide   refill reminders or otherwise communicate with you about a drug or biologic that is currently being prescribed for you. Communications for activities such as providing information about a generic equivalent of a drug being prescribed to you, as well as adherence communications encouraging you to take your prescribed medication as directed are excluded from marketing activities.

In  situations  where  marketing  communications involve financial compensation, Skin Cancer Specialists,  P.C.    will  obtain  a  valid  authorization from you before using or disclosing PHI for such purposes. The disclosure will indicate that we are receiving financial compensation from a third party. Additionally, where we have an arrangement with a business associate (including a subcontractor) who receives financial compensation from a third party in exchange   for   making   a   communication   about   a product or service, such communication also requires your prior authorization.

  1. Fundraising activities.   We   may   use   your demographic  information,  the  dates  on  which  you were treated at Skin Cancer Specialists, P.C., the outcome  of  your  treatment,  your  treating  physician and your insurance status to contact you in an effort to raise money for Skin Cancer Specialists, P.C.  and its operations.   If   you   do   not   want   Skin   Cancer Specialists,  P.C.     to  contact  you  for  fundraising efforts,   you   have   the  right   to   opt-out   of   these communications by notifying the Skin Cancer Specialists Privacy Officer in writing at 835 Cogburn Ave NW, Suite 100, Marietta, Georgia 30060.
  1. Research. Under certain circumstances, we may use and   disclose   your   medical   information   for research  purposes.  For  example,  a  research  project may involve comparing the health and recovery of all patients who received one medicine to those who received another, for the same condition. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of medical information and tries to balance  the  research  needs  with  patients’ needs  for privacy of their medical information. We may disclose your medical information to people preparing to conduct  a  research  project.  For  example,  we  may allow researchers  to  review patient  records  to  help them determine if a particular research project will be successful. We always require that researchers honor the confidential nature of your medical information. Finally, it is a requirement of all approved research studies that any publication of results contain full de- identification of the medical information; that is, in no way will a reader of the publication be able to identify you with the medical information disclosed in the publication. Where research involves the use or disclosure  of  psychotherapy  notes,  an  authorization for a use or disclosure of psychotherapy notes may only be combined with another authorization for psychotherapy notes.
  1. As Required by  Law.  We  will  disclose  your medical  information  when  required  to  do  so  by federal, state or local law.
  1. To Avert a Serious Threat to Health or Safety. We may use and disclose your medical information when necessary to prevent a serious threat to your health and safety or to the health and safety of others. Any disclosure, however, would only be to someone able to help prevent the threat.

Special situations:

  1. Military and Veterans. If you are a member of the armed forces, we may release your medical information   as   required   by   military   command authorities. We also may release medical information about foreign military personnel to the appropriate foreign military authorities.
  1. Workers’ Compensation. We may release your medical information for  workers’  compensation or similar programs. These programs provide benefits for work-related injuries or illness.
  1. Public Health Activities. We may disclose your medical information for public health activities. These activities generally include the following:
  • To prevent   or   control  disease,  injury  or disability
  • To report births and deaths
  • To report reactions to medicines or problems with products
  • 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 domestic violence. We  will  only  make  this  disclosure  when required or authorized by law.
  1. Health Oversight Activities.  We  may  disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include,  for  example,  audits,  investigations, inspections   and   licensure.   These   activities   are necessary   for   the   government   to   monitor   the healthcare system, government programs and compliance with civil rights laws.
  1. Lawsuits and Disputes. If you are involved in a lawsuit or   a   dispute,   we   may   disclose   your information in response to a court or administrative order. We also may disclose your medical information in response to a subpoena, search warrant, discovery request or other lawful process by someone else involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.
  1. Law Enforcement. We  may  release  medical information if asked to do so by a law enforcement official:
  • In  response   to   a   court   order,   subpoena, warrant, summons or similar process
  • To identify  or  locate  a  suspect,  fugitive, material witness or missing person
  • About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement
  • About a death we believe may be the result of criminal conduct
  • About   criminal   conduct   at   Skin   Cancer Specialists, P.C.
  • In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime
  1. National Security and  Intelligence  Activities. We   may   release   your   medical   information   to authorized federal officials for intelligence, counterintelligence  and  other  national  security activities authorized by law.
  1. Protective Services   for   the   President   and Others. We may disclose your medical information to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or to conduct special investigations.
  1. Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your medical information to the correctional   institution   or   law   enforcement official. This release would be necessary: (1) for the institution  to  provide  you  with  healthcare;  (2)  to protect your health and safety or the health and safety of others; or (3) for the safety and security of the individuals housed in the correctional institution.
  1. Coroners, Medical   Examiners   or   Funeral Directors.   We may disclose medical information to coroners, medical examiners or funeral directors as necessary to  enable  these parties to  carry out their duties.
  1. Breaches. In the event of a known or suspected violation of your privacy, we may disclose facts including some patient information to you, investigating authorities, and/or the U.S. Department of Health and Human Services. We may also share information regarding the  breach  with  the  news media, but would not provide them with any identifiable information about you.
  1. Psychotherapy Notes. Psychotherapy notes may not be disclosed without your authorization except in limited circumstances.
  1. Organ and Tissue Donation. If you are an organ donor, Skin  Cancer  Specialists,  P.C.  may  use  or release your health information to organizations that handle organ procurement or other entities engaged in procurement,  banking  or  transportation  of  organs, eyes  or  tissues  to  facilitate  organ,  eye  or  tissue donation and transplantation.



Other types and uses of your medical information described above or otherwise permitted by law will be made only with your written authorization, which you have the limited right to revoke in writing.



Although your health record is the physical property of Skin Cancer Specialists, P.C.   the information belongs to you.   You have the following rights regarding your medical information that we maintain:

  1. Right to inspect and copy. You have the right to inspect and obtain a copy of medical information that may be used to make decisions about your care. This includes medical and billing records in physical form or electronic copy. To inspect and/or copy medical information that may be used to make decisions about you, you must submit your request in writing to the manager of Medical Records at Skin Cancer Specialists, P.C.  (or his/her designee). If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with  your  request.  We  may  deny  your  request  to inspect  and  copy  in  certain,  very  limited circumstances. If  you are denied access to medical information, you may request that the denial be reviewed. Another licensed healthcare professional chosen by Skin Cancer Specialists, P.C.  will review your request and the denial. The person conducting the review will not be the person who denied your original request. We will comply with the outcome of the review.
  1. Right  to  request  third-party  disclosure.  You have the right to request that information regarding your care be sent to a third party. Your request must be signed, in writing and must clearly designate the third party to whom Skin Cancer Specialists, P.C. should  send  the  requested  information.  We  may charge a fee for the costs of copying, mailing or other supplies associated with your request.
  1. Right to amend.  You may ask us to amend your health information if you believe it is incorrect or incomplete and you may request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in   writing   and   submitted   to   the   Skin   Cancer Specialists Privacy Officer, 175 White Street, Suite 100, Marietta, Georgia 30060.  You must provide us with   a   reason   that   supports   your   request   for amendment.  Skin Cancer Specialists, P.C.  will deny your request if you fail to submit your request (and the reason supporting your request) in writing.  Also, we may  deny  your  request  if  you  ask  us  to  amend information that is in our opinion: (a) accurate and complete; (b) not part of the medical information kept by or for Skin Cancer Specialists, P.C.; (c) not part of the   medical   information   which   you   would   be permitted to inspect and copy; or (d) not created by Skin Cancer Specialists, P.C.,  unless the individual or entity that created the information is not available to amend the information.
  1. Right to an accounting of disclosures. You have the right to request an “accounting of  disclosures.” This is a list of the disclosures we made of your medical information. Exceptions: Disclosures as a result of a valid authorization and disclosure to individuals made as part of activities 1 to 14, 18, 20 and 25 above may not be available (every therapist, nurse, etc. involved in your care, every audit of care provided, etc.) and may not, therefore, be included in the accounting of disclosures provided to you. To request this list or accounting of disclosures, you must submit your request in writing to the Skin Cancer Specialists,  P.C.  Your  request  must  state  a  time period, which may not be longer than six years and may not include dates before October 9, 2003. The first list you request within a 12-month period will be free of charge. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost prior to providing the list, and you may choose to withdraw or modify your request at that time before any costs are incurred.
  1. Right to request restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or who pays for your care, such as a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had to a specific family member who is not a legal guardian. We are not required to agree to all of your requests. In particular, we will not agree if we have any concern that this could compromise our ability to provide appropriate care to you. Also, we cannot  agree  to  deny  access  to  your  records  by  a parent or legal guardian. You do have the right to restrict disclosures of medical information to a health plan if the disclosure is for payment or healthcare operations and pertains to a healthcare item or service for which you have paid out-of-pocket in full. To request restrictions, you must make your request in writing to the Skin Cancer Specialists Privacy Officer. In your request, you must tell us: (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; (3) to whom you want the limits to apply.
  1. Right to request confidential communications. You have the right to request that we communicate with you about your medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. We will make reasonable efforts to comply. We reserve the right to take back our agreement should we feel this is necessary to protect you. To request confidential communications, you must make your request in writing to the Skin Cancer Specialists Privacy Officer. We will not ask you the reason for your request. We will make reasonable efforts to accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
  1. 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. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our website,, or to obtain a paper copy   of   this   notice,   contact   the   Skin   Cancer Specialists Privacy Officer at 770-422-5557.
  1. Right to be notified following a breach of unsecured medical information. You have a right to and will receive  notifications  of  breaches  affecting your medical information. A breach means the access, use or disclosure of your unsecured protected health information in a manner not permitted under HIPAA. If this occurs, you will be provided information about the breach, information about the steps Skin Cancer Specialists,  P.C.  has  taken  to  minimize  harm  as  a result of the breach and how you can lessen any harm as a result of the breach.



If you believe your privacy rights have been violated, contact the Skin Cancer Specialists Privacy Officer at


All complaints must be in writing.

You may also send a written complaint to the U.S. Department of Health and Human Services at:

Region IV, Office for Civil Rights, DHHS

61 Forsyth Street, SW, Suite 16T70 Atlanta, GA


FAX 404-562-7881


Complaints filed directly with DHHS must: (1) be in writing; (2) contain the name of the entity against which  the  complaint  is  lodged;  (3)  describe  the relevant problems; and (4) be filed within 180 days of the time you became or should have become aware of the problem.

You will not be penalized in any way for filing a complaint.


Other uses of medical information:

Other uses and disclosures of medical information not

covered by this notice or state or federal laws that apply to Skin Cancer Specialists, P.C. will be made only with your written permission. If you provide us permission  to  use  or  disclose  your  medical information, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose your medical information for the reasons covered by your written authorization. Skin Cancer Specialists, P.C. is unable to take back any disclosures we have already made prior to your revocation of permission to disclose.


Notice of Privacy Policies Revision Number: 2. Adopted as of October 9, 2003

Revised effective April 1, 2016