By scheduling an appointment at Bespoke Medicine Beverly Hills, PC, you acknowledge that you have read and understood our privacy policy and agree to the following: We will collect and use your personal information to provide you with medical care, communicate important updates, and manage your appointments. You have the right to access your medical records, request amendments, and restrict certain uses of your information. If you have any questions about your privacy, please contact us at admin@bespokemedicinebh.com.
NOTICE OF PRIVACY PRACTICES AND COMMUNICATION CONSENT
Effective Date: January 1, 2025
This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully. Bespoke Medicine Beverly Hills (“the Practice,” “we,” “us”) understands the importance of privacy and is committed to protecting the confidentiality of your health information. We maintain records of the care we provide to you and may receive such records from others. These records help us deliver high-quality medical care, obtain payment when appropriate, and meet our legal obligations.
1. OUR LEGAL DUTIES AND RESPONSIBILITIES
We are required by law to maintain the privacy of your Protected Health Information (PHI) and to provide you with this Notice. We will use or disclose your information only as described here or as otherwise permitted by law. If a breach occurs that may compromise your PHI, we will notify you promptly as required by federal law.
2. HOW WE MAY USE ANDDISCLOSE YOUR HEALTH INFORMATION
We use and disclose PHI for treatment, payment, and healthcare operations, as well as for certain other purposes permitted or required by law:
• Treatment – To coordinate or manage your care with other providers, labs, or pharmacies.
• Payment – To bill and collect for services provided, or to facilitate your direct payment through Hint Health.
• Health Care Operations – For administrative, quality-improvement, auditing, and compliance purposes.
• Business Associates – We may share PHI with vendors that assist us (e.g., Hint Health, Spruce Health, LabCorp). All are bound by HIPAA.
• Required Disclosures – We may disclose PHI as required bylaw (e.g., public health, law enforcement, court orders, or government oversight).
• Optional Disclosures – We may share information with family or caregivers if you consent or in emergencies when permitted by law.
• Other Uses Requiring Authorization – We will not use or disclose PHI for marketing, sales, or non-care-related purposes without your written authorization.
3. ELECTRONIC COMMUNICATION AND TELEHEALTH NOTICE
We offer communication via Spruce secure messaging and video, Zoom telehealth, email, and SMS text messaging using our practice numbers, including (424) 587‑3818. While we take precautions, email and SMS are not fully secure. By providing these contact methods, you acknowledge this risk and authorize communication through these means. You may revoke consent inwriting at any time. Do not use these channels for emergencies; call 911 instead.
4. YOUR RIGHTS UNDERHIPAA AND CALIFORNIA LAW
You have the following rights regarding your health information:
• Access – You may review or request copies of your medical records in paper or electronic format.
• Amendment – You may request correction of inaccurate or incomplete information.
• Accounting – You may request a record of certain disclosures of your PHI.
• Restriction – You may request limitations on certain uses or disclosures, though we may not always agree.
• Confidential Communications – You may request that we contact you at an alternate address or number.
• Copy of Notice – You may request a paper or electronic copy of this Notice at any time.
5. CHANGES TO THISNOTICE
We reserve the right to change this Notice at any time and to make the revised Notice effective for all PHI we maintain. The current version will always be available in our office and on our website.
6. QUESTIONS OR COMPLAINTS
If you have questions, wish to exercise your rights, or believe your privacy rights have been violated, please contact:
Privacy Officer: Dr. Grace Tassa
Email: admin@BespokeMedicineBH.com
Phone: (424) 587‑3818
Address: 435 N Bedford Dr, Suite 411, Beverly Hills, CA 90210
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) – Region IX.
Address: 90 7th Street, Suite 4‑100, San Francisco, CA 94103
Phone: (800) 368‑1019 | Email: OCRMail@hhs.gov
Online: https://www.hhs.gov/hipaa/filing‑a‑complaint/index.html
You will not be penalized for filing a complaint.
