Effective Date: 2018 | Last updated: June 25, 2026
Golden Hills Plastic Surgery (“we,” “our,” or “the Practice”) is committed to protecting the privacy of your health information. We are required by federal law — the Health Insurance Portability and Accountability Act (HIPAA) — and by California law to maintain the privacy of your Protected Health Information (PHI), to provide you with this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.
The following categories describe the ways we may use and disclose your PHI without your written authorization. Not every use or disclosure in a category will be listed, but all the ways we are permitted to use and disclose information will fall within one of these categories.
We may use and disclose your PHI to provide, coordinate, or manage your medical care. For example, we may share information with plastic surgeons, anesthesiologists, surgical facilities, referring physicians, or other providers involved in your care (e.g., a pathologist reviewing a tissue specimen removed during a procedure).
We may use and disclose your PHI to obtain payment for services we provide. This includes submitting claims to your health insurance carrier (for covered reconstructive procedures), verifying insurance eligibility, and responding to billing inquiries. If you use third-party financing (such as CareCredit or Alphaeon), we may share the minimum necessary information required to process your application.
We may use and disclose your PHI for the Practice’s operational activities, such as quality assessment, training, scheduling, accreditation, licensing, auditing, and business management. Appointment Reminders and Treatment Alternatives We may contact you to remind you of appointments or to provide information about treatment alternatives or other health-related services that may be of interest to you.
We will disclose your PHI when required to do so by federal or California state law, including mandatory reporting obligations (e.g., certain communicable diseases, suspected abuse or neglect, gunshot wounds).
We may disclose PHI to public health authorities to prevent or control disease, injury, or disability.
We may disclose PHI to government agencies for activities authorized by law, such as audits, investigations, and inspections.
We may disclose PHI in response to a court or administrative order, subpoena, or other lawful process, subject to applicable legal protections.
We may disclose PHI to law enforcement officials as required or permitted by law.
We may use or disclose PHI when necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
We may disclose PHI to a coroner, medical examiner, or funeral director as authorized by law.
We may disclose PHI to organ procurement organizations consistent with applicable law.
We may disclose PHI as authorized by, and to the extent necessary to comply with, California workers’ compensation law.
We may share your PHI with third-party “business associates” (such as billing companies, IT vendors, and electronic health record providers) who perform services on our behalf. These parties are required by contract to safeguard your information.
We will obtain your written authorization before using or disclosing your PHI in the following circumstances:
Some services we provide are cosmetic in nature and may not be covered by insurance. Whether a procedure is cosmetic or reconstructive may appear in your records and may be disclosed to payers in connection with billing. We will make reasonable efforts to limit disclosure
of purely cosmetic treatment history to those with a need to know.
Plastic surgery evaluations may include psychological or mental health screening (for example, screening related to body image or body dysmorphic disorder). Any such information is treated with the same — or greater — protections as other PHI. California law provides heightened protections for mental health records, and we will not disclose such information without your authorization except as required by law or to prevent a serious threat to safety.
Photographic documentation is a routine part of surgical care for clinical and medical record purposes. These images are stored securely and access is limited to your care team. Any other use requires your written authorization (see Section 2).
If you elect to finance your procedure through a third-party lender, only the minimum information necessary to process your financing request will be shared. Financing companies are not health plans and are not covered by HIPAA; their own privacy policies will apply to information you provide directly to them.
California law provides additional privacy protections beyond federal HIPAA requirements. As a California patient, you have the following additional rights:
To the extent any personal information we collect falls outside those frameworks, you may have additional rights under the CCPA. Please contact us for more information.
You have the right to inspect and obtain a copy of your PHI that is maintained in a designated record set (medical and billing records). You may request an electronic copy. We may charge a reasonable cost-based fee. We will respond to your request within 15 business days (California law) or 30 days (federal HIPAA), whichever is sooner.
If you believe your PHI is incorrect or incomplete, you may request an amendment. We may deny the request in certain circumstances but will document any denial.
You have the right to request a list of certain disclosures we have made of your PHI during the past six years (federal) or one year (California). This does not include disclosures for treatment, payment, or health care operations.
You may request that we restrict the use or disclosure of your PHI for treatment, payment, or health care operations. We are not required to agree, except: if you pay for a service entirely out-of-pocket, you have the right under HIPAA to request that we not disclose information about that service to your health plan, and we must comply with that request.
You may request that we communicate with you in a specific way or at a specific location (e.g., by mail to a P.O. box rather than your home address). We will accommodate reasonable requests.
You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
If you have given us written authorization to use or disclose your PHI, you may revoke it at any time in writing. The revocation will not affect any prior uses or disclosures made in reliance on the authorization.
We are required by law to:
We reserve the right to change this Notice and to make the new Notice effective for all PHI we maintain, including information created or received before the new Notice takes effect. We will post any revised Notice in our office and on our website and will make a copy available upon request.
To exercise any of the rights described in this Notice, or if you have questions about our privacy practices, please contact our Privacy Officer:
Golden Hills Plastic Surgery — Privacy Officer
100 N. Wiget Ln., Suite #100
Walnut Creek, CA 94598
Phone: (925) 935-3528
Email: info@ghplasticsurgery.com
If you believe your privacy rights have been violated, you may file a complaint with us using the contact information above or with the U.S. Department of Health and Human Services, Office for Civil Rights:
U.S. Department of Health & Human Services Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll-Free: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/
You also have the right to file a complaint with the California Department of Justice, Office of the Attorney General, if you believe your rights under California’s Confidentiality of Medical Information Act have been violated.
YOU WILL NOT BE RETALIATED AGAINST FOR FILING A COMPLAINT.
This Notice is available on our website and at our office front desk. When you complete patient intake forms, you will be asked to acknowledge receipt of this Notice.
This Notice of Privacy Practices was prepared for Golden Hills Plastic Surgery. It is intended for informational purposes and does not constitute legal advice. Please consult a qualified healthcare attorney to ensure full compliance with all applicable federal and California state laws.
