NOTICE OF PRIVACY PRACTICES
Internal and Bariatric Medicine
Effective Date: [10/20/2026]
Privacy Contact: [Lina Awwad]
Telephone: [913 553 0945]
Email: [drsaradih@gmail.com]
Your Information. Your Rights. Our Responsibilities.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Internal and Bariatric Medicine is committed to protecting the privacy and security of your health information. This Notice of Privacy Practices explains your rights regarding your protected health information (PHI), the ways we may use and disclose that information, and our legal responsibilities under the Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws.
This notice applies to Internal and Bariatric Medicine and its workforce members who use or disclose protected health information in connection with the practice's healthcare services.
1. Your Rights
You have the following rights regarding your health information.
Obtain a Copy of Your Medical Records
You may request an electronic or paper copy of your medical records and other health information maintained by our practice.
We will generally provide a copy or summary within 30 days of your request, subject to extensions permitted by law. We may charge a reasonable, cost-based fee as allowed by applicable law.
Request Corrections to Your Records
You may ask us to correct information you believe is inaccurate or incomplete.
We may deny your request in certain circumstances but will provide a written explanation within the time required by law.
Request Confidential Communications
You may request that we contact you in a specific way, such as through a particular telephone number or mailing address.
We will accommodate reasonable requests.
Request Restrictions on Information Sharing
You may ask us not to use or disclose certain health information for treatment, payment, or healthcare operations. We are not required to agree to every requested restriction.
If you pay in full out of pocket for a healthcare service or item, you may request that we not disclose information about that service or item to your health plan for payment or healthcare operations. We must honor this request unless disclosure is required by law.
Request an Accounting of Disclosures
You may request a list of certain disclosures of your health information made during the six years preceding your request.
Some disclosures, including those for treatment, payment, and healthcare operations, generally are excluded from this accounting.
One accounting within a 12-month period is provided without charge. Additional requests may be subject to a reasonable, cost-based fee.
Obtain a Copy of This Notice
You may request a paper copy of this notice at any time, even if you previously agreed to receive it electronically.
Choose a Personal Representative
If an individual has legal authority to act on your behalf, such as a legal guardian or a person holding an appropriate healthcare power of attorney, that individual may exercise your privacy rights as permitted by law.
We will verify the person's authority before allowing access to your information.
File a Privacy Complaint
You may file a complaint if you believe your privacy rights have been violated.
You may contact our Privacy Officer or file a complaint directly with the U.S. Department of Health and Human Services.
We will not retaliate against you for filing a complaint.
2. Your Choices
In certain situations, you may tell us how you prefer your health information to be shared.
Family Members and Others Involved in Your Care
You may identify family members, friends, or other individuals who may receive information relevant to their involvement in your care or payment for your care.
If you are unable to express your preference, we may share information when permitted by law and when we determine that doing so is in your best interest.
Disaster Relief
We may share relevant health information with organizations assisting in disaster relief efforts, as permitted by law.
Uses Requiring Written Authorization
We generally must obtain your written authorization before:
Using or disclosing psychotherapy notes for purposes requiring authorization under HIPAA.
Using protected health information for marketing activities that require authorization.
Selling protected health information.
Making other disclosures that require written authorization under applicable law.
You may revoke an authorization in writing, except to the extent we have already acted in reliance on it.
Fundraising
If our practice conducts fundraising involving protected health information, we will follow applicable HIPAA requirements, including your right to opt out of fundraising communications.
Additional notice and choice requirements apply if fundraising communications would use records protected under 42 CFR Part 2.
3. How We Typically Use and Disclose Your Health Information
Treatment
We may use and disclose your health information to provide, coordinate, and manage your medical care.
For example, we may share relevant information with physicians, nurse practitioners, registered dietitians, specialists, hospitals, laboratories, pharmacies, and other healthcare professionals involved in your treatment.
Payment
We may use and disclose health information to obtain payment for healthcare services.
Examples include:
Verifying insurance eligibility and benefits.
Submitting insurance claims.
Requesting prior authorizations.
Responding to insurance coverage reviews.
Processing billing inquiries and payment disputes.
Healthcare Operations
We may use and disclose health information for activities necessary to operate our medical practice.
Examples include:
Quality improvement and patient safety.
Clinical and administrative reviews.
Staff training and supervision.
Credentialing and compliance.
Practice management and auditing.
Coordinating healthcare services.
Appointment Reminders and Healthcare Communications
We may contact you about appointments, test results, prescriptions, follow-up care, and other healthcare-related matters.
We will honor applicable privacy requirements and reasonable requests for confidential communications.
4. Other Uses and Disclosures Permitted or Required by Law
We may use or disclose your health information without your written authorization in certain circumstances, subject to applicable legal requirements.
These circumstances may include:
Public Health and Safety
Reporting communicable diseases, adverse medication reactions, suspected abuse or neglect, or information necessary to prevent or reduce a serious threat to health or safety.
Health Oversight
Cooperating with legally authorized audits, investigations, inspections, and licensing activities.
Research
Using or disclosing information for research when applicable legal requirements and safeguards are satisfied.
Legal Requirements
Disclosing information when required by federal or state law.
Organ and Tissue Donation
Sharing information with appropriate organizations involved in organ or tissue donation when permitted by law.
Medical Examiners and Funeral Directors
Providing information for legally authorized duties.
Workers' Compensation
Disclosing information as authorized by workers' compensation laws.
Law Enforcement and Government Functions
Responding to qualifying law enforcement requests, government activities, and other legally permitted disclosures.
Judicial and Administrative Proceedings
Responding to court orders, subpoenas, and other lawful legal processes when applicable privacy requirements are met.
Additional protections may restrict disclosure of certain categories of health information.
5. Substance Use Disorder Records — 42 CFR Part 2
Certain substance use disorder treatment records are subject to additional federal confidentiality protections under 42 CFR Part 2.
To the extent Internal and Bariatric Medicine maintains records protected by Part 2, we will comply with applicable requirements governing their use, disclosure, consent, and redisclosure.
When required, we will obtain patient consent before using or disclosing these records. A valid consent may permit certain uses and disclosures for treatment, payment, and healthcare operations, subject to applicable law.
Records protected by Part 2 generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against a patient without the patient's specific written consent or an appropriate Part 2 court order accompanied by a subpoena or other legal mandate.
Additional restrictions and patient rights may apply to these records.
6. Our Responsibilities
Internal and Bariatric Medicine is required by law to:
Maintain the privacy and security of protected health information.
Provide patients with a Notice of Privacy Practices.
Follow the privacy practices described in the currently effective notice.
Notify affected individuals of breaches of unsecured protected health information when required by law.
Obtain written authorization for uses and disclosures requiring authorization.
Comply with applicable federal and state privacy laws.
We use reasonable administrative, physical, and technical safeguards to protect health information.
We will not use or disclose protected health information in ways that are inconsistent with this notice unless permitted or required by law or authorized by you.
7. Additional Privacy Protections
Certain health information may be subject to additional federal or state confidentiality requirements.
When applicable Kansas or Missouri law provides greater privacy protections than HIPAA, we will comply with the more protective legal requirements.
Additional protections may apply to certain mental health, substance use disorder, and other sensitive medical records.
8. Changes to This Notice
We reserve the right to revise this Notice of Privacy Practices as permitted by law.
Any revised notice may apply to health information we already maintain as well as information received in the future.
The current notice will be available at our office, upon request, and on our website.
9. Questions and Complaints
If you have questions about this notice, wish to exercise your privacy rights, or believe your privacy rights have been violated, please contact:
Internal and Bariatric Medicine
Address: [10951 Lakeview Ave, Ste A, Lenexa, KS 66219]
Phone: [913 553 0945]
Email: [drsaradih@gmail.com]
You may also submit a complaint to:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Telephone: 1-877-696-6775
Website: https://www.hhs.gov/hipaa/filing-a-complaint/
You will not be retaliated against for filing a complaint.
Internal and Bariatric Medicine
Effective Date: [10/20/2026]