Welcome to Avalon Plastic Surgery Center. Our staff welcomes the opportunity to be involved in your health care. We strive to provide you with the best medical care possible in a friendly and comfortable environment. “Plastic” comes from the Greek word “Plastikos”, which means to mold or shape. Plastic surgery is the surgical specialty which deals with reconstructive and cosmetic surgical procedures. Reconstructive surgery is performed on abnormal or damaged structures of the body to improve function and restore a more normal appearance. Aesthetic or cosmetic surgery is performed to reshape normal structures of the body to improve one’s appearance and self esteem. At Avalon, we also offer an individualized skin care program. The SkinMedica program is a complete skin care line that aids in reducing the signs of aging and promotes healthy skin texture and appearance. We want to make your visit as comfortable and pleasant as possible. Our in-office surgical suite allows us to perform many cosmetic procedures in a private and comfortable environment.

Our Promise to you...

Our goal is to provide you with the information needed to make a plastic surgery health care decision. This will include diagnosis, treatment options, expected outcomes, post operative care, and recovery pertaining to your procedure. We encourage you to ask questions.

Hospitals

Dr. Barnard is on staff at Allen Memorial Hospital and MercyOne Waterloo, both in Waterloo, IA.

Insurance and Fees

We accept Medicare and many other insurance plans. We will file your primary and secondary insurances at no cost to you. Simply provide us with all policy information and a copy of your insurance card. A copy of the card must be on file for us to submit your claim. We will notify your insurance carrier if surgery is to be scheduled. It is your responsibility to let us know if a second opinion or pre certification is required. Ultimately, you are responsible to know your plan. We deal with many plans and can provide only the basic information to you. Most cosmetic surgical procedures are done in our office suite. This allows the finest care to you at the most reasonable cost. Fees for cosmetic procedures are due three weeks prior to the scheduled surgery. Account statements are sent out once a month. You are responsible for the balance not covered by your insurance. We ask that you keep your account current.

Notice of Information/Privacy Practices

This notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Avalon Plastic Surgery Center is required by law to follow the terms of this Notice as long as it is in effect. If you have any questions about this notice, contact Dr. Mark A. Barnard at 2710 St Francis Dr #401, Waterloo, IA 50702.

Your Rights under the Federal Privacy Standard:

Although your health records are the physical property of the health care provider who completed the records, you have the following rights with regard to the information contained therein:

  1. Request restriction on uses and disclosures of your health information for treatment, payment and health care operations. Avalon Plastic Surgery Center is not required to agree to a requested restriction.
  2. The right to receive confidential communication of protected health information.
  3. Obtain a copy of this notice of information; you have a right to a hard copy upon request.
  4. Inspect and copy your health information upon request. Again, this right is not absolute. In certain situation such as if access would cause harm, we can deny access.
  1. Request amendment/correction of your health information, We do not have to grant the request if the following conditions exist:
    1. We did not create the record. If, as in the case of a consultation report from another provider, we did not create the record, we cannot know whether is it accurate or not. Thus, in such cases, you must seek amendment correction from the party creating the record. If the party amends or corrects the record, we will put the corrected record into our records.
    2. The record is accurate and complete.
  1. Obtain an accounting of non-routine uses and disclosures, those other than for treatment, payment, and health care operations until a date that the federal Department of Health and Human Services will set after January 1, 2011. After that date, we will have to provide an accounting to you upon request for uses and disclosures for treatment, payment, and health care operations.
    1. To receive confidential communications of protected health information
    2. Revoke your consent or authorization to use or disclose health information except to the extent that we have taken action in reliance on the consent or authorization.

Our Responsibilities under the Federal Privacy Standard

In addition to providing you your rights, as detailed above, the federal privacy standard requires us to take the following measures:

  1. Maintain the privacy of your health information, including implementing reasonable and appropriate physical, administrative, and technical safeguards to protect the information.
  2. Provide you this notice as to our legal duties and privacy practices with respect to individually identifiable health information that we collect and maintain about you.
  3. Abide by the terms of this notice.
  4. Train our personnel concerning privacy and confidentiality.
  5. Implement a sanction policy to discipline those who breach privacy/confidentiality or our policies with regard thereto.
  6. Mitigate (lessen the harm of) any breach of privacy/confidentiality.
  7. We may contact you to provide appointment reminders or information about treatment and services.
  8. We may disclose health information to your health insurance, insurance issuer. We will not use or disclose your health information without your consent or authorization except as described in this notice or otherwise required by law.

Complaints: The notice must contain a statement that individuals may complain to the covered entity and to the Secretary of Health and Human Services if they believe their privacy rights have been violated, a brief description of how the individual may file a complaint with the covered entity, and a statement that the individual will not be retaliated against for fining a complaint.

How to Get More Information or to Report a Problem

If you have questions and/or would like additional information, you may contact Mark A. Barnard, MD at (319)-272-8488 or 2710 St Francis Dr #401, Waterloo, IA 50702. Individuals may bring complaints to Avalon Plastic Surgery Center without fear of retaliation by the practice, if they believe their privacy rights have been violated.

Examples of Disclosures for Treatment, Payment and Health Care Operations:

  1. We will use your health information for treatment. (Such as giving radiology department/surgery your diagnosis and summary of problems when scheduling/ordering tests/surgery)
  2. We will use your health information for health care operations. (Review of your medical record for quality control purposes.)
  3. We will use your health information for payment (Such as giving your insurance company your diagnosis /operations)
  4. Business associates. We provide some services through contracts with business associates.
  5. Notification: We may use or disclose information to notify or assist in notifying a family member, a personal representative, or another person responsible for your care, location and general condition.
  6. Communication with family: Unless you object, health professionals, using their best judgment, may disclose to a family member, another relative, a close personal friend, or any other person that you identify health information relevant to that person’s involvement in your care or payment related to your care.
  7. Research: We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
  8. Funeral directors: We may disclose health information to funeral directors consistent with applicable law to enable them to carry out their duties.
  9. Marketing/continuity of care: We may contact you to provide appointment reminders or information about treatment alternatives or other health related benefits and services that may be of interest to you.
  10. Food and Drug Administration (“FDA”): We may disclose to the FDA health information relative to adverse effects/events with respect to food, drugs, supplements, product or product defects, or postmarking surveillance information to enable product recalls, repairs, or replacement.
  11. Workers compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
  12. Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
  13. Correctional institution: If you are an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.
  14. Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
  15. Health oversight agencies and public health authorities: If embers of our work force or business associates believe in good faith that we have engaged in unlawful conduct or otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public, they may disclose your health information to health oversight agencies and/or public health authorities, such as the department of health.
  16. The federal Department of Health and Human Services (“DHHS”): Under the privacy standards, we must disclose your health information to DHHS as necessary to determine our compliance with those standards.

WE RESERVE THE RIGHT TO CHANGE OUR PRACTICES AND TO MAKE THE NEW PROVISIONS EFFECTIVE FOR ALL INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION THAT WE MAINTAIN. IF WE CHANGE OUR INFORMATION PRACTICES, WE WILL OFFER/GIVE A REVISED NOTICE TO YOU AT YOUR NEXT OFFICE VISIT.

Effective date: 2-2-04/revised 7-12-2020