Notice of Privacy Practices
Notice of Privacy Practices
We take your privacy very seriously and comply with all the directives of HIPAA to keep your information safe and protected.
Thank you for trusting us with your oral health!
This Notice describes how dental and medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
OUR LEGAL DUTY
Our dental practice is required by law to maintain the privacy and security of your protected health information (PHI). We are also required to provide you with this Notice of Privacy Practices explaining our legal duties and privacy practices regarding your health information.
We will follow the duties and privacy practices described in this notice and will notify you if a breach occurs that may have compromised the privacy or security of your information.
USES AND DISCLOSURES OF HEALTH INFORMATION
We may use and disclose your protected health information without your written authorization for the following purposes:
Treatment
We may use and disclose your health information to provide, coordinate, or manage your dental care and related services. This may include sharing information with dental specialists, dental laboratories, physicians, or other healthcare providers involved in your treatment.
Payment
We may use and disclose your health information to obtain payment for services provided to you. This may include submitting claims to your dental insurance company, verifying insurance coverage, or contacting your insurance carrier for payment purposes.
Health Care Operations
We may use and disclose your information for activities necessary to operate our dental practice. These activities may include quality assessment, employee training, licensing, accreditation, business planning, and administrative services.
OTHER USES AND DISCLOSURES PERMITTED BY LAW
We may also disclose your health information when permitted or required by law, including:
• Public health activities
• Health oversight activities (audits, inspections, investigations)
• Judicial or administrative proceedings
• Law enforcement purposes
• Workers’ compensation claims
• To prevent a serious threat to health or safety
• As otherwise required by federal, state, or local law
USES AND DISCLOSURES THAT REQUIRE AUTHORIZATION
We will obtain your written authorization for uses or disclosures of your health information that are not described in this notice. You may revoke an authorization at any time in writing.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights regarding your protected health information:
Right to Inspect and Copy
You have the right to inspect and obtain a copy of your health records. Patients have the right to request copies of dental records and X-rays, usually with a reasonable fee.
Right to Request Amendments
You have the right to request that we correct information in your record if you believe it is incorrect or incomplete.
Right to Request Restrictions
You may request restrictions on certain uses or disclosures of your health information. While we are not required to agree to all restrictions, we will comply when required by law.
Right to Confidential Communications
You may request that we contact you in a specific way, such as only by phone, email, or at a specific address.
Right to an Accounting of Disclosures
You may request a list of certain disclosures we have made of your health information.
Right to a Paper Copy of This Notice
You may request a paper copy of this notice at any time, even if you have agreed to receive it electronically.
OUR RESPONSIBILITIES
Our practice is required to:
• Maintain the privacy and security of your protected health information
• Provide you with this notice explaining our legal duties and privacy practices
• Follow the terms of this notice currently in effect
• Notify you if a breach occurs that may compromise the privacy or security of your information
We reserve the right to change the terms of this notice. Any changes will apply to all health information we maintain. Updated notices will be available in our office and on our website.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with our office and/or file a complaint with the U.S. Department of Health and Human Services at the following address:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: https://www.hhs.gov/ocr