Notice Of Privacy Practices (Dental)

Note: This Notice of privacy practices is provided for educational and informational purposes only. THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. The Health Insurance Portability & Accountability Act of 1996 (H1PPA) is a federal program that requires all medical records and other individually identifiable health information used or disclosed by us in any form, electronically, on paper or orally, be kept properly confidential. This Act gives you, the patient, significant new rights to understand how your health information is used. We have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information.

We may use and disclose your medical records only for each of the following purposes: treatment, payment and health care operations

Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. An example of this would include professional teeth cleaning services.
Payment means such activities as obtaining reimbursement for services, confirming insurance coverage, billing or collections activities, and utilization review. An example of this would be sending a claim for your visit to your insurance company for payment.
Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions and customer service. An example would be an internal quality assessment review.

We may also create and distribute non-identifiable health information by removing all references to individually identifiable information. We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may interest you. Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the Privacy Officer:

The right to restrict the disclosure of your protected health information (in writing). The request for restriction may be denied if the information is required for treatment, payment or health care options.
The right to receive confidential communications regarding our protected health information.
The right to inspect and copy your protected health information.
The right to amend your protected health information.
The right to receive and account for disclosures of protected health information.
The right to obtain a paper copy of this notice from us upon request.

We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information.

We reserve the right to change the terms of this Notice. The policies in any new notice will not be in effect until they are posted within and available at our office.

If you have complaints regarding the way your protected health information was handled, you may submit a complaint in writing to this office. You will not be retaliated against in any manner for a complaint.