Privacy Policy.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.  Please review carefully.

We respect our legal obligation to keep health information that identifies you private.  We are obligated by law to give you notice of our privacy practices.  This notice describes how we protect your health information and what rights you have regarding it. 

TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS:

                The most common reason why we use or disclose your health information is for treatment, payment, or health care operations.  Examples of how we use or disclose information of treatment purposes are: setting up an appointment for you, examining your teeth, prescribing medications, referring you to another doctor or clinic for other health care services, or getting copies of your health information from another professional that you may have seen before us.  Examples of how we use or disclose your health information for payment purposes are: financial or billing audits, or other sources of payment, preparing and sending bills or claims, and collecting unpaid amounts (either ourselves or through a collection agency or attorney).  “Health Care Operations” means those administrative and managerial functions that we have to do in order to run our office.  Examples of how we use or disclose your health information for health care operations are: asking you about your health or dental care plans, internal quality assurance, personnel decisions, participation in managed care plans, defense in legal matters, business planning, and outside storage of our records.

                We routinely use your health information inside our office for these purposes without any special permission.  If we need to disclose your health information outside of our office for these reasons, we usually will not ask you for special written permission. 

USES AND DISCLOSUES FOR OTHER REASONS WITHOUT PERMISSION:

                In some limited situations the law allows or requires us to use or disclose your health information without you permission.  Not all of these situations will apply to us, some may never come up at our office at all.  Such uses and disclosures are:

·         When a state or federal law mandates that certain health information be reported for a specific purpose.

·         For public health purpose, such as contagious disease reporting, investigation, or surveillance and notices to and from the federal Food and Drug Administration regarding drugs or medical devises.

·         Disclosures to government authorities about victims of suspected abuse, neglect or domestic violence.

·         Uses and disclosures for health oversight activities, such as for licensing doctors, for audits by Medicare or Medicaid, or for investigations of possible violations of health care laws.

·         Disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies.

·         Disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime, to provide information about a crime in our office, or to report a crime that happened somewhere else. 

·         Disclosure to a medical examiner to identify a dead person or to determine the cause of death, or to funeral directors to aid in burial, or to organizations that handle organ or tissue donations.

·         Uses or disclosures for health-related research.

·         Uses or disclosures for specialized government functions, such as the protection of the president or high-ranking government officials, for lawful national intelligence activities, for military purposes, or for the evaluation and health of members of foreign services.

·         Disclosures of de-identified information.

·         Disclosures relating to worker’s compensation programs.

·         Disclosures of a “limited data set” for research, public health, or health care operations.

·         Incidental disclosures that are an unavoidable by-product of permitted uses or disclosures.

·         Disclosures to “business associates” who perform health care operations for us and who commit to respect the privacy of your health information.

Unless you object, we will also share relevant information about your care with your family or friends who are helping you with your dental care.

SMS Privacy and Data Sharing

We respect your privacy and are committed to protecting your personal information. Mobile phone numbers, SMS opt-in consent, and text messaging consent information will not be shared, sold, rented, or disclosed to third parties or affiliates for marketing or promotional purposes.

We may use trusted service providers to facilitate text message communications on our behalf, subject to appropriate privacy and security protections. These service providers are not permitted to use your information for their own marketing purposes.

Text messaging opt-in data and consent will not be shared with any third parties or affiliates for their own marketing purposes.

APPOINTMENT REMIINDERS:

                We may call or write to you of your scheduled appointment or that it is time to make a routine appointment.  We may also call or write to notify you of other treatments or services available at our office that might help you.  Unless you tell us otherwise, we will mail you an appointment reminder on a post care, send you a text, and/or leave you a reminder message on your answering machine or with someone who answers your phone if you are not home.

OTHER USES OR DISCLOSURES:

                We will not make any other uses or disclosures of your health information unless you sign a written “authorization form.”  The content of an “authorization form” is determined by federal law.  Sometimes we may initiate the process if it’s your idea for us to send your information to someone else.  Typically, in this situation you will give us a properly completed authorization form or you can use one of ours.  If we initiate the process and ask you to sign an authorization form, you do not have to sign it.  If you do not sign the authorization form, we cannot make the use and disclosure.  If you do sign one, you may revoke it at any time unless we have already acted in reliance upon it.  Revocations must be in writing.  Send them to the office contact person named at the beginning of this notice.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION:

                The law gives you many rights regarding your health information. You can:

·         Ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment or health care operations.  We do not have to agree to do this, but if we agree, we must honor the restrictions that you want.  To ask for this restriction, send a written request to the office to the contact person at the address, fax, or email shown at the top of this notice.

·         Ask us to communicate with you in a confidential way, such as by phoning you at work rather than at home, by mailing health information to a different address, or by sending email to your personal email address.  We will accommodate these requests if they are reasonable, and if you pay us for any additional cost.  If you want to ask for any confidential communications, send a written request to the office contact person at the address, fax, or email shown at the beginning of this notice.

·         Ask to see or het photocopies of your health information.  By law, there are a few limited situations in which we can refuse to permit access or copying.  For the most part, however, you will be able to review or have a copy of your health information within 30 days of asking us (or 60 days if the information is stored off site).  You may have to pay for photocopies in advance.  If we deny your request, we will send you a written explanation, and instructions about how to get and impartial review of our denial id one is legally available.  By law, we can have one 30-day extension to the time for us to give you access or photocopies if we send you written notice of the extension.  If you want to review or get photocopies of your health records, send a written request to the office contact person at the address, fax, or email shown at the beginning of this notice.

·         We will amend the information within 60 days from when you ask.  We will send the corrected information to persons who we know got the wrong information, and others that you specify.  If we do not agree, you can write a statement of your position, and we will include it with your health information along with any rebuttal statement that we may write.  Once your statement of position and/or rebuttal is included in your health information, we will send it along whenever we make a permitted disclosure of your health information.  By law, we can have one 30-day extension of time to consider a request for amendment if we notify you in writing of the extension.  If you want to ask us to amend your health information, send a written request, including your reasons for the amendment, to the office contact person at the address, fax, or email shown at the beginning of this notice.

·         Get a list of disclosures that we have made for your health information within the past six years (or a shorter period if you want).  By law, the list will not include: disclosure of purposes of treatment, payment of healthcare operations, disclosures with your authorization, incidental disclosures, disclosures by law and some other limited disclosures.  You are entitled to one such list per year without charge.  If you want more frequent lists, you will have to pay for them in advance.  We will usually respond to your request within 60 days of receiving it, but by law we have one 30-day extension of time if we notify you of the extension in writing.  If you want a list, send a written request to the office contact person at the address, fax, or email shown at the beginning of this notice.

·         Get additional paper copies of this Notice of Privacy Practices upon request.  It does not matter whether you got one electronically or in paper form already.  If you want additional paper copies, send a written request to the office contact person at the address, fax, or email shown at the beginning of this notice.

OUR NOTICE OF PROVACY PRACTICES:

                By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it.  We reserve the right to change this notice at any time as allowed by law.  If we change this notice, the new privacy practices will apply to your health information that we already have as well as to such information that we may generate in the future.  If we change our Notice of Privacy Practices, we will post the new notice in our office, have copies available in our office and post it on our website.

COMPLAINTS:

                If you think that we have not properly respected the privacy of your health information, you are free to complain to us or the U.S. Department of Health and Human Services, Office of Civil Rights.  We will not retaliate against you if you make a complaint.  If you want to complain to us, send a written complaint to the office contact person at the address, fax, or email shown and the beginning of this notice.  If you prefer, you can discuss your complaint in person or by phone.

FOR MORE INFORMATION:

                If you want more information about our privacy practices, call or visit our office contact person at the phone number or address shown at the beginning of this notice.