Our Information Practices
Our policies and procedures protect the privacy of our current and former patients.
Types of Information We Collect
In the normal course of business, we collect the following types of information:
- Information requested on applications and other forms (including name, address, phone numbers, social security identification and personal health).
- Information furnished to us with your permission from other dental offices, medical offices, or other health care facilities that aid us in providing you with treatment.
- Information from your health insurance providers that results from or allows us to file claims on your behalf to obtain payment for services that we have rendered.
- Information, collected with your permission from consumer reports (such as credit reports).
Safeguarding Your Information
We maintain physical, electronic and procedural safeguards that meet state and federal regulations. Access to patient information is limited to people who need the information for authorized business purposes.
We are required to:
- Maintain the privacy of your health information as required by law.
- Provide you with a notice of our duties and privacy practices as to the information we collect and maintain about you (this brochure).
- Abide by the terms of this notice.
- Notify you if we cannot accommodate a requested restriction or request; and accommodate your reasonable requests regarding methods of sharing your health information.
How We Use Your Information
We use and disclose health information about you for treatment, healthcare operations and payment.
- We may use or disclose health information to provide you with appointment reminders (such as voice mail messages, postcards or letters).
- We may use and disclose your health information to obtain payment for services we provide you.
- We will provide information to Health Care Benefits providers such as insurance companies or employer provided health care benefits departments.
- We may share information with other dental or medical offices that we involved in your health care.
- We may provide information to members of your family or to friends/acquaintances that have been designated by you to assist you in providing health care.
- In the event of your incapacity or emergency circumstances, we will disclose health information based on determination using our professional judgment disclosing only health information that is directly relevant to the person’s involvement in your healthcare.
- We may provide information to other entities or offices as required by law. This may include: Judicial courts, public health offices, law enforcement officials, Food and Drug Administration, health oversight agencies, worker’s compensation offices or Military Armed Forces.
We will not knowingly share or provide any of your protected health information with any third parties for commercial purposes.
We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request.
Your Health Information Rights
The health and billing records we maintain are the physical property of the practice. The information in it, however, belongs to you.
You have a right to:
- Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office. We are not required to grant the request but we will try to be accommodating.
- Request that you be allowed to inspect and copy your health record and billing record.
- Appeal a denial of access to your health information unless judicial order prevents such access.
- Request that your health care information be amended to correct incomplete or incorrect information.
- Obtain an accounting of disclosures of your health information as required to be maintained by law. This accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to family members or friends in the course of providing care.
- You may request that communication of your health care be made by alternative means or at an alternative location be delivering the request in writing to our office.
- Revoke authorizations that you made previously to use or disclose information except to the extent information or actions have already been taken.