Privacy Policy/HIPAA Compliance
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.
We understand that medical information about you and your health
is personal "Protected Health Information" ("PHI")
and we are committed to protecting your medical information. PHI
includes individually identifiable information about your past,
present, or future health or condition, the provision of health
care to you,
or payment for such health care.
We use and disclose PHI about you for treatment, payment, and
health care operations.
Treatment: We may disclose PHI to your insurance provider, our
dentist(s) and other dental care providers for treatment
purposes. For example,
your dentist may wish to provide a dental service to you
but first seek information from your insurance provider as to whether
the
service has been previously provided.
Payment: We disclose your PHI in order to fulfill our duty
to check your coverage, determine your benefits, and secure
payment
for
services provided to you. For example, we use your PHI in
order to request
process of your claims by your insurance provider.
Health Care Operations: We disclose your PHI as a part of
certain operations, such as quality improvement. For example,
we may
use your PHI to evaluate the quality of dental services
that were performed.
We may be asked by the sponsor of your health plan to provide
your PHI to the sponsor. If we are asked to do so, we intend
to honor
such requests unless we are prohibited by law.
We may use or disclose your PHI without your authorization
for several other reasons. Subject to certain requirements,
we may
give out PHI
without your authorization for public health purposes,
auditing purposes, research studies, and emergencies.
We provide PHI
when otherwise
required by law, such as for law enforcement in specific
circumstances, or for judicial or administrative proceedings.
In any other
situation, we will ask for your written authorization
before using or disclosing
your PHI. If you choose to sign an authorization to allow
disclosure of your PHI, you can later revoke that authorization
to stop
any future uses and disclosures (other than for treatment,
payment and health care operations).
We may change our policies at any time. Before we make
a significant change in our policies, we will change
our notice
and send
the new notice to you. You can also request a copy
of our notice at any time.
Individual Rights
In most cases, you have the right to view or get a
copy of your PHI. You also have the right to receive
a list
of instances
where
we have
disclosed your PHI without your written authorization
for reasons other than treatment, payment or health
care operations.
If
you believe that information in your record is incorrect
or if important
information
is missing, you have the right to request that we
correct the existing information or add the missing information.
You may
request in
writing that we not use or disclose your PHI for
treatment,
payment and health
care operations except when specifically authorized
by you, when required by law, or in emergency circumstances.
We will
consider
your request but are not legally required to accept
it.
You also have the right to receive confidential communications
of PHI
by alternative means or at alternative locations,
if you clearly state
that disclosure
of all or part of your PHI could endanger you.
Complaints
If you are concerned that we have violated your privacy
rights, or you disagree with a decision we have
made about access
to your records,
you may contact the address listed below. You may
also send a written complaint to the U.S. Department
of
Health and
Human Services.
Customer Service can provide you with the appropriate
address upon request.
Our Legal Duty
We are required by law to protect the privacy of
your information, provide this notice about our
information practices, and
follow the information practices that are described
in this notice.
If you wish
to inspect your records, receive a listing of
disclosures, or correct or add to the information in your record,
or if you have
any questions,
complaints, or concerns, please contact our office.
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