Privacy Policy

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED

We are required by law to maintain the privacy of protected health information and to provide you with this notice of our legal duties and privacy practices with respect to protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services or payment of health care services.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION WITHOUT YOUR AUTHORIZATION

To Contact You: We may use your protected health information to contact you to remind you about appointments, inform you about treatment options, or advise you about other health-related benefits and services.

Treatment: We may use and disclose your protected health information to provide, coordinate or manage your health care and any related services. This includes coordinating your health care with a third party, consulting with another health care provider, or referring you to another health care provider. We may also share your health information with other providers.

Payment: We may use and disclose your protected health information to obtain or provide payment for your dental services. This may include sharing information with the person or entity responsible for paying, such as your health insurer. Your insurance company or health plan may need your information for activities such as determining eligibility or coverage for insurance benefits and reviewing services provided to you.

Operations: We may use or disclose your protected health information for our health care operations, such as to support our business activities and to ensure that quality dental care is provided. Some of these activities involve quality assessments, peer or employee review, training health care professionals, licensing and accreditation activities, data aggregation, compliance- or audit-related activities, and business planning and development. We may also disclose your protected health information to another provider, health plan, or health care clearinghouse that has or has had a relationship with you for certain of its health care operations.

Business Associates: We may disclose your protected health information to third parties that perform services, such as billing or legal services. We have written contracts with third parties requiring them to protect the privacy of your protected health information.

Treatment Alternatives and Health-Related Products and Services: We may use or disclose your protected health information to provide you with information about certain products or services including to describe our participation in a dentist network or health plan network, products or services we provide or include in a plan of benefits, and alternative treatments, therapies, dentists or settings of care.

Family and Friends: We may disclose your protected health information to individuals, such as family and friends, who are involved in your care or who help pay for your care. We may do this if you tell us we can do so, or if you know we are sharing your information with these people and you do not object. If you are unavailable or unable to tell us your preference, we may also disclose your information if, based on our professional judgment, we believe that disclosing the information is in your best interest and you would not object. If you are a minor, you also may have the right to block parental access to your health information in certain circumstances, if permitted by state law.

OTHER USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION WITHOUT AUTHORIZATION

We may use or disclose your protected health information without your authorization in certain other circumstances, such as when required by law or for public health and safety purposes. We will comply with the legal requirements and limitations applicable to these circumstances.

As Required by Law: We may use or disclose your protected health information when and as required by federal, state or local law.

Public Health Activities: We may disclose your protected health information to a public health authority for public health activities such as to prevent or control disease, injury or disability; to respond to or report suspected abuse or neglect, non-accidental physical injuries, reactions to medications, or problems with products; and to comply with medication or product recalls.

Health Oversight Activities: We may disclose your protected health information to health oversight agencies, such as government agencies that oversee the health care system, government programs, or compliance with civil rights laws, for oversight activities such as audits, investigations, inspections and licensing.

Lawsuits and Disputes: We may use or disclose your protected health information in response to a court or administrative order in an administrative or judicial proceeding, or in response to a subpoena, discovery request or other legal process.

Law Enforcement: We may use or disclose your protected health information for law enforcement purposes, so as to respond to legal processes, identify or locate a suspect, provide information about crime victims, report crimes occurring on our premises, and report suspected crimes in a medical emergency.

Coroners, Medical Examiners and Funeral Directors: We may disclose your protected health information to a coroner or medical examiner to identify a deceased person or determine the cause of death or for other lawful activities, or to a funeral director, as necessary to allow him/her to carry out his/her activities.

Organ and Tissue Donation: If you are an organ or tissue donor, we may disclose your protected health information to organizations that handle organ procurement or organ, eye or tissue donation or transplantation.

Research: We may use and disclose your protected health information in preparation for research or for research if and as approved by an institutional review board or privacy board.

Serious Threat to Health or Safety; Disaster Relief: We may disclose your protected health information to appropriate individuals or organization when and as necessary to prevent a serious threat to the health and safety of a person (including yourself) or of the public. We may also disclose your protected health information to identify, locate or notify your family members or persons responsible for you in a disaster.

Military and Veterans: We may disclose your protected health information as required by military command or another government authority if you are a member of the armed forces.

National Security; Intelligence Activities; Protective Service: We may disclose your protected health information to federal officials for intelligence, counterintelligence and other national security activities authorized by law, including activities related to the protection of the President, other authorized persons or foreign heads of state, or related to the conduct of special investigations.

Workers’ Compensation: We may disclose your protected health information for workers’ compensation or similar work-related injury programs, to the extent permitted or required by law.

Inmates: We may disclose your protected health information to a correctional institution (if you are an inmate) or a law enforcement official (if you are in that official’s custody) as necessary (i) for the institution to provide you with health care; (ii) to protect your or others’ health and safety; or (iii) for the safety and security of the correctional institution.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION WITH YOUR AUTHORIZATION

All uses and disclosures of your protected health information not covered by this Notice will be made only with your written authorization. You may revoke any authorization, at any time, by notifying, in writing, our office.

YOUR RIGHTS WITH RESPECT TO PROTECTED HEALTH INFORMATION

You have the following rights with respect to your protected health information. You may exercise these rights by submitting a written request to our office. Please contact our office with any questions about these rights.

Right to Inspect and Copy. You may inspect and obtain a copy of your protected health information maintained in your dental chart, including clinical and billing records and any other records that we use to make decisions about you. We may charge you a fee to cover costs of copying, mailing and associated supplies.

We may refuse to allow you to inspect or copy certain records, such as information compiled for legal actions and proceedings. If we deny your request, you may have a right to have this decision reviewed.