This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.We are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information. We must follow the privacy practices that are described in this notice while it is in effect. This notice will remain in effect until we replace it.We reserve the right to change our privacy practices and terms of this notice at any time, provided that such changes are permitted by applicable law, and to make new notice provisions effective for all protected health information that we maintain. When we make a significant change in our privacy practices, we will change this notice and provide copies of the new notice upon request. You may request a copy of our notice at any time.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
We may use and disclose your health information for different purposes, including treatment, payment, and health care operations. Some information, such as HIV-related information, genetic information, alcohol and/or substance abuse records, and mental health records may be entitled to special confidentiality protections under applicable state or federal law. We will abide by these special protections as they pertain to applicable cases involving these types of records.
TREATMENT: We may use and disclose your health information for your treatment. For example, we may disclose your health information to a specialist providing treatment to you.
PAYMENT: We may use and disclose your health information to obtain reimbursement for treatment and services you receive from us or another entity involved with your care. Payment activities include billing, collections, claims management, and determinations of eligibility and coverage to obtain payment from you, an insurance company, or another third party. For example, we may send claims to your dental health plan containing certain health information.
HEALTHCARE OPERATIONS: We may use and disclose your health information in connection with our healthcare operations. For example, healthcare operations include quality assessment and improvement activities, conducting training programs, and licensing activities.
INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE: We may disclose your health information to your family or any other individual identified by you when they are involved in your care or in the payment for your care. Additionally, we may disclose information about you to a patient representative. If a person has the authority by law to make health care decisions for you, we will treat that patient representative the same way we would treat you with respect to your health information.
DISASTER RELIEF: We may use or disclose your health information to assist in disaster relief efforts.
REQUIRED BY LAW: We may use of disclose your health information when we are required to do so by law. We may disclose your personal health information for law enforcement purposes as permitted by HIPAA, as required by law, or in response to a subpoena, court order, discovery request, or other lawful process.
PUBLIC HEALTH ACTIVITIES: We may disclose your health information for public health activities, including disclosures to: prevent or control disease; injury or disability; report child abuse or neglect; report reactions to medications or problems with products or devices; notify a person of a recall, repair, or replacement of products or devices; notify a person who may have been exposed to a disease or condition; or notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.
NATIONAL SECURITY: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institutions or law enforcement officials having lawful custody the protected information of an inmate or patient.
WORKER’S COMPENSATION: We may disclose your personal health information to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.
RESEARCH: We may disclose your personal health information to researchers when their research has been approved by an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your information.
CORONERS and MEDICAL EXAMINERS: We may release your personal health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death.
APPOINTMENT REMINDERS: We may use of disclose your health information to provide you with appointment reminders (such as voicemail messages, postcards, or letters).
BUSINESS ASSOCIATES: Some services in our organization are provided through contacts with business associates. Examples include but may not be limited to practice management software representatives, computer information technology support, and check cashing/banking. When these services are necessary for healthcare operations, your private health information may be disclosed only to the extent necessary for them to perform the job we have asked them to do. All of our business associates are required to safeguard your information and follow HIPPA Privacy Rules.
YOUR HEALTH INFORMATION RIGHTS: You have the right to request additional restrictions on our use or disclosure of your personal health information by submitting a written request to our office. We may not be required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency). You will receive notifications of breaches of your unsecured protected health information as required by law. You may also request a list of disclosures of your dental health information which will not include disclosures to third-party payors. For help with your health information rights, please contact one of our staff members during business hours.
QUESTIONS OR COMPLAINTS: We support your right to the privacy of your health information. If you want more information about our privacy practices or if you have questions or concerns, please contact us.