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 seeks 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.
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.
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.
Visitors are allowed to browse our site without entering any personal information or having any personal information recorded. The option to enter your name, e-mail address, phone number or any other personal information on our online form is voluntary to help us communicate with you. Enter this information only if you would like additional information about our practice or you are interested in scheduling an appointment. The information entered will be used by our practice solely to track and follow up with your requests and will NOT be sold to any third party. If you would like to opt-out of further communication with our office after being contacted by e-mail or phone, simply let us know, and we will comply immediately.
Our website contains links to other websites. We are not responsible for the content or privacy practices of those web sites.
This website uses standard analytics and tracking practices, including cookies and tracking pixels, from third parties to operate, monitor and improve the website and to provide additional advertising to you about our practice. The cookies and tracking practices that our third party partners use may include your IP address, website activity and other identifiers to match the cookies with this site. We and our third party partners may use these cookies to show you targeted ads for our practice on other websites. If you would like to opt out of these targeted ads, please visit optout.networkadvertising.org. No personally identifying information is collected except what you may choose to send to the practice through the contact form(s) on this site. For more information about the self-regulatory program for digital advertising, please visit youradchoices.com.