HIPAA Notice of Privacy Practices

01 How we may use and share your information

We use and share your health information mainly to provide, coordinate, and bill for your dental care. The categories below describe the main ways we’re permitted to do this without asking for your written authorization first.

Treatment

We may use your health information to provide dental treatment and services. We may share information about you with other dentists, specialists, hygienists, or staff involved in your care, including referrals to specialists such as oral surgeons or orthodontists.

Payment

We may use and share your health information to bill and collect payment from you, an insurer, or a third party. This can include sharing details about treatment you received so your dental plan will pay us or reimburse you.

Healthcare operations

We may use and share your information to run our practice, improve your care, and contact you when necessary. This includes quality assessment, staff training, licensing, and business management activities.

02Uses that require your written authorization

Other than the uses described above, we will not use or share your health information without your written authorization. This includes, for example, most uses of your information for marketing purposes, and disclosure of psychotherapy notes where applicable. If you provide us with authorization, you may revoke it in writing at any time, except to the extent we have already relied on it.

03Your rights regarding your information

You have the following rights with respect to your health information. To exercise any of these rights, contact our Privacy Officer using the details below.

04Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. You may revoke that permission, in writing, at any time.

05Filing a complaint

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

06Changes to this notice

We reserve the right to change this notice at any time. We reserve the right to make the revised notice effective for health information we already have about you, as well as any information we receive in the future. The current notice will always be posted on our website and available at our office.

07Contact our Privacy Officer

Questions about this notice, or requests related to your privacy rights, can be directed to: