HIPAA Notice of Privacy Practices

1. Overview

This Notice of Privacy Practices describes how medical information about you may be used and disclosed by our practice and how you can get access to this information.

Please review this notice carefully. We are required by law to:

• Maintain the privacy of Protected Health Information (PHI)
• Provide you with this notice of our legal duties and privacy practices
• Follow the terms of the notice currently in effect
• Notify you following a breach of unsecured PHI

2. How We May Use and Disclose Your Health Information

We will use and disclose your PHI only as permitted by law. The following categories describe the ways we may use and disclose your information.

2.1 Treatment

We will use and disclose your PHI to provide, coordinate, and manage your healthcare and related services. For example:

• Sharing information with your referring dentist about your surgery and post-operative care
• Consulting with specialists about your treatment plan
• Coordinating lab work, imaging, or pathology services
• Providing information to anesthesiologists for sedation procedures

2.2 Payment

We may use and disclose your PHI to obtain payment for services. For example:

• Submitting claims to your insurance company
• Verifying insurance coverage and benefits
• Obtaining pre-authorization for procedures
• Responding to insurance audits or requests for documentation

2.3 Healthcare Operations

We may use and disclose your PHI for healthcare operations, including:

• Quality improvement and patient safety activities
• Staff training and education
• Business planning and management
• Compliance and accreditation programs

2.4 Other Permitted Uses and Disclosures (Without Your Authorization)

We may use or disclose your PHI without your written authorization in the following situations:

• As required by law: When required by federal, state, or local law
• Public health activities: To prevent or control disease, injury, or disability
• Health oversight activities: For audits, investigations, inspections, or licensure
• Judicial and administrative proceedings: In response to court orders or subpoenas
• Law enforcement: When required by law enforcement officials
• Serious threats: To avert a serious threat to health or safety
• Workers' compensation: As authorized by workers' compensation laws
• Coroners and medical examiners: For identification or cause of death

2.5 Uses and Disclosures Requiring Your Authorization

We will obtain your written authorization for:

• Marketing purposes: Any marketing communications (we do not currently engage in marketing)
• Sale of PHI: Disclosure for remuneration (we do not sell PHI)
• Psychotherapy notes: If applicable
• Other uses: Any use or disclosure not described in this notice

You may revoke any authorization in writing at any time. However, we cannot take back disclosures already made with your authorization.

3. Your Rights Regarding Your Health Information

You have the following rights regarding your PHI:

3.1 Right to Access

You have the right to inspect and obtain a copy of your health records. Requests must be made in writing. We may charge a reasonable fee for copying and mailing costs.

3.2 Right to Amend

If you believe your health information is incorrect or incomplete, you may request an amendment. We may deny your request in certain situations, but we will provide you with a written explanation.

3.3 Right to an Accounting

You have the right to request an "accounting of disclosures" - a list of certain disclosures we have made of your PHI. This does not include disclosures for treatment, payment, or healthcare operations.

3.4 Right to Request Restrictions

You may request restrictions on how we use or disclose your PHI. We are not required to agree to your request except in specific situations involving payment to health plans.

3.5 Right to Confidential Communications

You have the right to request that we communicate with you about your health information in a specific way or at a specific location. We will accommodate reasonable requests.

3.6 Right to a Paper Copy of This Notice

You have the right to obtain a paper copy of this notice at any time, even if you have agreed to receive it electronically. Contact our office to request a copy.

4. Our Legal Duties and Responsibilities

We are required by law to:

• Maintain the privacy and security of your PHI
• Provide this notice of our privacy practices
• Follow the terms of the notice currently in effect
• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information

We will not:

• Use or disclose your information without authorization except as described in this notice
• Sell your PHI
• Use or disclose PHI for marketing purposes without your authorization
• Share your information with unauthorized parties

5. Changes to This Notice

We reserve the right to change this notice at any time and to make the revised notice effective for all PHI we maintain. If we make material changes, we will:

• Post the revised notice in our office
• Make copies available upon request
• Post the current notice on our website

6. Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

7. Contact Information

For questions about this notice, to exercise your rights, or to file a complaint, please contact: