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. The privacy of your health information is important to us.
This Notice of Privacy describes how we may use and disclose your protected health information(PHI) to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also descries your right to access and control your 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 condition and related health services.
Uses and Disclosures of Protected Health Information: Your protected health information may be used and disclosed by our organization, our office staff and others outside the office that are involved in your care and treatment for the purpose of providing health care services to you, pay your health care bills, to support the operation of the organization ,and any other use required by law.
Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or manangement of your health care with a. Third party. For example, we would disclose your protected health information, as necessary to a home health agency that provides care for you. For example, your protected health information my be provided to a physician who you have referred to ensure the physician has necessary information to diagnose or treat you.
Payment: Your protected health information will be used, as needed, to obtain payment for your dental care services. For example we may send claims to your dental health plan containing certain health information.
Appointment Reminders: We may use or disclose your health information in connection with our healthcare operations. For example heal care operations include quality assessment and improvement activities, reviewing the competence or qualifications of the healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing, or credentialing activities.
Disaster Relief: We may use or disclose your protected health information to assist in disaster relief efforts.
We may use or disclose your protected health information in the following situations without your authorization: As Required By Law, Public Health issues as required by law, Communicable diseases, Health Oversight, Abuse, Neglect, Legal Proceedings, Law Enforcement, Criminal Activity, Inmates, Military Activity, National Security, and Workers Compensation.
Required uses and disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500.
Other Permitted and Required Disclosures will be made only with your consent, authorization, or opportunity to object, unless required by law.
You may revoke this authorization, at any time in writing, except to the extent that your physician or this organization has taken an action in reliance on the use or disclosure indicated in the authorization.
Your Rights: Following is a statement of your rights and with respect to your protected health information.
You have the right to inspect and copy your protected health information: Under federal law, however you may not inspect or copy the following records; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information.
You have the right to request a restriction of your protected health information: This means you may ask us not to use or disclose any part of your protected health information for the purpose of treatment, payment, or healthcare operations. You may also request that any part of you protected health information not be disclosed to family members or friends who may be inked in your care for notification purposed as described in this Notice of privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply to.
Our organization is not required to agree to a restriction that you may request. If our organization believed it is in your best interest to permit use and disclosure of your protected health information, your protected information will not be restricted. You then have the right to use another Health Care Professional.
Complaints: You may complain to us or the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact of your complaint. We will not retaliate against you for filing a complaint.
We are required by law: to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protected health information, if you have any questions concerning or objections to this form, please ask to speak with out Office Manager Kourtney Conrad in person or by phone at (208) 733-9999.