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.
We are required by applicable federal and state law to maintain the privacy of your protected health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your protected health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect September 2012 and will remain in effect until we replace it.
We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all dental and health information that we maintain, including dental and health information we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and provide the new Notice at our practice location, and we will distribute it upon request.
You may request a copy of our Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this notice.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
We may use and disclose dental and health information for different purposes including treatment, payment and healthcare operations. Some information such as HIV, genetic, alcohol/substance abuse and mental health records may be entitled to special confidentiality protection under applicable state and/or federal law. We will abide by these special protections s they pertain to your records. We may use and disclose health information about you without authorization for the following purposes:
Treatment: We may use or disclose your dental or health information for your treatment. For example, we may disclose your health information to a physician or other healthcare provider providing treatment to you.
Payment: We may use and disclose your dental and health information to obtain payment to you for the services we provide to you. For example, we may send claims to your dental health plan containing certain dental and health information.
Healthcare Operations: We may use and disclose your health information in connection with our periodontal operations which may include quality assessment, improvement, and licensing activities.
Persons Involved In Care: We may use or disclose dental and health information to a family member, your personal representative, or another person identified by you when they are involved in your care or in the payment of your care, of your location, your general condition, or death. This person has the authority by law to make health care decisions for you. We will treat your representative the same way we would treat you with similar respect to health information and allowing a person to pick up periodontal records, radiographs, or other similar forms of dental and health information.
Disaster Relief: We may use your dental and health information to assist in disaster relief efforts.
Marketing Health-Related Services: We will not use your dental and health information for marketing communications.
Required by Law: We may use or disclose your dental and health information when we are required to do so by law in response to a subpoena or court order.
Public Health: We may use or disclose your health information to prevent or control disease, injury, or disability: notify the appropriate government authority if we believe you have been a victim of abuse, neglect, or domestic violence; and to report reactions to medications or problems with products and recall replacement products.
Health Oversight Activities: We may disclose your personal health information to an oversight agency for activities including audits, investigations, inspections, and credentialing as necessary for licensure and for the government to monitor the healthcare system, programs, and civil rights.
Judicial and Administrative Hearings: If you are involved in a lawsuit or dispute, we may disclose your personal health information in response to a court or administrative order or in response to subpoena, discovery request or other lawful process instituted by someone else involved a dispute but only if efforts have been made to contact you about the request or to obtain an order protecting the information requested.
Workers Compensation: We may disclose your personal health information to the