How your HEALTH INFORMATION may be used
To Provide Treatment
We will use your HEALTH INFORMATION within our office to provide you
with the best dental care possible. This may include administrative
and clinical office procedures designed to optimize scheduling and coordination
of care between hygienist, dental assistant, dentist, and business office
staff. In addition, we may share your health information with pharmacies
or other health care personnel providing your treatment.
To Obtain Payment
We may include your health information with an invoice used to collect
payment for treatment you receive in our office. We may do this with
insurance forms filed for you in the mail or sent electronically. We
will be sure to only work with companies with a similar commitment to
the security of your health information.To Conduct Health Care Operations
Your health information may be used during performance evaluations of
our staff. Some of our best teaching opportunities use clinical situations
experienced by patients receiving care at our office. As a result, health
information may be included in training programs for students, interns,
associates, and business and clinical employees. It is also possible
that health information will be disclosed during audits by insurance
companies or government appointed agencies as part of their quality
assurance and compliance reviews. Your health information may be reviewed
during the routine processes of certification, licensing or credentialing
activities.
In Patient Reminders
Because we believe regular care is very important to your oral and general
health, we will remind you of a scheduled appointment or that it is
time for you to contact us and make an appointment. Additionally, we
may contact you to follow up on your care and inform you of treatment
options or services that may be of interest to you or your family.
These communications are an important part of our philosophy of partnering
with our patients to be sure they receive the best preventive and restorative
care modern dentistry can provide. They may include postcards, folding
postcards, letters, [unless you tell us that you do not want to receive
these reminders].
Abuse or Neglect
We will notify government authorities if we believe a patient is the
victim of abuse, neglect or domestic violence. We will make the disclosure
only when we believe we are compelled by our ethical judgment, when
we believe we are specifically required or authorized by law or with
the patient’s agreement.
Public Health and National Security
We may be required to disclose to Federal officials or military authorities
health information necessary to complete an investigation related to
public health or national security. Health information could be important
when the government believes that the public safety could benefit when
the information could lead to the control or prevention of an epidemic
or the understanding of new side effect of a drug treatment or medical
device.
For Law Enforcement
As permitted or required by State or Federal law, we may disclose your
health information to a law, we may disclose your health information
to a law enforcement official for certain law enforcement purposes,
including, under certain limited circumstances, if you are a victim
of a crime or in order to report a crime.
Family, Friends and Caregivers
We may share your health information with those you tell us will be
helping you with your home hygiene, treatment, medications, or payment.
We will be sure to ask your permission first. In the case of an emergency,
where you are unable to tell us what you want we will use our very best
judgment when sharing your health information only when it will be important
to those participating in providing your care.
Authorization to Use or Disclose Health Information
Other than is stated above or where Federal, State or Local law requires
us, we will not disclose your health information other than with your
written authorization. You may revoke that authorization in writing
at any time.
Patient Rights
This new law is careful to describe that you have the following rights
related to your health information.
Restrictions
You have the right to request restrictions on certain uses and disclosures
of your health information. Our office will make every effort to honor
reasonable restriction preferences from our patients.
Confidential Communications
You have the right to request that we communicate with you in a certain
way. You may request that we only communicate your health information
privately with no other family members present or through mailed communications
that are sealed. We will make every effort to honor your reasonable
request for confidential communication.
Inspect and Copy Your Health Information
You have the right to read, review, and copy your health information,
including your complete chart, x-rays and billing records. If you would
like a copy of your health information, please let us know. We may need
to charge you a reasonable fee to duplicate and assemble your copy.
Amend Your Health Information
You have the right to ask us to update or modify your records if you
believe your health information records are incorrect or incomplete.
We will be happy to accommodate you as long as our office maintains
this information. In order to standardize our process, please provide
us with your request in writing and describe your reason for the change.
Your request may be denied if the health information record in question
was not created by our office, is not part of our records or if the
records containing your health information ore determined to be accurate
and complete.
Documentation of Health Information
You have the right to ask us for a description of how and where your
health information was used by our office for any reason other than
for treatment, payment or health operation. Our documentation procedures
will enable us to provide information or health information usage from
April 14, 2003 and forward. Please let us know in writing the time period
for which you are interested. Thank you for limiting your request to
no more than six years at a time. We may need to charge you a reasonable
fee for your request.
Request a Paper Copy of this Notice
You have the right to obtain a copy of this Notice of Privacy Practices
directly from our office at any time. Stop by or give us a call and
we will mail, or email a copy to you.
We are required by law to maintain the privacy of your health information
and to provide to you and your representative this Notice of our Privacy
Practices. We are required to practice the policies and procedures described
in this notice but we do reserve the right to change the terms of our
Notice. If we change our privacy practices we will be sure all of our
patients receive a copy of the revised Notice.
You have the right to express complains to us or to the Secretary of
Health and Human Services if you believe your privacy rights have been
compromised. We encourage you to express any concerns you may have regarding
the privacy of your information. Please let us know of your concerns
or complaints in writing.
Protection Your Confidential Health Information is Important
to Us
Notice of Privacy Practices
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.
Our Promise.
Dear Patient:
This is not meant to alarm you. Quite the opposite. It is our desire
to communicate to you that we are taking the new Federal [HIPAA-Health
Insurance Portability and Accountability Act] laws written to protect
the confidentiality of your health information seriously. We do not
ever want you to delay treatment because you are afraid your personal
health history might be unnecessarily made available to others outside
of our office.
So what has changed?
Why a privacy policy now?
Very good questions.
The most significant variable that has motivated the Federal government
to legally enforce the importance of the privacy of health information
is the rapid evolution of computer technology and its use in healthcare.
The government has appropriately sought to standardize and protect the
privacy of the electronic exchange of your health information. This
has challenged us to review not only how your health information is
used within our computers but also with the Internet, phone, faxes,
copy machines, and charts. We believe this has been an important exercise
for us because it has disciplined us to put in writing the policies
and procedures we use to ensure the protection of your health information
everywhere it is used.
We want you to know about these policies and procedures which we developed
to make sure your health information will not be shared with anyone
who does not require it. Our office is subject to State and Federal
law regarding the confidentiality of your health information and in
keeping with these laws, we want you to understand our procedures and
your rights as our valuable patient.
We will use and communicate your HEALTH INFORMATION only for the purposes
of providing your treatment, obtaining payment and conducting health
care operations. Your health information will not be used for other
purposes unless we have asked for and been voluntarily given your written
permission.