HIPAA & Privacy Practice Notice

OUR LEGAL DUTY

We are required by law to maintain the privacy of protected health information, to provide notice of our legal duties and privacy practices with respect to protected health information and to notify you following a breach of unsecured protected health information. We are required to follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect 04-01-2023 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, and to make new Notice provisions effective for all protected health information that we maintain. When we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request.

For more information about our privacy practices please contact us using the information listed at the end of this Notice.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

We may use and disclose your health information for different purposes, including treatment, payment and health care operations. Some information may be entitled to special confidentiality protections under applicable state or federal law. For each of these categories, we have provided a description and an example:

• Treatment: We may use and disclose your health information to provide you with medical treatment. We may use and disclose your health information to another dentist, physician or other health care provider involved in your care and treatment.
• Payment: We may use and disclose your health information to obtain payment for services we provided to you.
• Healthcare Operations: We may use and disclose your health information in connection with our healthcare operations.
• Your Authorization: You may give us written authorization to use your health information or to disclose it to anyone for any purpose. You may revoke it in writing at any time. We cannot use or disclose your health information for any reason except those described in this Notice.
• To Your Family and Friends: You have the right to request restrictions on disclosures to family members, other relatives, close personal friends, or any other person identified by you.
• Unsecured Email: We will send you unsecured emails pertaining to your health information without your prior authorization. If you do authorize communications via unsecured email, you have the right to revoke the authorization at any time.
• Individuals Involved in Your Care or Payment for Your Care: We may disclose your health information to your family, friends, any other individual identified by you as a patient representative when they are involved in your care or in the payment for your care. If a person has the authority by law to make health care decisions for you, we will treat that patient representative the same way we would treat you with respect to your health information
• Disaster Relief: We may use or disclose your health information to assist in disaster relief efforts.
• Required by Law: We may use or disclose your health information when we are required to do so by law.
• Marketing Health-Related Services: We will not use or disclose your information for marketing purposes without your written authorization. We may contact you about products or services related to your treatment.
• Change of Ownership: If this dental practice is sold or merged with another practice or organization your health records will become the property of the new owner. You may request that copies of your health information be transferred to another dental practice.
• Public Health Activities: We may, and are sometimes legally obligated to, disclose your health information to public health agencies for purposes related to preventing and controlling disease, injury or disability; reporting abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.
• National Security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to federal officials health information required for lawful intelligence, counterintelligence and other national security activities.
• Secretary of HHS: We will disclose your health information to the Secretary of the U.S. Department of Health and Human Services when required to investigate or determine compliance with HIPAA.
• Worker’s Compensation: We may disclose your PHI to the extent necessary to comply with state law in cases involving only claims relating to worker’s compensation or other programs described by law.
• Health Oversight Activities: We may disclose your PHI on oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and credentialing, as necessary for licensure and for the government to monitor the health care system, government
• programs.
• Judicial and Administrative Proceedings: If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order, a subpoena, discovery request, or other lawful process instituted by someone else involved in the dispute.
• Coroners, Medical Examiners, and Funeral Directors: We may release your PHI to a coroner or medical examiner.
• Change of Ownership: If this dental practice is sold or merged with another practice or organization your health records will become the property of the new owner. You may request that copies of your health information be transferred to another dental practice.
• Appointment Reminders: We may contact you to provide you with appointment reminders via voicemail, postcards, email or letters. Announcements: Upon arriving at our offices, we may use and disclose medical information by announcing your name when we are ready to see you.

PATIENT RIGHTS

You have the following rights with respect to your health information:

• Access: You have the right to look at or get copies. Requests must be in writing.
• Disclosure Accounting: You may request an accounting of disclosures.
• Right to Request a Restriction: You may ask us not to use or disclose for treatment, payment, or operations.
• Alternative Communication: You may request we contact you in a specific way.
• Amendment: You may request amendments to your records.
• Right to Notification of a Breach: You will receive notifications of breaches of your unsecured protected health information as required by law.
• Electronic Notice: You may request a paper copy of this Notice.

Questions and Complaints

If you are concerned that we may have violated your privacy rights, or if you disagree with a decision we made about access to your health information or in response to a request you made to amend or restrict the use or disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may complain to us using the contact information listed at the end of this Notice. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request. We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.

Our Privacy Official: Andrea C., Privacy Official, Office Manager
Telephone: (760) 940-0366
Fax: (760) 940-2023
Address: 1235 West Vista Way, Suite E, Vista, CA 92083
E-mail: [email protected]