Notice of Privacy Practices

1. How We May Use and Disclose Your PHI

We may use and disclose your PHI for the following purposes without requiring your written authorization:

• Treatment: To provide, coordinate, or manage your dental care, including referrals to specialists and consultations.
• Payment: To obtain payment for services rendered, including billing your insurance company, processing claims, and collecting payment.
• Health Care Operations: To evaluate and improve the quality of care we provide, train staff, conduct audits, and perform business planning.

2. Other Uses and Disclosures

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

• As required by law, including public health and oversight activities
• To avert a serious threat to health or safety
• For judicial and administrative proceedings as permitted by law
• For law enforcement purposes as authorized by law
• To notify family members or others involved in your care, as allowed by law
• For workers’ compensation purposes, as required by law

Any other use or disclosure of your PHI will be made only with your written authorization, which you may revoke at any time in writing.

3. Your Rights Regarding Your PHI

You have the following rights:

• Right to inspect and copy: You may request to inspect and obtain a copy of your dental records, subject to limited exceptions.
• Right to amend: You may request that we amend your PHI if you believe it is incorrect or incomplete.
• Right to an accounting of disclosures: You may request a list of certain disclosures of your PHI made in the past six years.
• Right to request restrictions: You may request that we limit how we use or disclose your PHI. We are not required to agree, but if we do, we will honor the restriction.
• Right to confidential communications: You may request that we communicate with you by alternative means or at alternative locations.
• Right to a paper copy: You may request a paper copy of this Notice at any time.

4. Our Duties

We are required by law to: maintain the privacy of your PHI; provide you with this Notice; follow the terms of this Notice as long as it is in effect; notify you following a breach of your unsecured PHI; and abide by the duties and privacy practices described in this Notice.

5. Changes to This Notice

We reserve the right to change the terms of this Notice at any time. The revised Notice will apply to all PHI we already maintain as well as any information we receive in the future. The effective date will be posted at the top of this page.

6. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

7. Contact Information