THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We are required by applicable federal and state law to maintain the privacy of your health information. We understand that medical information about you and your health is personal information and we are committed to protecting your health information.
We use and disclose health information about you for treatment, payment, and health care operations. For example:
Treatment: We may use or disclose your health information to a dentist, physician, or other healthcare provider providing treatment to you.
Payment: We may use and disclose your health information to obtain payment for services we provide to you.
Healthcare Operations: We may use and disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing, or credentialing activities.
You have the right to look at or get copies of your health information. You have the right to receive a list of instances in which we or our business associates disclosed your health information for purposes, other than treatment, payment, healthcare operations. You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency). You have the right to request that we communicate with you about your health information by alternative means or to alternative locations. You must make your request in writing.
If you are concerned that we have violated your privacy rights, or you disagree with a decision we have made about access to your records, you may contact the address listed below. You may also submit a written complaint to the U.S. Department of Health and Human Services. Customer Service can provide you with the appropriate address upon request.
Our Legal Duty
We are required by law to protect the privacy of your information and provide this notice about our information practices. If you wish to get a copy of your records, receive a listing of disclosures, or correct or add to the information in your record, or if you have any questions, complaints, or concerns, please contact our office.