We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effecton March 1, 2011 and will remain in effect until we replace it.
Treatment: We may disclose your health information to a physician or other healthcare provider providing treatment to you.
To You and Your Family and Friends: We must disclose your health information to you, as described in the Patient Rights section of this Notice. We may disclose your health information to a family member, friend or other person to the extent necessary to help with your healthcare or with payment for your healthcare, but only if you agree that we may do so.
Public Health: We may disclose your health information to public health officials. We may disclose your health information to a health oversight agency such as the United States Department of Health and Human Services or state department of health or government benefit programs such as Medicare or Medicaid for purposes relating to oversight of the health care system.
Workers’ Compensation: We may disclose your health information as authorized by, and in compliance with, laws relating to workers’ compensation and similar programs established by law that provide benefits for work-related illnesses and injuries without regard to fault.
National Security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities.
Law Enforcement and Judicial Processes: We may disclose to a correctional institution or law enforcement official having lawful custody of an inmate or patient under certain circumstances. We may disclose your health information to law enforcement officials for law enforcement purposes. We may disclose your health information in the course of a judicial or administrative proceeding in response to a court order, subpoena, discovery request or other lawful process. We may disclose your health information to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death, or other purposes as authorized by law. We may also disclose your PHI to funeral directors as necessary to carry out their duties. We may disclose your health information to organizations involved in the procurement, banking, or transplantation of cadaveric organs, eyes or tissue, for the purpose of facilitating organ and tissue donation where applicable.
Research: We may disclose your health information for the purpose of research. We will only disclose your health information for research purposes without your express authorization if the research protocol has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
Business Associates: We may disclose your health information to business associates who provide activities on behalf of Dental Dreams. Examples of when we may use a business associate include consulting and quality assurance activities provided by an outside consultant, billing and coding audits performed by an outside auditor, and other legal and consulting services provided in response to billing and reimbursement issues which may arise from time to time. If we provide your health information in such a manner, we will require our business associate to appropriately safeguard your information.
Psychotherapy Notes: We must obtain an authorization from you to use or disclose psychotherapy notes unless it is for treatment, payment or health care operations or is required by law, permitted by health oversight activities, to a coroner or medical examiner, or to prevent a serious threat to health or safety.
Marketing: We must obtain an authorization for any use or disclosure of your PHI for any marketing communications to you about a product or service that encourages you to use or purchase the product or service unless the communication is either (a) a face-to-face communication or; (b) a promotional gift of nominal value. However, we do not need to obtain an authorization from you to provide refill reminders, information regarding your course of treatment, case management or care coordination, to describe a health-related products or services that we provide, or to contact you in regard to treatment alternatives. We must notify you if the marketing involves financial remuneration.
Access: You have the right to look at or get copies of your health information, with limited exceptions. You may request that we provide copies in a format other than photocopies. We will use the format you request unless we cannot practicably do so. You may request and receive an electronic copy of your health information if we maintain your information in an electronic health record. You must make a request in writing to obtain access to your health information. You may obtain a form to request access to or a copy of your health information from the receptionist. We may charge you a reasonable cost-based fee for expenses such as copies and staff time. If you request an alternative format, we may charge a cost-based fee for providing your health information in that format. If you prefer, we will prepare a summary or an explanation of your health information for a fee.
Disclosure Accounting: 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 and certain other activities for the last 6 years. However, if you request an accounting of disclosures of your health information, the accounting may include disclosures made for the purpose of treatment, payment and health care operations to the extent that disclosures are made through an electronic health record. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.
Restriction: 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 unless you pay for a service entirely out-of-pocket. If you pay for services out-of-pocket, you may request that information regarding the service be withheld and not provided to a health coverage carrier. If we do agree to additional restrictions, we will abide by our agreement (except in an emergency).
Electronic Notice: You may agree to receive this Notice by electronic mail (e-mail). However you are entitled to receive a paper copy of this Notice in written form.