HIPAA Notice of Privacy Practices
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.
Our Responsibilities
We are required by law to maintain the privacy of your protected health information (PHI) and to provide you with this notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this notice as long as it remains in effect. We reserve the right to change our privacy practices and to make the new provisions effective for all PHI we maintain. We will post the revised notice in our office and on this website.
How We May Use and Disclose Your Health Information
Treatment
We may use your health information to provide, coordinate, or manage your dental care and any related services. For example, we may share your PHI with a specialist to whom we refer you, or with your general dentist to coordinate your treatment plan.
Payment
We may use and disclose your health information to obtain payment for the services we provide. For example, we may send claims information to your dental insurance carrier to receive reimbursement for treatment.
Healthcare Operations
We may use and disclose your health information in connection with our healthcare operations, such as quality assurance, staff training, and business management activities.
Your Rights
You have the following rights with respect to your protected health information:
- Right to inspect and copy — You may request to review and obtain a copy of your health records.
- Right to request correction — You may request that we correct health information about you that you believe is incorrect or incomplete.
- Right to an accounting of disclosures — You may request a list of certain disclosures we have made of your health information.
- Right to request restrictions — You may request restrictions on how we use or disclose your health information for treatment, payment, or operations.
- Right to confidential communications — You may request that we communicate with you about your health information in a specific way or at a specific location.
- Right to a paper copy of this notice — You may request a paper copy of this notice at any time.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
Contact Our Privacy Officer
For questions, concerns, or to exercise your rights, please contact us at:
Oral Plastic Surgery850 Prospect St, Suite 7
La Jolla, CA 92037
(858) 459-7374
info@oralplasticsurgery.com