HIPAA Privacy Policy

Privacy Practices Notice

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.

This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

Uses and Disclosures of Protected Health Information

Your protected health information may be used and disclosed by your physician, our office staff, and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, paying your health care bills, supporting the operation of the physician’s practice, and any other use required by law.

Treatment

We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the dentist has the necessary information to diagnose or treat you.

Payment

Your protected health information will be used, as needed, to obtain payment for your health care services. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission.

Healthcare Operations

We may use or disclose, as-needed, your protected health information in order to support the business activities of your dentist’s practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of dental students, licensing, and conducting or arranging for other business activities. For example, we may disclose your protected health information to dental school students that see patients at our office. In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your dentist. We may also call you by name in the waiting room when your dentist is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment.

Required Disclosures Without Authorization

We may use or disclose your protected health information in situations without your explicit consent, including when required by law, for public health reasons, or to law enforcement agencies as required by law. These situations include but are not limited to:

• Required by law
• Public health issues as required by law
• Communicable disease reporting
• Health oversight activities
• Abuse or neglect reporting
• Food and drug administration requirements
• Legal proceedings and law enforcement
• Coroners, funeral directors, and organ donation
• Research activities
• Criminal activity, military activity, and national security
• Workers’ compensation
• Inmates

Your Rights

Following is a statement of your rights with respect to your protected health information:

• You have the right to inspect and copy your protected health information.
• You have the right to request a restriction of your protected health information.
• You have the right to request confidential communications from us by alternative means or at an alternative location.
• You have the right to obtain a paper copy of this notice from us upon request, even if you have agreed to accept this notice electronically.
• You may request to have your dentist amend your protected health information.
• You have the right to receive an accounting of certain disclosures of your protected health information.

Complaints

You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact of your complaint. We will not retaliate against you for filing a complaint.

Contact Information

If you have questions or concerns about this privacy policy, please contact Graham Park Dental:

Effective Date

This notice was published and becomes effective on or before February 17, 2025.