Notice of Privacy Practices and Office Privacy Policy

Our Commitment to Your Privacy

We protect your personal and health information. Your dental record contains information about your health history, diagnosis, and treatment. Federal and Pennsylvania law require us to keep this information private, to give you this notice, and to follow it.

How We Use and Share Your Health Information

• Treatment. We use your information to provide, coordinate, and manage your dental care, and we may share it with other healthcare providers involved in your care. For example, we may send your X-rays to a specialist we refer you to, or speak with your physician about a medication you take.
• Payment. We use and share your information to bill and collect payment from you, your insurance company, or another party responsible for your bill. For example, we may send a claim listing your treatment to your dental plan.
• Healthcare Operations. We use your information to run our office, review the quality of our care, and train staff. For example, we may review charts to make sure our records are complete and accurate.
• Appointment Reminders. We may contact you by phone, text, or email about appointments and your care. Tell us if you prefer a different method.

We may also use or share your information when the law requires or permits it, including:

• When required by federal, state, or local law.
• To public health authorities to prevent or control disease or to report problems with medications or products.
• To report suspected abuse or neglect as Pennsylvania law requires.
• To prevent a serious and imminent threat to someone's health or safety.
• To health oversight agencies, including the Pennsylvania State Board of Dentistry, for audits, investigations, and licensing.
• In response to a court order, or a subpoena or other lawful process when the law permits.
• To law enforcement in the limited circumstances the law allows.
• To coroners, medical examiners, and funeral directors, and for organ and tissue donation.
• For workers' compensation claims.
• For specialized government functions such as military and national security purposes.

Information With Special Protection

Some information, such as HIV-related information, genetic information, mental health records, and alcohol or substance use disorder treatment records, has additional confidentiality protection under federal or Pennsylvania law. When a stricter law applies to your information, we follow the stricter law.

Substance Use Disorder Treatment Records (42 CFR Part 2)

Records from a federally assisted substance use disorder treatment program ("Part 2 records") have special federal protection. We are not a treatment program, but we may receive these records, for example when you share treatment history on your health history form or when another provider sends records to coordinate your care.

If you give a general consent allowing your Part 2 records to be used for treatment, payment, and healthcare operations, we may use and share those records for those purposes the same way we handle your other health information under this notice, until you revoke that consent in writing.

If we receive your Part 2 records under a consent for a specific purpose, we will use and share them only as that consent allows.

We will never use or disclose your Part 2 records, or testimony describing what they contain, in any civil, criminal, administrative, or legislative proceeding by any federal, state, or local authority against you, unless you give written consent or a court orders it after you, or the holder of the record, have been given notice and an opportunity to be heard. A court order authorizing use or disclosure must also be accompanied by a subpoena or other legal requirement compelling disclosure before the records are used or disclosed.

Uses That Require Your Written Authorization

We do not sell your health information, and we do not use it for marketing or fundraising. These uses, the sharing of psychotherapy notes, and any other use not described in this notice require your written authorization. You can revoke an authorization in writing at any time, except to the extent we have already acted on it.

Your Rights

• Get a copy of your record. You can ask to see or get a paper or electronic copy of your dental record. We will respond within 30 days and may charge a reasonable, cost-based fee.
• Ask us to correct your record. If you believe information in your record is wrong or incomplete, you can ask us in writing to correct it. We may say no, but we will explain why in writing within 60 days.
• Ask for confidential communications. You can ask us to contact you in a specific way or at a different address, for example sending bills somewhere other than your home. We will agree to all reasonable requests.
• Ask us to limit what we use or share. You can ask us not to use or share certain information for treatment, payment, or operations. We are not required to agree if it would affect your care. If you pay for a service in full out of pocket, you can ask us not to share information about that service with your health plan, and we will agree unless the law requires us to share it.
• Get a list of disclosures. You can ask for an accounting of certain disclosures we made in the six years before your request. This list does not include disclosures for treatment, payment, or healthcare operations, or disclosures you asked us to make. One list per year is free; we may charge a reasonable fee for additional requests within 12 months.
• Get a copy of this notice. You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. If someone holds your healthcare power of attorney or is your legal guardian, that person can exercise your rights. We will confirm their authority before acting.

To use any of these rights, contact our Privacy Officer below.

Our Legal Duties

We are required by law to maintain the privacy and security of your health information, provide you with this notice of our legal duties and privacy practices, follow the terms of the notice currently in effect, and notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

Office Policy on Confidentiality

We will not share your information with friends, family members, or others without your permission, except when required by law or necessary for your care. Conversations about your treatment may be overheard only as part of the normal course of providing care in an open clinical environment, but staff are trained to minimize this as much as possible.

Changes to This Notice

We may change this notice, and changes will apply to all information we have about you. The current version will be posted in our office and on our website, and a copy is available on request.

Questions or Complaints