- Mon - Thu: 8am - 4pm
- #####Fri: 8am - 2pm
Patient privacy is important to the doctors and staff at our practice. We are required by law to maintain the privacy of Protected Health Information (PHI) and to provide individuals with notice of our legal duties and privacy policies with respect to PHI. PHI is information that identifies you and relates to your past, present, or future physical or mental health or condition and related health care services. This Notice of Privacy Practices (Notice) explains how we may use and disclose PHI to provide treatment, payment or health care operations and for other purposes permitted or required by law. Also, this Notice describes your rights with respect to PHI about you.
Our office is obligated to follow the terms of this Notice. We will not use or disclose PHI about you without your written authorization, except as described in this Notice. We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain. The most up to date version of this notice will be available on our website, petitesmilesdentistry.com, at all times.
You have the following rights pertaining to your PHI:
Obtain a paper copy of the Notice upon request. You may request a paper copy of this Notice, or any revised Notice at any time.
Request a restriction on certain uses and disclosures of PHI. You have the right to request additional restriction on our use or disclosure of PHI about you by sending a written request to our Privacy Officer. We are not required to agree to those restrictions.
Inspect and obtain a copy of your PHI. You have the right to see a copy of PHI about you contained in a designated record set for as long as our office maintains the PHI. The designated record set may include billing, charting, and x-rays. We may charge a reasonable fee for copying and mailing such records.
The following describes how we use your PHI:
We may use and disclose PHI about you to coordinate or manage your health care services.
Example: Should a prescription be needed to treat a patient in the office, your PHI may be disclosed to a pharmacist.
We may give PHI about you to others to bill and collect payment for treatment provided to you.
Example: Your PHI will be used in billing your insurance company for treatment rendered in our office
We may use and disclose PHI in performing business activities.
Example: We routinely conduct in-office chart audits to ensure correctness of billing, We are also likely to disclose PHI for the purposes without a written consent.
We contract other companies to perform services in our office. These companies may have access to PHI in assisting us. In order to protect your PHI, we require all business associates to appropriately safeguard the information.
Example: We contract an outside company to provide us with technical support on our computer system. In assisting us with maintaining our systems, this company has access to PHI.
We must disclose PHI about you when required to do so by law.
Any other uses and disclosures will be made only with your written authorization.
Please send us an email at [email protected] with the sublect line: Attn Privacy Officer.
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