READY SET SMILE HIPAA Information

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT PATIENTS MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. THE PRIVACY OF YOUR HEALTH INFORMATION IS IMPORTANT TO US.

OUR LEGAL DUTY

Federal and state law requires us to maintain the privacy of your child’s health information. That law also requires us to give you this notice about our websites and our privacy practices, our legal duties and your rights concerning your health information. We are required to follow the privacy practices we describe in this notice while it is in effect. This notice takes effect 5/15/2017, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the term of this notice at any time, provided that any applicable law permits the changes. We reserve the right to make the changes in our privacy practices and the content of our notice effective for all health information that we maintain, including health information we created or received prior to any changes. Before we make a significant change in our privacy practices, or for additional copies of this notice, please contact us using the information listed at the end of this notice.

OUR USES AND DISCLOSURES OF YOUR HEALTH INFORMATION

We use and disclose health information about your child for treatment, payment, and health care operations. For example:

Treatment: We may use your child’s health information for treatment or disclose it to a dentist, physician or other health care provider providing treatment to you.

Payment: This may use and disclose your child’s health information to obtain payment for services we provide to you. We may also disclose your health information to another health care provider or entity that is subject to the federal Privacy Rules for its payment activities.

Health Care Operations: We may use and disclose your child’s health information for our health care operations. Health care operations include quality assessment and improvement activities, reviewing the competence or qualifications of health care professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities. We may disclose your child’s health information to another health care provider or organization that is subject to the federal privacy rules and that has a relationship with you to support some of their health care operations. We may disclose your child’s information to help these organizations conduct quality assessment and improvement activities, review the competence or qualifications of health care professionals, or detect or prevent care fraud and abuse.

Your Authorization: You may give us written authorization to use your child’s health information or to disclose it to anyone for any purpose. If you give us authorization, you may revoke it in writing at any time. Your revocation will not affect any uses or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your child’s health information for any reason except those described in this notice.

To Your Family and Friends: We may disclose your child’s health information to a family member, friend, or other person to the extent necessary to help with your health care or with payment for your health care. Before we disclose your child’s health information to these people, we will provide you with an opportunity to object to our use or disclosure. If you are not present, or in the event of your incapacity or an emergency, we will disclose your child’s medical information based on our personal judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays, or other similar forms of health information. We may use or disclose information about your child to notify or assist in notifying a person involved in your care, of your location and general condition.

Appointment Reminders: We may use or disclose your child’s health information to provide you with appointment reminders (such as voicemail messages, postcards, or letters).

Disaster relief: We may use or disclose your child’s health information to a public or private entity authorized by law or by its charter to assist in disaster relief efforts.

Public Benefit: We may use or disclose your child’s medical information as authorized by law for the following purposes deemed to be in the public interest or benefit:

* As required by law;

* For public health activities, including disease and vital statistic reporting, child abuse reporting, FDA oversight, and to employers regarding work-related illness or injury;

* To report child abuse, neglect, or domestic violence;

* To health oversight agencies;

* In response to court and administrative orders and other lawful processes;

* To law enforcement officials pursuant to subpoenas and other lawful processes, concerning crime victims, suspicious death, crimes on our premises, reporting crimes in emergencies, and for purposes of identifying or locating a suspect or other person;

* To coroners, medical examiners, and funeral directors;

Amendment: You have the right to request that we amend your child’s health information. Your request must be in writing, and it must explain why we should amend the information. We may deny your request under certain circumstances.

QUESTIONS AND COMPLAINTS

If you want more information about our privacy practices or have questions or concerns, please contact us using the information listed at the end of this notice.

If you believe that:

* We may have violated your privacy rights,

* We made a decision about access to your health information incorrectly,

* Our response to a request you made to amend or restrict the use or disclosure of your health information was incorrect, or

* We should communicate with you by alternative means or at alternative locations,

You may contact us using the information listed below. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request. We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.

CONTACT THE DENTAL OFFICE AT:

Ready.Set.Smile

Telephone: (612)721-6118

Revised 5/15/17- JMA