Your protected health information may be used and disclosed by your dentist, 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. Your protected health information may also be used and disclosed to pay your health care bills and to support the operation of the dental practice.

The following are examples of the types of uses and disclosures of your protected health information that the dental office is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office. Such uses and disclosures include:

Treatment: We may use or disclose your protected health information to provide, coordinate, or manage your dental care and any related services. This includes the coordination or management of your health care with a third party. We will also disclose protected health information to other dentists who may be treating you. In addition, we may disclose your protected health information from time to time to another dentist or health care provider who, at the request of your dentist, becomes involved in your care by providing assistance with your health care diagnosis or treatment, e.g., a laboratory or specialist.

Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you. Such services include, but are not limited to, making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.

Health Care Operations: We may use or disclose, as needed, your protected health information in order to support the business activities of your dentist’s practice.

For example, 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 to remind you of an appointment via telephone or mail.

We will share your protected health information with third-party “business associates” that perform various activities for the practice, e.g. billing, transcription services, etc. Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information.

We may use and disclose your protected health information, as necessary, to conduct quality assessments and improvement activities, to review health care professionals’ competence and qualifications; to evaluate practitioner and provider performance; to conduct training programs; and for accreditation, licensing, certification, and credentialing activities.

Your Authorization: Other uses and disclosures of your protected health information will be made only with your written authorization unless otherwise permitted or required by law as described in this Notice. You may revoke your authorization at any time, in writing. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in this Notice.

Others Involved In Your Health Care: Unless you object, we may use or disclose health information to notify or assist in the notification of (including identifying or locating) a family member, your personal representative, or another person responsible for your care, of your location, your general condition, or death. If you are present, prior to the use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of emergency circumstances or your incapacity to agree or object, we will disclose protected health information based on a determination using our professional judgment, disclosing only health information that is directly relevant to the person’s involvement in your healthcare and only that which is in your best interest. We may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care. We will also use our professional 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.

Emergencies: We may use or disclose your protected health information in an emergency treatment situation. We must present to you our Notice of Privacy Practices as soon as it is reasonably practicable after the delivery of treatment. If your dentist or another dentist in the practice is required by law to treat you, she/he may still use or disclose your protected health information to treat you, and you will be provided our Notice of Privacy Practices as soon as reasonably practicable after the delivery of treatment. We must make a good faith effort to obtain a written acknowledgment of the receipt of this notice to you, or document our good faith efforts to obtain such acknowledgement and the reason(s) why the acknowledgment of was not obtained.

Marketing Health-Related Services: We will not use your health information for marketing communication without your written authorization.

Required By Law: We may disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.

Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury, or disability. We may also disclose your protected health information to a foreign government agency that is collaborating with the public health authority when directed by the public health authority.

Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Health Oversight: We may disclose your protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil laws.

Abuse or Neglect: We may disclose your protected health information to a public health authority, which is authorized by law to receive reports of child abuse or neglect. We may disclose your protected health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, domestic violence, or other crimes. We may also disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others. In such cases, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Legal Proceedings: We may disclose your protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), in certain conditions, in response to a subpoena, discovery request, or another lawful process.

Law Enforcement: We may disclose your protected health information for law enforcement purposes, as long as applicable legal requirements are met. These law enforcement purposes include, but are not limited to, (1) legal processes required by law, (2) limited information requests for identification and location purposes, (3) information pertaining to victims of a crime, and (4) suspicion that death has occurred as a result of criminal conduct.

Coroners, Funeral Directors, & Organ Donation: We may disclose your protected health information to a coroner or medical examiner for identification purposes, determining the cause of death, or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose your protected health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out her/his duties. We may disclose your protected health information in reasonable anticipation of death for organ or tissue donation purposes.

Criminal Activity: Consistent with federal and state laws, we may use or disclose your protected health information if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.

National Security and Military Activity: We may disclose your protected health information to military authorities or Armed Forces personnel when appropriate conditions apply. We may disclose, to authorized state and federal officials, health information required for lawful intelligence, counterintelligence, and national security activities. We may also disclose protected health information for the determination of benefits eligibility through the Department of Veteran Affairs and to foreign military authorities. We may disclose your protected health information to a correctional institution or law enforcement officials if we are directed to do so by proper authorities if you are an inmate of a correctional facility.

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