Notice of privacy practices

Our commitment to your privacy

This notice describes how medical information about your child may be used and disclosed, and how you can get access to this information. We are required by law to maintain the privacy of protected health information and to provide you with this notice of our legal duties and privacy practices.

How we may use health information

Treatment: we may use your child’s health information to provide, coordinate or manage dental care, including sharing records with specialists, hospitals or anesthesia providers involved in treatment.

Payment: we may use and disclose information to bill and collect payment from you, an insurance carrier or a third party, including verifying coverage and obtaining pre-authorization.

Health care operations: we may use information for quality assessment, staff training, licensing and other business activities that support safe, effective care.

Your rights

You have the right to inspect and copy your child’s dental records, to request an amendment to those records, and to receive an accounting of certain disclosures we have made.

You have the right to request restrictions on how we use or disclose information, to request confidential communications at an alternative address or phone number, and to receive a paper copy of this notice at any time.

You have the right to be notified in the event of a breach of unsecured protected health information.

Uses that require your authorization

Other uses and disclosures not described in this notice will be made only with your written authorization. You may revoke that authorization in writing at any time, except where we have already relied on it.

Questions or complaints

If you believe your privacy rights have been violated, or you have questions about this notice, please contact our office. You may also file a complaint with the U.S. Department of Health and Human Services. We will never retaliate against you for filing a complaint.