RDHAP
Privacy Policy
NOTICE OF PRIVACY PRACTICES
ASK Gentle Dental Hygiene Services
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Legal Duty
ASK Gentle Dental Hygiene Services is required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the California Confidentiality of Medical Information Act (CMIA) to maintain the privacy and security of your protected health information. We are required by law to provide you with this Notice of our legal duties and privacy practices and to follow the terms of the Notice currently in effect. We are also required to notify you in the event of a breach of your unsecured protected health information as required by federal and California law.
We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. Any revised Notice will apply to all protected health information that we maintain. The current Notice will be available in our office and on our website, if applicable, and copies will be provided upon request.
Uses and Disclosures of Health Information
We may use and disclose your protected health information for purposes of treatment, payment, and healthcare operations.
For treatment, we may use and disclose your protected health information to provide, coordinate, or manage your dental care and related services. This may include consultation with other healthcare providers, referrals, and contacting you regarding appointments or recall information.
For payment, we may use and disclose your protected health information to obtain reimbursement for services provided to you. This includes billing, claims management, eligibility determinations, utilization review, and collection activities.
For healthcare operations, we may use and disclose your protected health information for administrative and operational purposes necessary to run our practice. These activities include quality assessment and improvement, staff training, licensing and accreditation activities, compliance functions, and general business management.
We may disclose relevant protected health information to a family member, personal representative, or another individual involved in your care or payment for your care, unless you object. If you are unable to agree due to incapacity or emergency circumstances, we will use professional judgment to determine whether disclosure is in your best interest and will limit disclosure to information directly relevant to that person’s involvement.
We may use or disclose your protected health information when required to do so by federal or California law.
We will disclose your protected health information to the Secretary of the U.S. Department of Health and Human Services when required for purposes of determining our compliance with applicable privacy laws.
Appointment Reminders and Health-Related Communications
We may use your protected health information to contact you with appointment reminders, recall notices, or information about treatment alternatives or other health-related benefits and services that may be of interest to you. These communications may be made by voicemail, text message, mail, or other reasonable means.
Other Uses and Disclosures
Uses and disclosures of protected health information not described in this Notice will be made only with your written authorization, unless otherwise permitted or required by law. Your written authorization is required for the use or disclosure of psychotherapy notes, for marketing purposes where required by law, and for the sale of protected health information. You may revoke your authorization in writing at any time, except to the extent that we have already relied on it.
Certain types of information may receive additional protections under California or federal law, including HIV or AIDS information, genetic testing information, and substance use disorder treatment records, when applicable. We will comply with the requirements of those laws when such information is involved.
Your Health Information Rights
You have the right to inspect and obtain a copy of your protected health information, with limited exceptions. Requests must be made in writing. We may charge a reasonable, cost-based fee for copies. Under California law, copies of records are generally provided within fifteen days of receiving a written request, and inspection is generally permitted within five working days. If your request for access is denied, you have the right to request a review of the denial as permitted by law.
You have the right to request an amendment of your protected health information if you believe it is incorrect or incomplete. Your request must be in writing and must include a reason supporting the amendment. We may deny your request under certain circumstances and will provide a written explanation if we do.
You have the right to receive an accounting of certain disclosures of your protected health information as provided by law.
You have the right to request restrictions on certain uses and disclosures of your protected health information. Although we are not required to agree to most requested restrictions, we must agree to a request to restrict disclosure of protected health information to a health plan if the disclosure is for payment or healthcare operations and relates solely to a service for which you have paid out of pocket in full, unless disclosure is otherwise required by law.
You have the right to request confidential communications. You may request that we communicate with you at a specific address, telephone number, or by a particular method. We will accommodate reasonable requests.
You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
Breach Notification
You have the right to receive written notification if we discover a breach of your unsecured protected health information as required by federal and California law.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with ASK Gentle Dental using the contact information listed below. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.
Contact Information
For questions about this Notice or to exercise any of your rights, please contact:
ASK Gentle Dental Hygiene Services
1 (805) 558-7582