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This notice describes how your health information may be used and disclosed and how you can get access to the information. Please review it carefully. The privacy of your health information is important to The Hills Dental Care.Our Legal Duty: The Hills Dental care is required by applicable federal and state laws to maintain the privacy of your health information. We are also required to provide you with this notice about our privacy policies, our legal duties and your rights concerning your health information. We must follow the privacy policies that are described in this notice while it is in effect. This notice went in to effect April 1, 2003 with the latest revision on September 23, 2013, and will remain in effect until modified or replaced. We reserve the right to change our privacy policies and the terms of this notice at any time, provided such changes are permitted by applicable law. We resene the right to make the changes in our privacy policies and the new terms of our notice effective for all health information that we maintain, including health information we created or received before we made the changes. Changing this notice will precede all significant modifications. This notice will be available upon request and may request a copy at any time.Uses and Disclosures of Health Information: Information regarding your health may be used and disclosed to others, in electronic or other format, for the purpose of treatment, payment and other healthcare operations without your written authorization. Examples cited below further explain the use and disclosure process and examples of situations where we do not need your written authorization to use or disclose your health information.Treatment: We may use or disclose your health information to a physician, dentist or other healthcare provider providing treatment to you.Payment: We may use and disclose your health information to obtain payment for services we provided to you. Healthcare Operations: We may use and disclose your protected health information in relations with our healthcare process. These processes include an assessment, improvement activities, reviewing the competence or qualifications of healthcare professionals, provider performances and evaluating practitioner, conducting training programs, accreditation, certification, licensing or credentialing activities.Your Authorization: In addition to our use of your health information for treatment, payment, or healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosure permitted by your authorization while it is 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.Person Involved in Care: In order to accommodate the notification of your location, your general condition, or death, your protected health information may be used or disclosed to a family member, your personal representative or another person responsible for your care. If you are present and wish to object to such disclosures of your health information you may do so. In the event of your incapacity or emergency circumstances, we will disclose health information using our professional judgment disclosing only protected health infbnnation that is directly relevant to the persons involvement in your healthcare. We will use our professional judgment and our experience with common practices 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 protected health information.Business Associates: We may disclose your health infbmiation to a business associate, that needs the infbmiation in order to perform a function or service for our business operations. We will do so only if the business associate signs an agreement to protect the privacy of your health information.Marketing Health-Related Services: We will not use your health information for marketing communication without your written authorization. We may use and disclose your health information to send you information by mail or e-mail regarding health related sen ices available to you, general dental health news, and offers available only to our patients. Fundraising: We will not use your health information for fundraising activities without your written consent. Required bv Law: We may use or disclose your health information when we are required by law to do so.Public Health Activities: We may disclose your health information to authorized public health officials so they may carry out public health activities. For example, wc may share you information with government officials that arc responsible for controlling disease, injury or disability.Abuse or Neglect: As required by law, if wc have reason to believe that you arc a victim of possible abuse, neglect, domestic violence or other possible crimes, your protected health information may be disclosed to the appropriate authorities. Wc may 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.National Security: Under some circumstances the military may require disclosure of health care information for armed forces personnel. For the purpose of national securities activities, counter intelligence and lawful intelligence, authorized federal authorities may require disclosure of protected health information. Protected health care information disclosure may be made to correctional facilities or law enforcement authorities with the lawful authority requiring custody of such information.ApDointment Reminders: Wc may use or disclose your health information to provide you with appointment reminders (such as voicemail messages, postcards, e-mails or letters).Patient RightsAccess: You have the right to inspect or obtain copies of your health information with limited exceptions. If wc maintain your health information in electronic form then you have the right to obtain a copy in the form and format you request if the information is readily producible in that format, or, if not, a mutually agreeable alternative format. You also have the right to direct us to send a copy of your health information to a third party you clearly designate. Your request must be a written, signed request. Wc may charge a fee for producing dental records and x-rays as allowed by law.Disclosure Accounting: You have the right to receive a list of instances in which we or our business associates disclosed health information for purposes other than treatment, payment, healthcare operations and certain other activities in (he last 6 years but not before April 14, 2003. If you request the accounting more than once in a 12 month period, wc may charge you a reasonable, cost based fee tor responding to additional requests.Restrictions: You have the right to request that wc place additional restrictions on our use or disclosure of your health information, including uses or disclosures for treatment, payment, and healthcare operations and to family members, friends and others involved in your care or payment for your care. This request must be a written request that is signed. If we agree to the requested restrictions, we will put these restrictions in place except in an emergency situation or as required by law.Breach Notification: We will provide you with notification of a breach of unsecured health information as required by law.Alternative Communication: You have the right to request that wc communicate with you about your health information by alternative means or alternative locations. This request must be in writing. Your request must specify how or where you wish to be contacted, and provide explanation regarding how payments will be handled if we communicate with you through alternative means or location you request.Amendment: If you believe we have health information about you that is incorrect or incomplete, you have a right to request that we amend your health information. This request must be in writing and it must explain why the information should be amended. We may deny your request under certain circumstances and will respond to you in writing with the reason wc cannot grant your request.Electronic Notice: If you received this notice on our website or by e-mail then you are also entitled to receive the notice in written form.
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