Protecting Your Health Information: Sonrisa Dental’s Privacy Policy

This Privacy Policy covers services provided to you by our office. By law, we are required to maintain the privacy of protected health information and to provide you with the Policy of our legal duties and privacy practices with respect to protected health information. Protected health information consists of information about you (including demographic information) that may identify you and that relates to your past, present, or future physical or mental health or condition. It also includes related health care services.

The Policy describes how Sonrisa Dental may use and disclose your protected health to carry out treatment, payment, or health care operations. Other uses and disclosures of your information will be made only with your written authorization (unless otherwise permitted or required by law). The Policy also describes your rights to access and control your protected health information and informs you of your rights to make a complaint to either the office or to the Secretary of Health and Human Services if you believe we have violated your rights.

We are required to abide by the terms of the Policy. We may change the terms of the policy at any time. The new notice will be effective for all protected health information that we maintain at the time of the change. We can provide you with any revised Policy upon request. You may contact our office by one of two ways: calling our Office Manager and requesting that a revised copy be sent to you in the mail, or asking for one at your next appointment.

NOTICE OF PRIVACY PRACTICES

This Notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

If you have any questions about this Notice, please contact the OFFICE MANAGER.

We are required by law to maintain the privacy of our patients’ health information and to provide you with this Notice of our legal duties and privacy practices with respect to protected health information. Protected health information consists of information about you – including demographic information – that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.

1 USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION

Uses and Disclosures of Protected Health Information for Treatment, Payment, or Operations.

Your protected health information may be used by your doctor for treatment, payment, and health care operations as described here without authorization from you. It may be used and disclosed by your doctor, the office staff, and others outside our office who are involved in your care and treatment for the purpose of providing health care services to you and to pay your health care bills, which are used to support the operation of the doctor’s practice.

The following are examples of ways in which your protected healthcare information may be used by your doctor and the office staff without your specific authorization. Please note that these examples are not meant to be exhaustive, only to describe the types of uses and disclosures that can possibly be made by our office.

  • Treatment: Your protected healthcare information may be used and disclosed to provide, coordinate, or manage your health care and any related services, including services rendered from another doctor, consultation with another doctor, or the management of your health care with a third party.
  • Payment: Your information may be used, as needed, to obtain or provide payment for your medical services. This includes disclosures to other entities, such as in the case that your health insurance plan may undertake certain activities (for example, making a determination of eligibility or coverage for benefits, reviewing services provided, and undertaking utilization review activities) before it approves or pays for services recommended to you.
  • Operations: Your protected health information may be disclosed or used, as needed, to support the business activities of your doctor’s practice. These activities include – but are not limited to – quality assessment and improvement activities; reviewing the competence or qualifications of professionals; business planning and development; and conducting or arranging for other business activities.