Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL/DENTAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

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1. Our Commitment to Your Health Privacy

At Harmony Dental, we are required by law to maintain the privacy of your Protected Health Information (PHI) and to provide you with this detailed notice of our legal duties and privacy practices. We are also required to abide by the terms of this Notice of Privacy Practices currently in effect.

2. Uses and Disclosures of Health Information

We may use and disclose your Protected Health Information (PHI) for treatment, payment, and health care operations:

• For Treatment: We may disclose health information about you to dental hygienists, specialists, doctors, or other dental office personnel who are involved in taking care of you. For example, sharing dental X-rays with a consulting specialist.
• For Payment: We may use and disclose health information so that the treatment and services you receive may be billed and payment may be collected from you, an insurance company, or a third party.
• For Health Care Operations: We may use and disclose health information to run the practice and make sure all of our patients receive quality care. For example, using information to conduct quality assessments or to contact you as an appointment reminder.

3. Permitted and Required Uses and Disclosures

We may also use or disclose your PHI without your prior authorization for public health activities, law enforcement purposes, judicial proceedings, or in emergency circumstances. For any other purpose, we will obtain your written authorization, which you may revoke at any time.

4. Your Patient Rights Under HIPAA

You have the following rights regarding Protected Health Information we maintain about you:

• Right to Inspect and Copy: You have the right to inspect and obtain a copy of your dental records, billing records, and other records used to make decisions about your care.
• Right to Amend: If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information.
• Right to Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations.
• Right to a Paper Copy of This Notice: You have the right to receive a paper copy of this notice at any time, even if you have agreed to receive this notice electronically.

5. Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized or retaliated against for filing a complaint.

6. Contact Details

For more information about our privacy practices, or to raise a question or complaint, please contact our Privacy Officer: