Scott E. Hayhurst, DMD
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.
This notice takes effect on the 09/01/2008 and remains in effect until we replace it.
1. Our Pledge Regarding Dental Information
The privacy of your dental information is important to us. We understand that your medical information is personal and we are committed to protecting it. We create a record of the care and services you receive at our dental office. We need this record to provide you with quality care and to comply with certain legal requirements. This notice will tell you about the ways we may use and share dental information about you. We also describe your rights and certain duties we regarding the use and disclosure of dental information. Throughout this notice we refer to your medical information as dental information.
2. Our Legal Duty
Law Require Us To:
- Keep you dental information private.
- Give you this notice describing our legal duties, privacy practices, and your rights regarding your dental information.
- Follow the terms of the current notice.
We Have The Right To:
- Change our privacy practices and the terms of the notice at any time, provided that the changes are permitted by law.
- Make the changes in out privacy practices and the new terms of our notice effective for all dental information that we keep, including information previously created or received before the changes.
Notice of Change to Privacy Practices:
- Before we make and important change in our privacy practices, we will change this notice and make the new notice available upon request.
Use and Disclosure of Your Dental Information
The following section describes ways that we use and disclose dental information. For each kind of use or disclosure, we will explain that we mean and give an example. Not every use or disclosure will be listed. However, we have listed all of the different ways we are permitted to use and disclose dental information. We will not use or disclose your dental information for any purpose not listed below, without your specific written authorization. Any specific written authorization you provide may be revoked at any time by writing to us at the address provided at the end of this notice.
For Treatment: We may use dental information about you to provide you with dental treatment or services. We may disclose dental information about you to doctors, nurses, technicians, or other people who are taking care of you. We may also share dental information about you to your other health care providers to assist them in treating you.
For Payment: We may use and disclose your dental information for payment purposes. A bill may be sent to you or a third party payer. The information on or accompanying the bill may include your dental information.
For Health Care Operations: We may use and disclose your dental information for our health care operations. This might include measuring and improving quality, evaluating the performance of employees, conducting training programs, and getting the accreditation, certificates, licenses, and credentials we need to serve you.
Additional Uses and Disclosures: In addition to using and disclosing your dental information for treatment, payment and healthcare operations, we may use and disclose dental information for the following purposes.
Notification: We may use and disclose dental information to notify or help notify: a family member, your personal representative or another person responsible for your care. If you are present, we will get your permission if possible before we share, or give you the opportunity to refuse permission. In case of emergency, and if you are not able to give or refuse permission, we will show only the health information that professional judgment allows to make decisions in your best interest about allowing someone to pick up medicine, dental supplies, X-ray or other dental information for you.
Funeral Director, Coroner, Medical Examiner: To help them carry our their duties, we may share the dental information of a person who has died with a coroner, medical examiner, funeral director, or an organ procurement organization.
Specialized Government Functions: Subject to certain requirements, we may disclose or use dental information for military personal and veterans, for national security and intelligence activities, for protective services for the President and others, for medical suitability determinations for the Department of State, for correctional institutions, and other law enforcement official or correctional institution under certain circumstances.
Court Orders and Judicial and Administrative Proceedings: We may disclose dental information in response to a court or administrative order, subpoena, discovery request, or other lawful process, under certain circumstances. Under limited circumstances, such as court order, warrant, or grand jury subpoena, we may share your dental information with law enforcement officials. We may share limited information with a law enforcement official concerning the dental information of an inmate or person in lawful custody with a law enforcement official or correctional institution under certain circumstances.
Public Health Activities: As required by law, we may disclose your dental information to health or legal authorities charged with preventing or controlling disease, injury or disability, including child abuse or neglect. We may also disclose your dental information to persons subject to jurisdiction of the food and Drug Administration for the purposes of reporting adverse events associated with product defects or problems, to enable product recalls, repairs or replacements, to track products, or to conduct activities required by the Food and Drug Administration. We may also, when we are authorized by law to do so, notify a person who may have been exposed to a communicable disease or otherwise be at risk of contracting or spreading a disease or condition.
Victims of Abuse, Neglect, or Domestic Violence: We may use and disclose dental information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. We may share dental information when necessary to help law enforcement officials capture a person who has admitted to being part of a crime or has escaped from legal custody.
Workers Compensation: We may disclose dental information when authorized or necessary to comply with laws relating to workers compensation or other similar programs.
Health Oversight Activities: We may disclose dental information to an agency providing health oversight for oversight activities authorized by law, including audits, civil, administrative, or criminal investigations of proceedings, inspections, licensure or disciplinary actions, or other authorized activities.
Law Enforcement: Under certain circumstances, we may disclose dental information to law enforcement officials. These circumstances include reporting required by certain laws (such as the reporting or certain types of wounds), pursuant to certain subpoenas or court orders, reporting limited information concerning identification and location at the request of a law enforcement official, reports regarding limited information concerning identification and location at the request of a law enforcement official, reports regarding suspected victims or crimes at the request of a law enforcement official, reporting death, crimes on our premises, and crimes in emergencies.
Appointment Reminders: We may disclose dental information for purposes of sending you appointment postcards or otherwise reminding you of your appointments.
Alternative and additional Dental Services: We may use and disclose dental information to furnish you with information about health-related benefits and services that may be of interest to you, and to describe or recommend treatment alternatives.
Accuracy of Chart Documentation: Consultations or discussions related to your dental health may be recorded for accuracy in chart documentations and treatment planning.