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.
You have the right to:
- Get a copy of your paper or electronic health record
- Correct your health record if you believe it is inaccurate
- Request confidential communication (for example, by phone or email)
- Ask us to limit what we use or share
- Get a list of those with whom we’ve shared your information
- Get a copy of this privacy notice at any time
- Choose someone to act for you (for example, a legal guardian)
- File a complaint if you believe your privacy rights have been violated
You have choices about how we use and share your information in the following situations:
- Telling family and friends about your care
- Including your information in a patient directory
- Sharing your information for marketing purposes
- Disclosing information to outside organizations (with your authorization)
If you give us permission to share information, you may revoke that permission at any time in writing.
We typically use or share your health information in the following ways:
Treatment: We can use your health information and share it with other professionals who are treating you.
Example: A dentist working on your treatment may need to consult with a specialist.
Payment: We can use and share your health information to bill and receive payment from health plans or other entities.
Example: We send your health information to your insurance company for reimbursement.
Health Care Operations: We use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information to review the quality of our services.
We may also share your information when required by law, for public health or safety reasons, or with health oversight agencies.
In some cases, we will ask for your written authorization before using or sharing your health information.
This includes most uses and disclosures for:
- Marketing purposes
- Sale of your health information
- Sharing psychotherapy notes
You may revoke your authorization at any time by providing written notice to our office.
Revocation will not affect any information already shared based on your prior consent.
We are required by law to:
- Maintain the privacy and security of your protected health information (PHI)
- Notify you promptly if a breach occurs that may have compromised the privacy or security of your information
- Follow the duties and privacy practices described in this notice
- Provide you with a copy of this notice upon request
We will not use or share your information other than as described here unless you tell us we can in writing.
If you have questions or would like more information, contact:
HIPAA Privacy Officer
State of the Art Dental Group
801 Pleasant Dr, Suite 160
Rockville, MD 20850
📞 (240) 683-8111
If you believe your privacy rights have been violated, you may file a complaint with:
Office for Civil Rights (OCR)
U.S. Department of Health and Human Services
Website: https://www.hhs.gov/ocr/privacy/hipaa/complaints
You will not be retaliated against for filing a complaint.