This notice describes how medical/dental information we receive may be used and disclosed, and information about patient rights. Please review it carefully.
NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION:
Oral Surgery & Implant Centers is committed to using your protected health information responsibly. Our practice is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. Protected health information is the information we create and obtain in providing our services to you. Such information may include: documenting your symptoms, examination and test results, diagnoses, treatment, and applying for future care or treatment for insurance purposes, as well as the billing documents provided to insurance companies for those services.
PATIENT HEALTH INFORMATION RIGHTS
Oral Surgery & Implant Centers maintains a health and billing record for each patient. The information in these records belongs to the patient. Patients have the right to:
Request a restriction on certain uses and disclosures of health information by delivering the request in writing to our office. We are not required to grant the request, but we will comply with any request granted;
Request to inspect and copy your health, and billing record—patients may exercise this right by delivering the request in writing to our office;
Appeal a denial of access to protected health information except in certain circumstances;
Request that health care record be amended to correct incomplete or incorrect information by delivering a written request to our office;
File a statement of disagreement if an amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of protected health information;
Obtain an accounting of disclosures of health information as required to be maintained by law by delivering a written request to our office. An accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to the patient or made at patient request, or disclosures made to family members or friends in the course of providing care;
Request that communication of health information be made by alternative means or at an alternative location by delivering the request in writing to our office;
Revoke authorizations that had been made previously to use or disclose information except to the extent information or action has already been taken by delivering a written revocation to our offices.
Oral Surgery & Implant Centers is required to:
Maintain the privacy of patient health information as required by law;
Provide patients with a notice of our duties and privacy practices as to the information we collect and maintain;
Abide by the terms of this Notice;
Notify patients if we cannot accommodate a requested restriction or request;
Accommodate reasonable patient requests regarding methods to communicate health information.
We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain.