HIPAA NOTICE OF PRIVACY PRACTICES

• Treatment, payment and health care operations.
• Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. An example of this would include treatment for pain or injury to your teeth.
• Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this  would be sending a bill for your visit to your insurance company for payment.
• Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. An example would be an internal quality assessment review.

• To your family and friends: We must disclose your information to you. We may also disclose your health information to a family member, friend or other person to the extent necessary to help with your healthcare or with payment of your healthcare, but only if you agree that we may do so,  or if we are presented a valid legal document showing authority of another person to act on your behalf, as, for example, a medical power of attorney or declaration of guardianship.
• To persons involved in your care: We may use or disclose health information to notify, assist in the notification of (including identifying or locating) a family member, your personal representative or another person responsible for your care of your general condition. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to use uses or disclosure.
• As required by law: we may use or disclose your health information when we are required to do so by law.
• In case of suspected abuse or neglect: we may disclose your health 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 disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.
• For other governmental purposes: we may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to correctional institution or law enforcement official having custody of protected health information of inmate or patient under certain circumstances.

• The right to request restrictions on certain uses and disclosures of protected health information, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.
• The right to reasonable requests to receive confidential communications of protected  health information from us by alternative means or at alternative locations.
• The right to inspect and copy your protected health information.
• The right to amend your protected health information.
• The right to receive an account of disclosures of protected health information.
• The right to obtain and we have the obligation to provide to you a paper copy of this notice from us at your first service delivery date.
• The right to request a written acknowledgment that you have received a copy of our Notice of Privacy Practices, and an obligation to document our good faith efforts why an acknowledgment was not obtained.
• If you pay for a service or health care item out-of-pocket in full, the right to ask us not to share that information with your health insurer. We will say "yes" unless a law requires us to share that information or unless sharing the information is required for carrying out your treatment.