HIPAA Notice of Privacy Practices

You have the right to see and get a copy of your dental and health records, and several other rights described below. To use any of these rights, contact our privacy officer (details below).

We use and share your health information mainly to treat you, to get paid for your care and to run our practice.

• Treatment: we use your information to provide your care and share it with other professionals treating you. Example: we send X-rays to a specialist you are referred to.

• Payment: we use and share your information to bill and get paid by health plans or other payers. Example: we give your dental insurer details of a filling so it can pay the claim.

• Running our practice: we use your information to manage the practice, improve care and contact you when needed. Example: we use your phone number to remind you of an appointment by call, text or email.

Other ways we may share your information

We are allowed or required to share your information in other ways, usually for purposes that benefit public health or safety, and only when we meet the conditions set by law:

• helping with public health and safety issues, such as reporting suspected abuse, neglect or domestic violence, reporting adverse reactions to medicines, and preventing a serious threat to anyone's health or safety
• doing research, under strict conditions
• complying with the law, including when the Department of Health and Human Services asks to check that we are following federal privacy law
• responding to organ and tissue donation requests, and working with a medical examiner or funeral director
• handling workers' compensation claims, law enforcement purposes, health oversight activities and special government functions such as military or national security
• responding to a court or administrative order, or a subpoena

Pennsylvania law may give your information extra protection in some cases. Where it does, we follow the stricter rule.

For some health information, you can tell us your choices about what we share.

If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest. We may also share information when needed to lessen a serious and imminent threat to health or safety.

Fundraising: We do not use your information for fundraising.

Marketing: We do not use your information for marketing without your written permission.

• We are required by law to keep your protected health information private and secure.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us in writing that we can. If you give us permission, you can change your mind at any time by letting us know in writing.

We can change the terms of this notice, and the changes will apply to all the information we have about you. The new notice will be available on request, in our office and on this website.

For questions about this notice or to use any of your rights, contact:

If you believe your privacy rights have been violated, you can file a complaint with us or with the federal government. We will not retaliate against you for filing a complaint.

• With us: contact our privacy officer at the address or phone number above. We accept complaints by phone, in person or in writing.

• With the U.S. Department of Health and Human Services Office for Civil Rights: file online through the OCR complaint portal, or write to Centralized Case Management Operations, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F HHH Bldg., Washington, D.C. 20201, or call 1-877-696-6775. Complaints should be filed within 180 days of when you knew of the problem; OCR may extend this for good cause.