Notice of Privacy Practices

Our Responsibilities

Atlas Dental Studio and Orthodontics is required by the Health Insurance Portability and Accountability Act (HIPAA) to maintain the privacy of your Protected Health Information (PHI). We are required by law to:

• Maintain the privacy and security of your health information.
• Provide you with this Notice of our legal duties and privacy practices.
• Follow the terms of the Notice currently in effect.
• Notify you if a breach compromises the privacy or security of your unsecured health information.

How We May Use and Disclose Your Information

We may use or disclose your health information for the following purposes without your written authorization.

Treatment

To provide, coordinate, and manage your dental care. For example, we may share your records with a specialist we refer you to for orthodontic or oral surgery treatment.

Payment

To bill insurance companies, process payments, verify coverage, and collect amounts owed. For example, we may send treatment details to your dental plan to obtain payment.

Health Care Operations

To improve quality of care, train staff, conduct audits, maintain records, and operate our practice.

Appointment Reminders and Treatment Options

We may contact you by telephone, text message, email, or mail to remind you of an appointment, to confirm scheduling, or to tell you about treatment alternatives or other health-related benefits and services that may be of interest to you.

Individuals Involved in Your Care

Unless you object, we may share relevant information with family members or others involved in your care or in payment for your care.

Required by Law

When required by federal, state, or local law.

Public Health and Safety

When permitted or required for public health activities, or to prevent a serious and imminent threat to health or safety.

Law Enforcement

When legally required or authorized.

Uses Requiring Your Written Authorization

We will obtain your written authorization before using or disclosing your information for purposes not otherwise permitted by law. This includes most uses and disclosures for marketing purposes, and any sale of your health information.

You may revoke your authorization at any time in writing. A revocation will not apply to information we have already used or disclosed in reliance on that authorization.

Your Rights

You have the right to:

• Receive a paper copy of this Notice, even if you agreed to receive it electronically.
• Request restrictions on certain uses and disclosures of your health information. We are not required to agree to every requested restriction.
• Restrict disclosure to your health plan of information about a service you paid for yourself, in full, out of pocket. We are required to honor this request.
• Request that we communicate with you confidentially, such as at an alternate address or phone number.
• Inspect and receive a copy of your dental records, subject to applicable law.
• Request corrections or amendments to your records.
• Receive an accounting of certain disclosures we have made of your health information.
• File a complaint without fear of retaliation.

Questions or Complaints

If you believe your privacy rights have been violated, you may contact our Privacy Officer using the information below.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at 200 Independence Avenue SW, Washington, D.C. 20201, by calling 1-877-696-6775, or online at hhs.gov/ocr/privacy/hipaa/complaints. Filing a complaint will not affect your care in any way.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for health information we already hold as well as information we receive in the future. The current version will always be posted in our office and on this page, and will show its effective date.