Notice of Privacy Practices

We are committed to protecting the privacy of your personal health information (PHI). This Notice of Privacy Practices describes how we may use and disclose your PHI to carry out treatment, payment, or health care operations, and also describes your rights to access and control your PHI.

Uses and Disclosures of Protected Health Information

Treatment

Your PHI may be used and disclosed by our office staff and others outside of our office involved in your care for the purpose of providing health care services to you — including referrals to physicians, specialists, or laboratories.

Payment

We may use and disclose your PHI to obtain payment for services, including sharing with billing companies, insurance companies, health plans, government agencies, and collection agencies.

Health Care Operations

We may use or disclose your PHI to support business activities including staff training, quality improvement processes, and resolving complaints within the practice.

Other Permitted Disclosures Without Your Permission

• If required by law
• Public health activities
• Health oversight agencies
• Legal proceedings
• Police or other law enforcement purposes
• Coroners and funeral directors
• Medical research (IRB-approved)
• Special government and national security purposes
• Correctional institutions
• Workers' Compensation

Other Uses and Disclosures

We may share PHI with business associates (e.g. billing or transcription companies), through health information exchanges, for fundraising activities, to notify you of treatment alternatives, and for appointment reminders. We may also share with family members or caregivers unless you object.

Uses Requiring Your Written Authorization

• Marketing
• Sale of your information
• Release of psychotherapy notes
• All other uses not described in this Notice

Your Privacy Rights

All requests to exercise your rights must be made in writing to renee@laytondentistrync.com.

• Right to access and copy your PHI — You may inspect and obtain a copy of your records. A reasonable fee may apply.
• Right to request restrictions — You may request we not use or disclose certain PHI. We must honor restrictions when you pay out of pocket in full.
• Right to request alternative communication — We will agree to reasonable requests for alternate contact methods or locations.
• Right to request amendment — You may request corrections to your health information with an explanation of why.
• Right to an accounting of disclosures — You may request a list of who has received your PHI for purposes other than treatment, payment, or operations.
• Right to a paper copy of this Notice — Available upon request. We will provide it on your first visit.
• Right to breach notification — You have the right to be notified of any breach of your PHI.

Complaints

If you believe we have violated your privacy rights, please contact:

You may also file a complaint with the United States Secretary of Health and Human Services. Filing a complaint will not result in any retaliation against you.

This notice was published and becomes effective on April 13, 2003.