HIPAA Policy | Newkirk Dental Center

1.

Our Commitment to Your Privacy

Newkirk Dental Center is committed to protecting the privacy of your health information. This Notice of Privacy Practices describes how we may use and share your protected health information (PHI) and explains your rights regarding that information. We are required by law to maintain the privacy of your health information and to provide you with this notice.

We will follow the terms of this notice as long as it is in effect. We reserve the right to change our privacy practices and the terms of this notice at any time. If we make changes, we will post the updated notice in our office and on our website. You may request a copy of the current notice at any time.

2.

What Information We Collect

We collect health information about you from a variety of sources, including information you provide directly, information from other health care providers, and information created during the course of your treatment. This information may include:

Your name, address, phone number, date of birth, and other personal identifiers
Your medical and dental history
Records of the care and treatment you receive at our practice
Insurance and payment information
X-rays, photographs, and other clinical images
Information from other health care providers involved in your care

3.

How We Use and Share Your Health Information

Treatment, Payment, and Health Care Operations

We may use and share your health information for the following purposes without obtaining a separate authorization from you:

Treatment. We may use your health information to provide, coordinate, and manage your dental care. This includes sharing information with other health care providers involved in your treatment, such as specialists, laboratories, and pharmacies. For example, we may share your X-rays with a dental laboratory to fabricate a crown or with a specialist to whom we refer you.

Payment. We may use and share your health information to bill and collect payment for the services we provide. This includes submitting claims to your insurance company, confirming coverage and benefits, and following up on payment. For example, we may share information about your treatment with your dental plan to obtain prior authorization or to verify that a procedure is covered.

Health Care Operations. We may use and share your health information for activities that support our practice, such as quality assessment, staff training, legal and auditing functions, and business management. For example, we may use information from patient records to evaluate the effectiveness of our treatment methods or to train our team members.

Disclosures Required or Permitted by Law

We may also use or share your health information without your authorization in the following circumstances:

When required by federal, state, or local law
For public health activities, such as reporting disease or injury to public health authorities
To report suspected abuse, neglect, or domestic violence
For health oversight activities, such as audits or investigations by government agencies
In response to a court order, subpoena, or other lawful process
For law enforcement purposes, as permitted by law
To avert a serious threat to your health or safety or the health or safety of others
For workers compensation or similar programs
To coroners, medical examiners, or funeral directors, as permitted by law
For organ or tissue donation purposes
For research purposes, under certain conditions
To military authorities, as permitted by law, if you are a member of the armed forces
For national security and intelligence activities, as permitted by law

Any other use or disclosure of your health information not described in this notice will require your written authorization. You may revoke an authorization at any time in writing.

4.

Your Rights Regarding Your Health Information

You have the following rights regarding the health information we maintain about you:

Right to Access and Copies

You have the right to inspect and obtain a copy of your health information, including dental records, X-rays, and billing records. You must submit your request in writing. We may charge a reasonable fee for copying and mailing your records. In certain limited circumstances, we may deny your request, and you may request a review of that denial.

Right to Request Corrections

If you believe the health information we have about you is incorrect or incomplete, you have the right to request that we amend it. You must submit your request in writing and include the reason for the requested change. We may deny your request under certain circumstances, such as if we did not create the information or if we determine the information is accurate and complete.

Right to Request Restrictions

You have the right to request that we restrict the use or disclosure of your health information for treatment, payment, or health care operations. You also have the right to request that we restrict disclosures to a health plan for services you have paid for out of pocket in full. We are not required to agree to all requests, but we will comply with any restriction we agree to.

Right to an Accounting of Disclosures

You have the right to request a list of disclosures we have made of your health information, with the exception of disclosures made for treatment, payment, health care operations, disclosures you authorized, and certain other exceptions. Your request must be in writing and may specify a time period of up to six years. The first accounting in any 12-month period is free; we may charge a fee for additional requests.

Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this Notice of Privacy Practices at any time, even if you have agreed to receive it electronically. You may request a copy from our office at any time.

5.

How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services.

To file a complaint with Newkirk Dental Center, please contact us using the information below. You will not be retaliated against for filing a complaint.

To file a complaint with the Secretary of the U.S. Department of Health and Human Services, visit www.hhs.gov/hipaa/filing-a-complaint or call (877) 696-6775.

6.

Contact Us Regarding This Policy

If you have questions about this Notice of Privacy Practices, would like to request a paper copy, or wish to exercise any of the rights described above, please contact us:

Newkirk Dental Center 327 W. South St. Newkirk, OK 74647 Phone: (580) 362-2600 Email: info@newkirkdentalcenter.com

Please review our Privacy Policy for additional information about how we handle your personal information. For details about our general office practices, visit our Office Policies page. To learn more about your experience as a patient at Newkirk Dental Center, visit our Patient Information page. To reach our team, visit our Contact page.

HIPAA Privacy Policy — Newkirk Dental Center