NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Responsibilities
We are required by law to:
– Maintain the privacy and security of your protected health information (PHI)
– Provide you with this Notice of our legal duties and privacy practices
– Follow the terms of this Notice currently in effect
– Notify you promptly if a breach occurs that may compromise the privacy or security of your information
How We May Use and Disclose Your Health Information
We may use and disclose your health information without your authorization for the following purposes:
Treatment
To provide, coordinate, or manage your health care and related services. This includes sharing information with other doctors, specialists, hospitals, labs, imaging centers, and pharmacies involved in your care.
Payment
To bill and collect payment from health plans or other entities. This may include providing information to your insurance company to determine eligibility, coverage, or medical necessity.
Health Care Operations
For practice operations such as quality assessment, staff training, accreditation, licensing, legal services, auditing, business planning, and administrative activities.
As Required by Law
We may disclose your information when required to do so by federal, state, or local law.
Public Health and Safety
To public health authorities for activities such as preventing disease, reporting abuse or neglect, or reporting adverse reactions.
Business Associates
We may share information with third-party vendors who perform services for us (such as billing, IT support, shredding, or legal services). These vendors are required by law to safeguard your information.
Substance Use Disorder Records (42 CFR Part 2)
If we receive or maintain information about you from a substance use disorder treatment program that is protected by federal law (42 CFR Part 2), that information is subject to additional privacy protections.
If we receive such records through general consent for treatment, payment, and/or health care operations, we may use and share those records for those same purposes, as permitted by law.
However:
– We will NOT use or disclose Part 2 records or any testimony about those records in any civil, criminal, administrative, or legislative proceeding against you without:
– Your specific written consent, OR
– A court order after you have been notified
These records are subject to stricter confidentiality protection than other HIPAA-protected information.
Other Uses and Disclosures
Any uses and disclosures not described in this Notice will be made only with your written authorization. You may revoke an authorization at any time in writing, except to the extent we have already acted on it.
Fundraising Communications
If we conduct fundraising activities, you have the right to opt out of receiving fundraising communications. We will provide clear instructions on how to opt out.
Redisclosure Notice
Information disclosed pursuant to this Notice may be subject to redisclosure by the recipient and may no longer be protected by HIPAA, except for information protected by 42 CFR Part 2, which remains subject to stricter protections.
Your Rights
You have the right to:
– Get a copy of your medical record
– Correct your medical record
– Request confidential communication
– Ask us to limit what we use or share
– Get a list of those with whom we’ve shared your information
– Get a copy of this privacy notice
– Choose someone to act for you
– File a complaint if you believe your privacy rights have been violated
You will not be retaliated against for filing a complaint.
Changes to This Notice
We reserve the right to change this Notice. Any changes will apply to all information we have about you. The revised Notice will be posted in our offices and available upon request.
Questions or Complaints
If you have questions about this Notice or wish to file a complaint, please contact:
Privacy Officer
Commonwealth Oral and Facial Surgery & Dental Implant Center
2100 North Broad Street Ste. 106, Lansdale, PA 19446
Phone: 215-368-8104
Email: [email protected]
You may also file a complaint with the U.S. Department of Health and Human Services. Filing a complaint will not affect your care.