HIPAA Privacy Policy
Purpose of this Notice
This notice describes how your protected health information (PHI) may be used and disclosed by our dental practice and how you can access this information. Please review it carefully.
Your Rights
You have the right to:
- Access your records: You can request to see or get an electronic or paper copy of your dental records.
- Request corrections: You may ask us to correct information you believe is incorrect or incomplete.
- Request confidential communications: You can ask us to contact you in a specific way (e.g., only by phone or at a specific address).
- Request restrictions: You may ask us not to use or share certain health information, although we may not be required to agree.
- Get a list of disclosures: You can ask for a list of times we shared your health information, with whom, and why.
- Choose someone to act for you: If you’ve given someone legal authority (e.g., medical power of attorney), that person can exercise your rights.
- File a complaint: You can file a complaint with us or with the U.S. Department of Health and Human Services if you feel your privacy rights have been violated.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised your information.
- We must follow the duties and privacy practices described in this notice.
- We will not use or share your information other than as described here unless you give us written permission.
How we may use and share your Health Information
We typically use or share your health information in the following ways:
- For Treatment: We can use your health information and share it with other professionals who are treating you
(e.g., referrals to specialists or labs).
- For Payment: We can use and share your information to bill and receive payment from health plans or other entities.
- For Healthcare Operations: We may use your health information to manage the practice, improve care, and ensure quality.
Other ways we may share your information include:
- Public health and safety issues (e.g., reporting adverse reactions, preventing disease)
- Complying with the law (e.g., court orders, subpoenas)
- Health oversight activities (e.g., audits, investigations)
- Work with medical examiners or funeral directors (in the event of a patient’s death)
- Address workers’ compensation, law enforcement, or national security requests
We will never share your information for marketing or sell your information without your written authorization.
Our use of Technology and Communications
Please note that email, text messaging, or website contact forms may not be HIPAA-secure unless otherwise noted. Do not submit sensitive and personal health information through unsecured channels.
Changes to this Notice
We reserve the right to change this privacy policy at any time, and updates will apply to all PHI we maintain. Any changes made will be posted on our website and available at our office upon request.
Contact for more information or to file a complaint
If you have any questions or concerns about this policy or wish to file a complaint, contact:
Riverside Smiles
19415 Deerfield Ave, Ste 212,
Leesburg, VA 20176.
You may also contact:
U.S. Department of Health & Human Services - Office for Civil Rights
