Our legal duty
We are required by law to protect the privacy of your protected health information (“medical information”). We are also required to provide this notice about our privacy practices, legal duties, and your rights concerning your medical information.
We must follow the privacy practices described in this notice while it is in effect. We may change our privacy practices and the terms of this notice when permitted by law, and may make new terms applicable to all medical information we maintain, including information created or received before a change.
If we make a material change, we will provide a revised notice. The current notice will be available in our facility and on our website, and you may request a copy at any time. We maintain physical, electronic, and procedural safeguards in accordance with applicable state and federal standards.
Uses and disclosures of your medical information
Treatment
We may disclose your medical information, without prior approval, to a dentist or healthcare provider who is providing treatment or evaluating your health. For example, information may be shared with an oral surgeon to determine whether surgical care is needed.
Payment
Your medical information may be used to seek payment from your insurance plan or from you. An insurance plan may request information about dates and services to process a claim.
Health care operations
We may use and disclose information for health care operations, including quality assessment, provider performance review, training, accreditation, licensing, audits, legal services, fraud prevention, customer service, complaint resolution, billing, business planning, and administration.
Your authorization
You or your legal representative may provide written authorization for other uses or disclosures. You may revoke that authorization in writing at any time, except when we have already acted in reliance on it. We will obtain authorization before using medical information for marketing, fundraising, or commercial purposes where required.
Family, friends, and others involved in your care
We may share information relevant to a family member, friend, or other person you involve in your care or payment. When you are unavailable, incapacitated, or in an emergency, we will use professional judgment to decide whether disclosure is in your best interest.
Reminders and health-related services
We may use your information to communicate about appointments, dental care, treatment alternatives, and health-related products or services. Reminders may be delivered by mail, email, or telephone using the contact information you provide.
Public health and legally permitted activities
We may use or disclose information when required or authorized by law for activities including:
- Public-health reporting, including disease, vital statistics, abuse, neglect, or domestic violence.
- Preventing a serious and imminent threat to health or safety.
- Health-care oversight, licensing, peer review, and fraud prevention.
- Research when permitted by applicable law.
- Court orders, administrative orders, and other lawful process.
- Law-enforcement, coroner, medical-examiner, funeral-director, and organ-procurement purposes.
- Military, national-security, correctional, and workers’ compensation purposes.
Specially protected information
Substance Use Disorder treatment records have enhanced protections and cannot be used in legal proceedings without consent or a court order. Federal or state law may also provide greater protection for information concerning HIV/AIDS, mental health, genetic testing, alcohol or drug treatment, sexually transmitted disease, reproductive health, and abuse or neglect.
Business associates and breach notices
We may disclose information to business associates that perform services for us when necessary. Those associates are contractually required to protect the information. We may also use your contact information to provide legally required notices concerning unauthorized access or disclosure.
Your rights
- See and obtain a copy of your health records.
- Request an amendment to your health information.
- Request an accounting of certain disclosures.
- Receive a copy of this Notice of Privacy Practices.
- Authorize or decline certain uses and disclosures, including marketing where applicable.
- Receive information through confidential or alternative communication methods.
- Request restrictions on certain uses or disclosures.
- Opt out of fundraising communications.
- File a complaint without retaliation if you believe your rights were denied or your information was not protected.
Complaints
If you believe we violated your privacy rights, disagree with a decision about access or amendment, or have concerns about how we use, disclose, or communicate your medical information, contact our Privacy Officer at 719-544-7672.
You may also submit a written complaint to the Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, Washington, DC 20201, or call 1-800-368-1019.
Rocky Mountain Dental Co. supports your right to privacy and will not retaliate against you for filing a complaint.