NOTICE OF PRIVACY PRACTICES
PROVIDER NOTICE OF INFORMATION 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.

I. DENTAL PRACTICE COVERED BY THIS NOTICE

This Notice describes the privacy practices of The Orthodontic Group of Chester County (“Dental Practice”). “We” and “our” means the Dental Practice. “You” and “your” means our patient.

II. HOW TO CONTACT US / OUR PRIVACY OFFICIAL

If you have any questions or would like further information about this Notice, you can contact The Orthodontic Group of Chester County Privacy Official at:

[email protected]

III. OUR PROMISE TO YOU AND OUR LEGAL OBLIGATIONS

The privacy of your health information is important to us. We understand that your health information is personal and we are committed to protecting it. This Notice describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law.

It also describes your rights to access and control your protected health information. Protected health information is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

We are required by law to:

  • Maintain the privacy of your protected health information;

  • Give you this Notice of our legal duties and privacy practices with respect to that information; and

  • Abide by the terms of our Notice that is currently in effect.

IV. LAST REVISION DATE

This Notice was last revised on August 1, 2021.

V. HOW WE MAY USE OR DISCLOSE YOUR HEALTH INFORMATION

The following examples describe different ways we may use or disclose your health information. These examples are not meant to be exhaustive. We are permitted by law to use and disclose your health information for the following purposes:

A. Common Uses and Disclosures

  • Treatment – We may use your health information to provide you with dental treatment or services, such as cleaning or examining your teeth or performing dental procedures. We may disclose health information about you to dental specialists, physicians, or other health care professionals involved in your care.

  • Payment – We may use and disclose your health information to obtain payment from health plans and insurers for the care that we provide to you.

  • Health Care Operations – We may use and disclose health information about you in connection with health care operations necessary to run our practice, including review of our treatment and services, training, evaluating the performance of our staff and health care professionals, quality assurance, financial or billing audits, legal matters, and business planning and development.

  • Appointment Reminders – We may use or disclose your health information when contacting you to remind you of a dental appointment. We may contact you by using a postcard, letter, phone call, voice message, text or email.

  • Treatment Alternatives and Health-Related Benefits and Services – We may use and disclose your health information to tell you about treatment options or alternatives or health-related benefits and services that may be of interest to you.

  • Disclosure to Family Members and Friends – We may disclose your health information to a family member or friend who is involved with your care or payment for your care if you do not object or, if you are not present, we believe it is in your best interest to do so.

  • Disclosure to Business Associates – We may disclose your protected health information to our third-party service providers (“business associates”) that perform functions on our behalf or provide us with services if the information is necessary for such functions or services.

B. Less Common Uses and Disclosures

  • Disclosures Required by Law – We may use or disclose patient health information to the extent we are required by law to do so.

  • Public Health Activities – We may disclose patient health information for public health activities and purposes, including preventing or controlling disease, reporting abuse or neglect, adverse reactions to medications, and product recalls.

  • Victims of Abuse, Neglect or Domestic Violence – We may disclose health information to the appropriate government authority about a patient whom we believe is a victim of abuse, neglect or domestic violence.

  • Health Oversight Activities – We may disclose patient health information to a health oversight agency for activities necessary for the government to provide oversight of the health care system.

  • Lawsuits and Legal Actions – We may disclose patient health information in response to court or administrative orders, subpoenas, discovery requests, or other lawful processes.

  • Law Enforcement Purposes – We may disclose your health information to a law enforcement official for law enforcement purposes.

  • Coroners, Medical Examiners and Funeral Directors – We may disclose your health information to allow them to carry out their duties.

  • Organ, Eye and Tissue Donation – We may use or disclose your health information for donation and transplant purposes.

  • Research Purposes – We may use or disclose your information for research purposes pursuant to applicable approvals.

  • Serious Threat to Health or Safety – We may use or disclose your health information if necessary to prevent or lessen a serious threat to anyone’s health or safety.

  • Specialized Government Functions – We may disclose your health information for military, national security, or correctional institution purposes.

  • Workers' Compensation – We may disclose your health information to comply with workers' compensation laws or similar programs.

VI. YOUR WRITTEN AUTHORIZATION FOR OTHER USES OR DISCLOSURES

Uses and disclosures of your protected health information that involve psychotherapy notes, marketing, sale of your protected health information, or other uses not described in this notice will be made only with your written authorization, unless otherwise permitted or required by law.

You may revoke this authorization at any time, in writing, except to the extent that this office has taken action in reliance on the authorization.

VII. YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION

You have the following rights with respect to certain health information that we have about you. To exercise any of these rights, you must submit a written request to our Privacy Official.

  • Right to Access and Review – You may request access to and a copy of your health information.

  • Right to Amend – You may request that we amend incorrect or incomplete health information.

  • Right to Restrict Use and Disclosure – You may request limits on how we use or disclose your health information.

  • Right to Confidential Communications – You may request that we communicate with you by alternative means or at alternative locations.

  • Right to an Accounting of Disclosures – You may request a list of certain disclosures of your health information.

  • Right to a Paper Copy of this Notice – You may obtain a paper copy of this Notice at any time.

  • Right to Receive Notification of a Security Breach – We are required by law to notify you if the privacy or security of your health information has been breached.

VIII. SPECIAL PROTECTIONS FOR CERTAIN HEALTH INFORMATION

Certain federal and state laws may require special privacy protections that restrict the use and disclosure of certain health information, including HIV-related information, alcohol and substance abuse information, mental health information, and genetic information.

IX. OUR RIGHT TO CHANGE OUR PRIVACY PRACTICES AND THIS NOTICE

We reserve the right to change the terms of this Notice at any time. Any change will apply to the health information we have about you or create or receive in the future.

We will post the revised Notice on our website and in our office and will provide a copy upon request.

The effective date of this Notice is 05/01/2020.

X. HOW TO MAKE PRIVACY COMPLAINTS

If you have any complaints about your privacy rights or how your health information has been used or disclosed, you may file a complaint with us by contacting our Privacy Official listed above.

You may also file a written complaint with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

XI. ENSURING YOUR INFORMATION REMAINS CONFIDENTIAL

No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All other categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.