Privacy Policy
Your Information. Your Rights. Our Responsibilities.
This notice explains how your medical information may be used and shared, and how you can access your information. Please read it carefully.
Your Rights
When it comes to your health information, you have certain rights. Below is an overview of your rights and our responsibilities to help protect your information.
Access Your Medical Records
You have the right to request an electronic or paper copy of your medical records and other health information we maintain.
You may ask to view or receive a copy of your records at any time.
We may provide either a full copy or a summary of your health information.
A reasonable, cost-based fee may apply.
Request Corrections to Your Records
If you believe any information in your medical record is incorrect or incomplete, you may request a correction.
Requests must be submitted to our office.
We may deny the request in certain cases, but we will provide a written explanation within 60 days.
Request Confidential Communications
You may request that we contact you in a specific way or send communications to a different address.
Examples include:
Contacting you at your home or office phone
Sending mail to an alternate address
We will accommodate all reasonable requests.
Request Restrictions on Information Sharing
You may ask us not to use or share certain health information for treatment, payment, or healthcare operations.
We are not always required to agree to these requests if doing so could affect your care.
If you pay for a service entirely out of pocket, you may request that we not share related information with your insurance provider unless required by law.
Request a Record of Information Disclosures
You may request a list of certain times we have shared your health information over the past six years.
This list will include:
Who the information was shared with
Why it was shared
Please note:
Disclosures related to treatment, payment, and healthcare operations are not included.
One request per year is provided free of charge. Additional requests within 12 months may involve a reasonable fee.
Request a Copy of This Privacy Notice
You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
We will provide a copy promptly upon request.
Choose Someone to Act on Your Behalf
If you have granted someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make healthcare decisions on your behalf.
We will verify their authority before taking action.
File a Complaint
If you believe your privacy rights have been violated, you may contact us directly.
Phone: 305-317-9887
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights:
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints
We will never retaliate against you for filing a complaint.
Your Choices
For certain health information, you may tell us how you would like your information to be shared.
You have the right to request that we:
Share information with family members, close friends, or others involved in your care
Share information during disaster relief situations
Include your information in a hospital directory
If you are unable to communicate your preferences, we may share information if we believe it is in your best interest or necessary to reduce a serious threat to health or safety.
Situations Requiring Your Written Permission
We will never share your information for the following purposes without your written authorization:
Marketing activities
Sale of your information
Most sharing of psychotherapy notes
Fundraising Communications
We may contact you regarding fundraising efforts. You may request at any time that we stop contacting you for fundraising purposes.
How We Use and Share Your Health Information
Treatment
We may use and share your health information with healthcare professionals involved in your treatment.
Example: A doctor treating you may consult another healthcare provider regarding your overall health condition.
Healthcare Operations
We may use your information to:
Operate our practice
Improve patient care
Contact you when necessary
Example: We may use your health information to manage your treatment and services.
Billing and Payment
We may use and share your health information to bill and receive payment from health plans or other organizations.
Example: We may provide information to your insurance company to process payment for services.
Additional Uses and Disclosures
In certain situations, we are permitted or required by law to share health information for public benefit purposes.
Public Health and Safety Activities
We may share information to:
Prevent disease
Assist with product recalls
Report medication reactions
Report suspected abuse, neglect, or domestic violence
Prevent serious threats to health or safety
Research
Your information may be used or shared for approved health research purposes.
Legal Compliance
We may disclose your information when required by federal or state law, including requests from the Department of Health and Human Services.
Organ and Tissue Donation
We may share health information with organ procurement organizations.
Medical Examiners and Funeral Directors
We may share information with coroners, medical examiners, or funeral directors when necessary after a person’s death.
Workers’ Compensation and Government Requests
We may disclose health information:
For workers’ compensation claims
For law enforcement purposes
To health oversight agencies
For certain government functions such as military, national security, or protective services
Legal Proceedings
We may share information in response to:
Court orders
Administrative orders
Subpoenas
Other lawful legal requests
Our Responsibilities
We are required by law to:
Maintain the privacy and security of your protected health information
Notify you promptly if a breach compromises your information
Follow the privacy practices described in this notice
Provide you with a copy of this notice
We will not use or share your information beyond what is described here unless you provide written permission. You may change your authorization at any time by notifying us in writing.
For more information, please visit:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
Changes to This Notice
We reserve the right to update the terms of this privacy notice at any time. Any updates will apply to all information we maintain about you.
The latest version of this notice will always be available:
Upon request
At our office
On our website
Gio Aldama Family Dentistry