Our responsibilities
We are required by law to maintain the privacy and security of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, to follow the terms of the notice currently in effect, and to notify you if a breach occurs that may have compromised the privacy or security of your information.
How we may use and disclose your information
- Treatment: We may use your information to provide care and share it with other professionals treating you, such as a specialist or dental laboratory.
- Payment: We may use and share your information to bill and receive payment from you, your insurance plan, or others responsible for payment.
- Health care operations: We may use and share your information to run our practice, improve care, train staff, and contact you when necessary.
- Appointment reminders and health information: We may contact you about appointments and treatment alternatives or other health-related services.
- Family and others involved in your care: We may share relevant information with people you identify, unless you object.
Other permitted or required disclosures
We may also share your information when required or permitted by law, including for public health and safety activities; reporting abuse, neglect, or domestic violence; health oversight activities; lawsuits and legal proceedings; law enforcement; coroners and medical examiners; research under approved safeguards; workers’ compensation; specialized government functions; and to respond to the US Department of Health and Human Services when it investigates our compliance. Massachusetts law may provide additional protections for certain sensitive information, and we follow the law that is most protective.
Uses that require your written authorization
We will obtain your written authorization for most uses and disclosures of psychotherapy notes, for uses and disclosures for marketing, for the sale of PHI, and for any other use not described in this notice. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.
Your rights
- Access: Ask to see or get a paper or electronic copy of your records. We may charge a reasonable, cost-based fee.
- Amendment: Ask us to correct information you believe is wrong or incomplete. We may say no, but will tell you why in writing.
- Confidential communications: Ask us to contact you in a specific way or at a specific location. We will say yes to reasonable requests.
- Restrictions: Ask us to limit what we use or share. We are not required to agree, except that we must agree not to share information with your health plan for a service you paid for in full out of pocket, unless the law requires it.
- Accounting of disclosures: Ask for a list of certain times we shared your information.
- Paper copy: Ask for a paper copy of this notice at any time.
- Personal representative: Someone with legal authority, such as a health care proxy or guardian, may exercise your rights for you.
Complaints
If you believe your privacy rights have been violated, you may complain to us using the contact details below, or to the US Department of Health and Human Services Office for Civil Rights: 200 Independence Avenue SW, Washington, DC 20201; 1-877-696-6775; www.hhs.gov/ocr/complaints (opens in a new tab). We will not retaliate against you for filing a complaint.
Changes to this notice
We may change the terms of this notice, and the changes will apply to all information we hold. The new notice will be available on request, in our office, and on this website.
Contact
Privacy Officer, South Boston Dental Care590 E Broadway, South Boston, MA 02127
Phone: (617) 268-1015
Email: info@southbostondentalcare.com