This Privacy Practice Notice describes how health information about you may be used and disclosed and how you can obtain access to this information. Please review it carefully. The privacy of your health information is very important to us.
Our office strictly abides by the HIPAA (Health Insurance Portability and Accountability Act) privacy and security rules. For more information on HIPAA, please visit the U.S. Department of Health and Human Services.
Our Legal Duty
We are required by applicable federal and state laws to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect 04/14/03 and will remain in effect until replaced. You may request a copy of this Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.
Uses and Disclosures of Health Information
To make sure that your health information is protected in a way that does not interfere with your healthcare, your information can be used and disclosed:
- With a physician or other healthcare provider providing treatment to you.
- To obtain payment for services we provide to you.
- To conduct healthcare operations within our office. For example, we may use a sign-in sheet at the reception desk where you will be asked to sign in. We may call you by name in the reception room when the doctor is ready to see you, and he may have a copy of that day’s schedule with your name on it in his operatory.
- With your family, relatives, friends, or others you identify who are involved with your healthcare or your healthcare bills, but only if you agree that we may do so.
In addition to our use of your healthcare information for treatment, payment, or healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us written authorization, we cannot use or disclose your health information for any reason except those described in this Notice.
Persons Involved in Care
We may use or disclose health information to notify a family member, your personal representative, or another person responsible for your care, of your location, your general condition, or death. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of emergency circumstances, we will disclose only health information that is directly relevant to the person’s involvement in your healthcare. We will also use our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays or other similar forms of health information.
Required by Law
We may use or disclose your health information when we are required to do so by law.
Abuse or Neglect
We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence, or the possible victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.
We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose health information to correctional institutions or law enforcement officials having lawful custody of protected health information of inmates or patients under certain circumstances.
We will NOT use or share your health information for marketing or advertising purposes without your written authorization.
For additional information, please contact us at:
Carmel Valley Endodontics
12264 El Camino Real, Suite 206
San Diego, CA 92130