HIPAA Statement

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY. THE PRIVACY OF YOUR HEALTH INFORMATION IS IMPORTANT TO US.

Our Legal Duty

Sandia View Family Dental is required by applicable federal and state law to maintain the privacy of your protected health information. We are also required to provide you with this Notice explaining our privacy practices, our legal duties, and your rights concerning your health information.

We must follow the privacy practices described in this Notice while it is in effect. This Notice will remain in effect until it is replaced.

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We may make changes to our privacy practices and the terms of this Notice effective for all health information we maintain, including information created or received before the changes were made.

Before we make a significant change to our privacy practices, we will update this Notice and make the revised Notice available upon request.

You may request a copy of this Notice at any time. For more information about our privacy practices, or to request additional copies of this Notice, please contact us using the information listed at the end of this page.

Uses and Disclosures of Health Information

We may use and disclose your health information for treatment, payment, and healthcare operations.

Treatment

We may use or disclose your health information to dentists, dental specialists, physicians, laboratories, pharmacies, or other healthcare providers who are involved in providing treatment or services to you.

Payment

We may use and disclose your health information to obtain payment for services we provide to you. This may include submitting information to dental or medical insurance companies or other third-party payers.

Healthcare Operations

We may use and disclose your health information in connection with the operation of our dental practice. Healthcare operations may include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating provider performance, training programs, accreditation, certification, licensing, credentialing, business planning, and administrative activities.

Your Authorization

In addition to our use of your health information for treatment, payment, and healthcare operations, you may provide us with written authorization to use or disclose your health information for other purposes.

If you provide written authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosure that occurred while your authorization was in effect.

Except as otherwise permitted or required by law, we will not use or disclose your protected health information for purposes not described in this Notice without your written authorization.

Family, Friends, and Others Involved in Your Care

We may disclose your health information to a family member, friend, personal representative, or another person involved in your healthcare or payment for your healthcare when appropriate and permitted by law.

If you are present and able to make healthcare decisions, we will generally provide you with an opportunity to agree or object before making such a disclosure.

If you are unable to agree or object because of incapacity or an emergency, we may use our professional judgment to determine whether disclosure is in your best interest and will disclose only information directly relevant to that person's involvement in your care.

We may also use professional judgment to allow another person to pick up prescriptions, dental appliances, records, X-rays, or other similar items on your behalf.

Appointment Reminders and Treatment Communications

We may use your health information to contact you regarding appointments, appointment reminders, treatment recommendations, follow-up care, or other information related to your dental care.

Marketing

We will not use or disclose your protected health information for marketing purposes when written authorization is required by law without first obtaining your authorization.

Required by Law

We may use or disclose your health information when required to do so by federal, state, or local law.

Public Health and Safety

We may disclose your health information when permitted or required by law for certain public health activities, including disease prevention, reporting adverse events, or preventing a serious threat to the health or safety of a person or the public.

Abuse, Neglect, or Domestic Violence

We may disclose your health information to appropriate government authorities when permitted or required by law if we reasonably believe that a patient may be a victim of abuse, neglect, domestic violence, or another crime.

Judicial and Administrative Proceedings

We may disclose your health information in response to certain court orders, subpoenas, discovery requests, or other lawful legal processes when permitted or required by law.

Law Enforcement

We may disclose health information to law enforcement officials in certain circumstances permitted or required by law.

Business Associates

We may disclose protected health information to third-party service providers, known as business associates, who perform services on our behalf when those services require access to protected health information.

Business associates are required by law and contractual agreement to appropriately safeguard protected health information.

Your Rights

You have certain rights regarding your protected health information.

Access to Your Health Information

You have the right to inspect and obtain a copy of your health information, with certain exceptions.

You may be required to submit your request in writing. We may charge a reasonable, cost-based fee for copies, postage, supplies, or other expenses permitted by law.

Electronic Copies

If your protected health information is maintained electronically, you may request an electronic copy in a format that is readily producible or another format agreed upon by you and Sandia View Family Dental.

Disclosure Accounting

You have the right to request an accounting of certain disclosures of your health information made by us or our business associates.

This accounting generally does not include disclosures made for treatment, payment, healthcare operations, disclosures authorized by you, and certain other disclosures excluded by law.

Restrictions

You have the right to request additional restrictions on certain uses or disclosures of your health information.

We are generally not required to agree to a requested restriction unless otherwise required by law.

If we agree to a restriction, we will comply with that restriction except when information is needed to provide emergency treatment or when disclosure is otherwise required by law.

You may also have the right to request that information about healthcare services for which you have paid in full out of pocket not be disclosed to a health plan when the disclosure is for payment or healthcare operations and is not otherwise required by law.

Alternative or Confidential Communications

You have the right to request that we communicate with you about your health information using alternative methods or at alternative locations.

For example, you may ask us to contact you at a particular phone number or mailing address.

We may require that your request be made in writing and specify the alternative method or location.

Amendment

You have the right to request that we amend information in your health or dental records if you believe the information is incorrect or incomplete.

Your request must generally be made in writing and explain why the information should be amended.

We may deny the request under certain circumstances permitted by law. If we deny your request, you may have the right to submit a written statement of disagreement.

Copy of This Notice

You have the right to receive a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

Breach Notification

You have the right to receive notification following a breach of your unsecured protected health information when notification is required by law.

Questions and Complaints

If you would like additional information about our privacy practices or have questions or concerns about your privacy rights, please contact Sandia View Family Dental.

If you believe your privacy rights have been violated, you may submit a complaint to us using the contact information below.

You may also submit a complaint to the U.S. Department of Health and Human Services Office for Civil Rights.

We support your right to the privacy of your health information. We will not retaliate against you for filing a complaint.

Contact Information

Sandia View Family Dental
701 Broadmoor Blvd NE
Rio Rancho, NM 87124

Phone: (505) 891-1100
Website: www.sandiaviewdental.com

For questions regarding this Notice of Privacy Practices or your protected health information, please contact our office.