Our Commitment to Your Privacy
Upper Dental is committed to protecting the privacy of your health information. This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA). It also explains your rights regarding your health information and how you can exercise those rights.
We are required by law to maintain the privacy of your health information, provide you with this notice of our legal duties and privacy practices, and follow the terms of the notice that is currently in effect.
How We Use and Disclose Your Health Information
We use and disclose your health information for treatment, payment, and healthcare operations, as well as for other purposes permitted or required by law.
Treatment, Payment, and Healthcare Operations
Treatment: We may use and disclose your health information to provide, coordinate, or manage your dental care. For example, we may share your information with other healthcare providers involved in your treatment, such as dental specialists or physicians.
Payment: We may use and disclose your health information to obtain payment for the dental services we provide to you. This includes submitting claims to insurance companies, verifying coverage, and processing payments.
Healthcare Operations: We may use and disclose your health information for activities necessary to run our practice, such as conducting quality assessments, training staff, and improving patient care services.
Other Permitted or Required Disclosures
We may use or disclose your health information without your authorization for the following purposes:
- When required by federal, state, or local law
- For public health activities, such as reporting disease or injury
- To government authorities if we suspect abuse, neglect, or domestic violence
- For health oversight activities, such as audits or investigations
- In response to a court order, subpoena, or other lawful process
- For law enforcement purposes, as permitted by law
- To coroners, medical examiners, or funeral directors for identification or funeral purposes
- For organ, eye, or tissue donation purposes
- For research purposes, under certain conditions
- To avert a serious threat to health or safety
- For workers' compensation or similar programs
- For military or national security purposes, as required by law
Uses and Disclosures Requiring Your Authorization
Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and disclosures that constitute a sale of your health information require your written authorization. You may revoke any authorization you provide at any time, in writing, except to the extent that we have already taken action based on your authorization.
Your Rights Regarding Your Health Information
You have the following rights regarding your health information at Upper Dental.
Right to Access Your Records
You have the right to inspect and obtain a copy of your health information that we maintain, with limited exceptions. We may charge a reasonable, cost-based fee for copies.
Right to Request Restrictions
You have the right to request that we restrict the use or disclosure of your health information for treatment, payment, or healthcare operations. We are not required to agree to your request, except in certain circumstances.
Right to Amend Your Records
If you believe that your health information is incorrect or incomplete, you have the right to request an amendment. We may deny your request under certain circumstances.
Right to an Accounting of Disclosures
You have the right to request an accounting of certain disclosures we have made of your health information. This accounting does not include disclosures made for treatment, payment, or healthcare operations.
Right to Receive Confidential Communications
You have the right to request that we communicate with you about your health information in a certain way or at a certain location. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice
You have the right to receive a paper copy of this Notice of Privacy Practices upon request, even if you have agreed to receive this notice electronically.
Our Duties Under HIPAA
We are required by law to:
- Maintain the privacy and security of your protected health information
- Provide you with this notice of our legal duties and privacy practices
- Notify you if a breach of your unsecured health information occurs
- Follow the terms of the notice currently in effect
We reserve the right to change the terms of this notice and make the new notice effective for all health information we maintain. We will post any revised notice on our website and in our offices.
How to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
To file a complaint with Upper Dental, please contact us using the information below. To file a complaint with the federal government, visit www.hhs.gov/ocr/privacy/hipaa/complaints/.
Contact Us Regarding This Notice
If you have questions about this notice, would like to exercise any of your rights, or wish to file a complaint, please contact:
Upper Dental Privacy Officer
Call us at (954) 982-8505
Or visit our contact page for more information.
Effective Date and Updates
This Notice of Privacy Practices is effective as of January 1, 2025. We reserve the right to revise this notice at any time. The most current version will always be available on our website and at our office locations.
For more information about how we handle your information, please review our Privacy Policy. You may also be interested in our Notice of Non-Discrimination and Patient Information page.
