Notice of Privacy Practices

If you have questions about this notice, need help exercising your rights, or wish to make a privacy complaint, contact:

Privacy Officer
B Dental Studio
10075 Jog Road, Suite 200
Boynton Beach, Florida 33437
Phone: 561-903-7680

When it comes to your health information, you have certain rights. This section explains those rights and some of our responsibilities.

Obtain an Electronic or Paper Copy of Your Records

You may ask to inspect or obtain an electronic or paper copy of your dental record and other health information we maintain about you, including X-rays when applicable.

We will generally provide a copy or summary within 30 days after receiving your request. We may charge a reasonable, cost-based fee as permitted by law. In limited circumstances, we may deny access. If we deny a request, we will explain the reason in writing and tell you whether the decision may be reviewed.

Ask Us to Correct Your Records

You may ask us to correct health information that you believe is inaccurate or incomplete. We may deny the request, but we will explain the reason in writing, generally within 60 days. You may submit a written statement of disagreement as permitted by law.

Request Confidential Communications

You may ask us to contact you in a particular way, such as only by telephone, text, email, or mail, or to send communications to a different address. We will accommodate reasonable requests.

Ask Us to Limit What We Use or Disclose

You may ask us not to use or disclose certain health information for treatment, payment, or health care operations. We are generally not required to agree, and we may deny the request if it could affect your care or our ability to operate lawfully. If we agree, we will follow the restriction except when information is needed for emergency treatment or as otherwise permitted by law.

Obtain an Accounting of Certain Disclosures

You may ask for a list of certain disclosures of your health information made during the six years before the date of your request, including who received the information and why.

The accounting will not include disclosures for treatment, payment, health care operations, or certain other disclosures excluded by law. We will provide one accounting during any 12-month period at no charge. We may charge a reasonable, cost-based fee for additional requests during the same period and will tell you the cost before proceeding.

Obtain a Copy of This Notice

You may request a paper copy of this notice at any time, even if you previously agreed to receive it electronically. We will provide a copy promptly. The current notice is also available on our website and at our office.

Choose Someone to Act for You

If you have given someone health care power of attorney, if someone is your legal guardian, or if another person is legally authorized to act as your personal representative, that person may exercise your rights and make choices about your health information.

We will verify that the person has appropriate authority before taking action. Rights involving a minor’s information may be exercised by a parent, guardian, or other person as provided by applicable law.

File a Complaint

You may complain if you believe your privacy rights have been violated. Contact the B Dental Studio Privacy Officer using the information above.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by:

• visiting https://www.hhs.gov/hipaa/filing-a-complaint;
• calling 1-877-696-6775; or
• writing to the U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201.

For certain health information, you may tell us your preferences about what we disclose. Tell us what you want us to do, and we will follow your instructions when required by law.

Family, Friends, and Others Involved in Your Care

You may tell us whether we may share relevant information with a family member, close friend, caregiver, or another person involved in your care or payment for your care.

If you are unable to tell us your preference, such as during an emergency or when you are incapacitated, we may disclose information when we believe it is in your best interest and the disclosure is permitted by law. We may also disclose information when necessary to lessen a serious and imminent threat to health or safety.

Disaster Relief

We may disclose limited information to an organization assisting with disaster relief so that family members or others responsible for your care can be notified of your location, condition, or status, unless you object when given the opportunity.

Marketing, Sale of Information, and Psychotherapy Notes

We will obtain your written authorization before:

• using or disclosing protected health information for marketing when authorization is required;
• selling protected health information; or
• using or disclosing most psychotherapy notes, if we maintain any.

If you provide written authorization, you may revoke it in writing at any time. Revocation will not affect actions already taken in reliance on the authorization.

We may use and disclose health information without written authorization for treatment, payment, and health care operations, as permitted by law.

Treatment

We may use and disclose your health information to provide, coordinate, or manage your dental care.

For example, we may share relevant information with another dentist, physician, dental specialist, dental laboratory, pharmacy, imaging provider, or other health professional involved in your care. We may use your records, medical history, X-rays, photographs, scans, treatment plans, and laboratory information to diagnose, plan, and provide treatment.

Payment

We may use and disclose your health information to bill for services and obtain payment from you, an insurance plan, a payment processor, a financing provider, or another responsible party.

For example, we may provide information to your dental insurance plan so it can determine eligibility, coverage, medical necessity, benefits, or payment.

Health Care Operations

We may use and disclose your health information to operate the practice, improve the quality of care, and perform administrative activities.

Examples include:

• quality assessment and improvement;
• reviewing the competence and performance of our team;
• training and education;
• licensing, credentialing, auditing, and compliance;
• business planning, management, and customer service;
• legal, accounting, and risk-management services;
• appointment reminders and treatment follow-up;
• contacting you about treatment alternatives or health-related services that may benefit you; and
• maintaining, securing, and supporting our information systems.

Business Associates

We may share health information with third parties that perform services for us involving protected health information, such as practice-management, patient-communication, billing, information technology, records storage, or professional-support providers.

When required, these business associates must sign agreements requiring them to protect your information and use it only as permitted by law and their agreement with us.

We may use or disclose health information for the following purposes when applicable legal requirements are satisfied.

Public Health and Safety

We may disclose information for public health or safety activities, including:

• preventing or controlling disease;
• reporting adverse reactions or product problems;
• assisting with product recalls;
• reporting suspected abuse, neglect, or domestic violence;
• preventing or reducing a serious and imminent threat to health or safety; and
• complying with public health reporting requirements.

Health Oversight

We may disclose information to health oversight agencies for activities authorized by law, including audits, investigations, inspections, licensing, and disciplinary proceedings.

Compliance With Law

We will disclose information when federal, state, or local law requires it, including to the U.S. Department of Health and Human Services if it requests information to determine our compliance with federal privacy law.

Workers’ Compensation

We may disclose health information as authorized by and necessary to comply with workers’ compensation laws or similar programs.

Law Enforcement and Government Functions

We may disclose health information for certain law-enforcement purposes, to correctional institutions or authorized government officials, or for special government functions such as military, national security, and protective services, when permitted or required by law.

Judicial and Administrative Proceedings

We may disclose health information in response to a court or administrative order, subpoena, discovery request, or other lawful process when legal requirements are satisfied.

Coroners, Medical Examiners, and Funeral Directors

We may disclose health information to a coroner, medical examiner, or funeral director as authorized by law.

Organ and Tissue Donation

We may disclose health information to organizations involved in organ, eye, or tissue donation and transplantation when applicable.

Research

We may use or disclose health information for research when the research has been approved through a legally authorized review process, when another legal permission applies, or when you have signed an authorization.

Other Uses and Disclosures

Uses and disclosures not described in this notice will be made only with your written authorization unless otherwise permitted or required by law.

Florida law may provide additional confidentiality and access protections for patient and dental records. Florida law generally restricts disclosure of patient records without the patient’s authorization unless a legal exception applies and requires dentists to maintain appropriate dental and medical-history records.

If we receive or maintain records that are specifically protected by federal substance use disorder confidentiality regulations under 42 C.F.R. Part 2, those records receive the additional protections required by law. Such records generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a qualifying court order and subpoena, as applicable.

We are required by law to:

• maintain the privacy and security of your protected health information;
• provide you with this notice describing our legal duties and privacy practices;
• follow the duties and privacy practices described in the notice currently in effect;
• notify you promptly if a breach occurs that may have compromised the privacy or security of your information; and
• comply with applicable federal and Florida privacy laws.

We will not use or disclose your information other than as described in this notice unless you authorize us in writing or another use or disclosure is permitted or required by law.

We may change the terms of this notice and apply the revised notice to all health information we maintain, including information created or received before the revision.

If we make a material change, the updated notice will be available on our website, in our office, and upon request. The effective date at the top of the notice will show when the current version became effective.