Notice of Privacy Practices
Effective Date: January 15th, 2024
THIS NOTICE DESCRIBES HOW MEDICAL AND DENTAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
At Cosmetic Smile Center, we are committed to protecting your health information. We are required by law to maintain the privacy of Protected Health Information (PHI) and to provide you with this notice of our legal duties and privacy practices.
I. How We May Use and Disclose Your Health Information
We use your health information for treatment, payment, and healthcare operations.
- For Treatment: We may disclose your PHI to other dentists, physicians, or specialists involved in your care. For example, we may share X-rays with a specialist if we refer you for additional treatment.
- For Payment: We may use and disclose your PHI so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party.
- For Healthcare Operations: We may use your PHI to run our practice and ensure all patients receive quality care (e.g., quality assessment, training, or business planning).
- Appointment Reminders: We may use your information to contact you (via phone, email, or text) as a reminder for upcoming dental appointments.
- As Required by Law: We will disclose PHI when required to do so by federal, state, or local law, such as in response to a court order or for public health activities.
II. Your Patient Rights
You have the following rights regarding the health information we maintain about you:
- Right to Inspect and Copy: You have the right to inspect and obtain a copy of your dental and billing records. We may charge a reasonable, cost-based fee for copies.
- Right to Amend: If you feel the information we have is incorrect or incomplete, you may ask us to amend it. You must provide a reason for the request.
- Right to an Accounting of Disclosures: You can request a list of certain disclosures we’ve made of your PHI for purposes other than treatment, payment, or operations.
- Right to Request Restrictions: You have the right to request a restriction on how we use or disclose your PHI. While we are not always required to agree, we must agree if you pay for a service in full out-of-pocket and ask us not to share that information with your health insurer.
- Right to Confidential Communications: You can ask that we contact you in a specific way (e.g., home phone only) or at a specific address.
- Right to a Paper Copy: You may ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
III. Your Choices
For certain health information, you can tell us your preferences about what we share.
- Family and Friends: With your permission, we may share information with a family member or friend involved in your care.
- Disaster Relief: We may share your information in a disaster relief situation.
- Marketing: We will never sell your information or share it for marketing purposes without your express written authorization.
IV. Frequently Asked Questions (FAQ)
Q: Is my dental information safe on your website or digital patient portal? A: Yes. We use industry-standard encryption and security protocols to ensure that any information submitted through cosmeticsmilecenterfl.com or our patient communication systems is protected.
Q: Can I request my dental records be sent to another dentist? A: Absolutely. You have the right to request a transfer of records. We typically require a signed “Release of Records” form to ensure your privacy during the transfer.
Q: Do you share my information with my insurance provider? A: Yes, we share the minimum necessary information required to process your claims and obtain payment for the services provided.
Q: What happens if there is a data breach? A: In the unlikely event of a breach of your unsecured PHI, we are required by law to notify you promptly so you can take protective steps.
V. Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the Secretary of the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.
Contact Information: Cosmetic Smile Center
9625 Westview Drive Coral Springs, FL 33076
954-227-1417
