NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION
Protected health information includes demographic and medical information that concerns the past, present, or future physical or mental health of an individual. Demographic information could include your name, address, telephone number, social security number, and any other means of identifying you as a specific person. Protected health information contains specific information that identifies a person or can be used to identify a person.
Protected health information is health information created or received by a health care provider, health plan, employer, or health care clearinghouse. Pembroke Pines Dental Solutions can act as each of the above business types. This medical information is used by Pembroke Pines Dental Solutions in many ways while performing normal business activities.
Your protected health information may be used or disclosed by Pembroke Pines Dental Solutions for purposes of treatment, payment, and health care operations. Health care professionals use medical information in clinics or hospitals to take care of you. Your protected health information may be shared, with or without your consent, with another health care provider for purposes of your treatment. Pembroke Pines Dental Solutions may use or disclose your health information for case management and services. Pembroke Pines Dental Solutions may send the medical information to insurance companies, Medicare, or community agencies to pay for the services provided to you.
Your information may be used by certain department personnel to improve Pembroke Pines Dental Solutions’ health care operations. Pembroke Pines Dental Solutions may also send you appointment reminders, information about treatment options or other health-related benefits and services.
Some protected health information can be disclosed without your written authorization as allowed by law. Those circumstances include:
- Reporting abuse of children, adults, or disabled persons.
- Investigations related to a missing child.
- Internal investigations and audits by The Department of Health divisions, bureaus, and offices.
- Investigations and audits by the state’s Inspector General and Auditor General, and the legislature’s Office of Program Policy Analysis and Government Accountability.
- Public health purposes, including vital statistics, disease reporting, public health surveillance, investigations, interventions, and regulation of health professionals.
- District medical examiner investigations;
- Research approved by The Department of Health.
- Court orders, warrants, or subpoenas;
- Law enforcement purposes, administrative investigations, and judicial and administrative proceedings.
- Other uses and disclosures of your protected health information by Pembroke Pines Dental Solutions will require your written authorization. This authorization will have an expiration date that can be revoked by you in writing. These uses and disclosures may be for marketing and for research purposes, certain uses and disclosure of psychotherapist notes, and the sale of protected health information resulting in remuneration to Pembroke Pines Dental Solutions.
You have the right to request Pembroke Pines Dental Solutions to restrict the use and disclosure of your protected health information to carry out treatment, payment, or health care operations. You may also limit disclosures to individuals involved with your care. Pembroke Pines Dental Solutions is not required to agree to any restriction.
You have the right to be assured that your information will be kept confidential. Pembroke Pines Dental Solutions will make contact with you in the manner and at the address or phone number you select. You may be asked to put your request in writing. If you are responsible to pay for
services, you may provide an address other than your residence where you can receive mail and where we may contact you.
You have the right to correct your protected health information. Your request to correct your protected health information must be in writing and provide a reason to support your requested correction. Pembroke Pines Dental Solutions may deny your request, in whole or part, if it finds the protected health information:
- Was not created by Pembroke Pines Dental Solutions.
- Is not protected health information.
- Is by law not available for your inspection.
- Is accurate and complete.
If your correction is accepted, Pembroke Pines Dental Solutions will make the correction and tell you and others who need to know about the correction. If your request is denied, you may send a letter detailing the reason you disagree with the decision. Pembroke Pines Dental Solutions will respond to your letter in writing. You also may file a complaint, as described below in the section titled Complaints.
You have the right to receive a summary of certain disclosures Pembroke Pines Dental Solutions may have made of your protected health information. This summary does not include:
- Disclosures made to you.
- Disclosures to individuals involved with your care.
- Disclosures authorized by you.
- Disclosures made to carry out treatment, payment, and health care operations.
- Disclosures for public health.
- Disclosures to health professional regulatory purposes.
- Disclosures to report the abuse of children, adults, or disabled.
This summary does include disclosures made for:
- Purposes of research, other than those you authorized in writing.
- Responses to court orders, subpoenas, or warrants.
You may request a summary for not more than a 6 year period from the date of your request. If you received this Notice of Privacy Practices electronically, you have the right to a paper copy upon request.
Pembroke Pines Dental Solutions is required by law to maintain the privacy of your protected health information. This Notice of Privacy Practices tells you how your protected health information may be used and how Pembroke Pines Dental Solutions keeps your information private and confidential. This notice explains the legal duties and practices relating to your protected health information. 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 take our obligations to protect your privacy seriously. If you have any questions about this Notice, please contact our Privacy Contact. If you believe your privacy rights have been violated, you may submit a complaint to the Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue, S.W., Washington, D.C. 20201, Telephone 202-619-0257 or Toll-Free 877-696-6775.
This Notice of Privacy Practices is effective beginning October 26, 2020, and shall be in effect until a new Notice of Privacy Practices is approved and posted.
“Standards for the Privacy of Individually Identifiable Health Information; Final Rule.” 45 CFR Parts 160 through 164. Federal Register 65, no. 250 (December 28, 2000). “Standards for the Privacy of Individually Identifiable Health Information; Final Rule” 45 CFR Part 160 through 164. Federal Register, Volume 67 (August 14, 2002). HHS, Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information and Nondiscrimination Act; Other Modifications to the HIPAA Rules, 78 Fed. Reg. 5566 (Jan. 25, 2013).