There are some situations when we do not need your written authorization before using your health information or sharing it with others, including:
Treatment:
We may use and disclose your Protected Health Information to provide, coordinate, or manage your health care and any related services. For example, your Protected Health Information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.
Payment:
Your Protected Health Information may be used, as needed, to obtain payment for your health care services after we have treated you. In some cases, we may share information about you with your health insurance company to determine whether it will cover your treatment.
Healthcare Operations:
We may use or disclose, as needed, your Protected Health Information in order to support the business activities of our practice, for example: quality assessment, employee review, training of medical students, licensing, fundraising, and conducting or arranging for other business activities.
Appointment Reminders and Health-related Benefits and Services:
We may use or disclose your Protected Health Information, as necessary, to contact you to remind you of your appointment, and inform you about treatment alternatives or other health-related benefits and services that may be of interest to you. If we use or disclose your Protected Health Information for fundraising activities, we will provide you the choice to opt out of those activities. You may also choose to opt back in.
Friends and Family Involved in Your Care:
If you have not voiced an objection, we may share your health information with a family member, relative, or close personal friend who is involved in your care or payment for your care, including following your death.
Business Associate:
We may disclose your health information to contractors, agents and other “business associates” who need the information in order to assist us with obtaining payment or carrying out our business operations. For example, a billing company, an accounting firm, or a law firm that provides professional advice to us. Business associates are required by law to abide by the HIPAA regulations.
Proof of Immunization:
We may disclose proof of immunization to a school about a student or prospective student of the school, as required by State or other law. Authorization (which may be oral) may be obtained from a parent, guardian, or other person acting in loco parentis, or by the adult or emancipated minor.
Incidental Disclosures:
While we will take reasonable steps to safeguard the privacy of your health information, certain disclosures of your health information may occur during or as an unavoidable result of our otherwise permissible uses or disclosures of your health information. For example, during the course of a treatment session, other patients in the treatment area may see, or overhear discussion of your health information.
We may use or disclose your health information if you need emergency treatment or if we are required by law to treat you.
We may use or disclose your Protected Health Information in the following situations without your authorization: as required by law, public health issues, communicable diseases, abuse, neglect or domestic violence, health oversight, lawsuits and disputes, law enforcement, to avert a serious and imminent threat to health or safety, national security and intelligence activities or protective services, military and veterans, inmates and correctional institutions, workers’ compensation, coroners, medical examiners and funeral directors, organ and tissue donation, and other required uses and disclosures.
We may release some health information about you to your employer if your employer hires us to provide you with a physical exam and we discover that you have a work-related injury or disease that your employer must know about in order to comply with employment laws.
Under the law, we must also disclose your Protected Health Information when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements under Section 164.500.
Research:
We may disclose your health information to researchers conducting research with respect to which your written authorization is not required as approved by an Institutional Review Board or privacy board, in compliance with governing law.
The confidentiality of your substance use disorder (SUD) treatment records maintained by this facility is protected by federal law and regulations (42 CFR Part 2 and the HIPAA Privacy Rule). Generally, we cannot disclose information that identifies you as a person with a substance use disorder to anyone outside the facility without your written consent.
With your written consent, we may use and disclose your SUD information for treatment, payment, and health care operations. You may revoke your consent at any time in writing, except to the extent that we have already relied on it.
Use and Disclosure for Legal Proceedings:
SUD treatment records from programs subject to 42 CFR Part 2 generally cannot be used or disclosed in legal proceedings against the patient unless there is specific written consent or a court order.
Redisclosure of SUD Records:
If SUD records are disclosed with patient consent, the recipient can re-disclose them to contractors or legal representatives for specified TPO activities if a written agreement is in place that maintains confidentiality. Otherwise, redisclosure is prohibited.
SUD Counseling Notes:
SUD counseling notes require a separate, specific consent for their use or disclosure and cannot be used or disclosed based on a general TPO consent.
Fundraising Communications:
If SUD records are used or disclosed for fundraising, patients must be given a clear opportunity to opt out.
Exceptions:
We may share information without your consent in a medical emergency, to report suspected child abuse as required by law, or to law enforcement if you commit a crime on our premises.
Stricter State Laws:
If state law offers greater protection, the more stringent state law applies.
There are certain situations where we must obtain your written authorization before using your health information or sharing it, including: Most uses of psychotherapy notes, when appropriate.
Marketing:
We may not disclose any of your health information for marketing purposes if our practice will receive direct or indirect financial payment not reasonably related to our practice’s cost of making the communication.
Sale of Protected Health Information:
We will not sell your Protected Health Information to third parties.You may revoke the written authorization at any time, except when we have already relied upon it. To revoke a written authorization, please write to the Privacy Officer at our practice. You may also initiate the transfer of your records to another person by completing a written authorization form.
Right to Inspect and Copy Records:
You have the right to inspect and obtain a copy of your health information, including medical and billing records. Requests must be submitted in writing. We may charge a fee for copying, mailing, or supplies. Electronic copies will be provided if readily producible. Certain records may be excluded as allowed by law.
Right to Amend Records:
You may request an amendment in writing if you believe your information is incorrect or incomplete. If denied, we will provide a written explanation.
Right to an Accounting of Disclosures:
You may request a list of disclosures made in the past six years, excluding TPO and certain other disclosures. One free request per year; additional requests may incur a fee.
Right to Receive Notification of a Breach:
You will be notified within sixty (60) days if there is more than a low probability that your unsecured PHI has been compromised.
Right to Request Restrictions:
You may request restrictions on certain uses or disclosures. Physicians must comply when you have paid in full out of pocket and request that information not be shared with your health plan.
Right to Request Confidential Communications:
You may request alternative communication methods. We will not ask for a reason.
Right to Have Someone Act on Your Behalf:
You may designate a personal representative to act for you.
Right to Obtain a Copy of Notices:
You may request a paper copy of this Notice at any time.
Right to File a Complaint:
You may file a complaint with the Privacy Officer at (781) 205-1124 or with the U.S. Department of Health and Human Services, Office of Civil Rights. No retaliation will occur.
Use and Disclosures Where Special Protections May Apply:
Certain sensitive information (e.g., substance abuse treatment, HIV, mental health, psychotherapy, genetic information) may be subject to additional protections under state or federal law.
.png)
.png)
If you have questions about your child’s dental health, or if you would like to book an appointment, leave us your contact information and we’ll reach out as soon as possible!