We may use and disclose your health information for your treatment. For example, we may disclose
your health information to a specialist providing treatment to you.
We may use and disclose your health information to obtain reimbursement for the treatment and
services you receive from us or another entity involved with your care. Payment activities include
billing, collections, claims management, and determinations of eligibility and coverage to obtain
payment from you, an insurance company, or another third party. For example, we may send claims to
your dental health plan containing certain health information.
We may use and disclose your health information in connection with our healthcare operations.
For example, healthcare operations include quality assessment and improvement activities,
conducting training programs, and licensing activities.
We may disclose your health information to your family or friends or any other individual identified by
you when they are involved in your care or in the payment for your care. Additionally, we may disclose
information about you to a patient representative. If a person has the authority by law to make health
care decisions for you, we will treat that patient representative the same way we would treat you with
respect to your health information.
We may use or disclose your health information to assist in disaster relief efforts.
We may use or disclose your health information when we are required to do so by law.
We may disclose to military authorities the health information of Armed Forces personnel under
certain circumstances. We may disclose to authorized federal officials health information required for
lawful intelligence, counterintelligence, and other national security activities. We may disclose to a
correctional institution or law enforcement official having lawful custody, the protected health
information of an inmate or patient.
We will disclose your health information to the Secretary of the U.S. Department of Health and
Human Services when required to investigate or determine compliance with HIPAA.
We may disclose your PHI to the extent authorized by and to the extent necessary to comply with
laws relating to worker’s compensation or other similar programs established by law.
We may disclose your PHI for law enforcement purposes as permitted by HIPAA, as required by law,
or in response to a subpoena or court order.
We may disclose your PHI to an oversight agency for activities authorized by law. These oversight
activities include audits, investigations, inspections, and credentialing, as necessary for licensure and
for the government to monitor the health care system, government programs, and compliance with civil
rights laws.
If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or
administrative order. We may also disclose health information about you in response to a subpoena,
discovery request, or other lawful process instituted by someone else involved in the dispute, but
only if efforts have been made, either by the requesting party or us, to tell you about the request or to
obtain an order protecting the information requested.
We may disclose your PHI to researchers when their research has been approved by an institutional
review board or privacy board that has reviewed the research proposal and established protocols to
ensure the privacy of your information.
We may release your PHI to a coroner or medical examiner. This may be necessary, for example, to
identify a deceased person or determine the cause of death. We may also disclose PHI to funeral
directors consistent with applicable law to enable them to carry out their duties.
We may contact you to provide you with information about our sponsored activities, including
fundraising programs, as permitted by applicable law. If you do not wish to receive such
information from us, you may opt out of receiving the communications.
Your authorization is required, with a few exceptions, for disclosure of psychotherapy notes, use or
disclosure of PHI for marketing, and for the sale of PHI. We will also obtain your written authorization
before using or disclosing your PHI for purposes other than those provided for in this Notice (or as
otherwise permitted or required by law). You may revoke an authorization in writing at any time. Upon
receipt of the written revocation, we will stop using or disclosing your PHI, except to the extent that we
have already taken action in reliance on the authorization.
You have the right to look at or get copies of your health information, with limited exceptions. You
must make the request in writing. You may obtain a form to request access by using the contact
information listed at the end of this Notice. You may also request access by sending us a letter to
the address at the end of this Notice. If you request information that we maintain on paper, we
may provide
photocopies. If you request information that we maintain electronically, you have the right to an
electronic copy. We will use the form and format you request if readily producible. We will charge you a
reasonable cost-based fee for the cost of supplies and labor of copying, and for postage if you want
copies mailed to you. Contact us using the information listed at the end of this Notice for an
explanation of our fee structure.
If you are denied a request for access, you have the right to have the denial reviewed in accordance
with the requirements of applicable law.
With the exception of certain disclosures, you have the right to receive an accounting of disclosures
of your health information in accordance with applicable laws and regulations. To request an
accounting of disclosures of your health information, you must submit your request in writing to the
Privacy Official. If you request this accounting more than once in a 12-month period, we may charge
you a reasonable, cost-based fee for responding to the additional requests.
You have the right to request additional restrictions on our use or disclosure of your PHI by
submitting a written request to the Privacy Official. Your written request must include (1) what
information you want to limit, (2) whether you want to limit our use, disclosure or both, and (3) to
whom you want the limits to apply. We are not required to agree to your request except in the case
where the disclosure is to a health plan for purposes of carrying out payment or health care
operations, and the information pertains solely to a health care item or service for which you, or a
person on your behalf (other than the health plan), has paid our practice in full.
You have the right to request that we communicate with you about your health information by
alternative means or at alternative locations. You must make your request in writing. Your request
must specify the alternative means or location, and provide satisfactory explanation of how payments
will be handled under the alternative means or location you request. We will accommodate all
reasonable requests.
However, if we are unable to contact you using the ways or locations you have requested we may
contact you using the information we have.
You have the right to request that we amend your health information. Your request must be in writing,
and it must explain why the information should be amended. We may deny your request under certain
circumstances. If we agree to your request, we will amend your record(s) and notify you of such. If we
deny your request for an amendment, we will provide you with a written explanation of why we denied it
and explain your rights.
We will not share your opt-in to an SMS campaign with any third party for purposes unrelated to
providing you with the services of that campaign. We may share your Personal Data, including your
SMS opt-in or consent status, with third parties that help us provide our messaging services, including
but not limited to platform providers, phone companies, and other vendors who assist us in the
delivery of text messages. All of the above categories exclude text messaging originator opt-in data
and consent; this information will not be shared with any third parties.
If you consent to receive SMS from Progressive Implantology & Periodontics, you agree to receive
SMS from us. Reply STOP to unsubscribe: Reply HELP for help; msg&data rates may apply;
messaging frequency may vary.
You will receive notifications of breaches of your unsecured protected health information as required by
law.
You may receive a paper copy of this Notice upon request, even if you have agreed to receive this
Notice electronically on our Web site or by electronic mail (e-mail).
If you want more information about our privacy practices or have questions or concerns, please contact
us.
If you are concerned that we may have violated your privacy rights, or if you disagree with a decision
we made about access to your health information or in response to a request you made to amend or
restrict the use or disclosure of your health information or to have us communicate with you by
alternative means or at alternative locations, you may complain to us using the contact information
listed at the end of this Notice. You also may submit a written complaint to the U.S. Department of
Health and Human Services. We will provide you with the address to file your complaint with the U.S.
Department of Health and Human Services upon request.
We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
