Privacy Policy

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.

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If you have any questions about this Notice please contact the Privacy Officer at
949-997-6453 or info@newlifeimplantcenter.com.

This Notice of Privacy Practices describes how we protect your health information and what rights you have regarding your health information. “Protected health information” is information about you, including demographic and financial information, that may identify you and that relates to your past, present, or future physical or mental health condition and related health and dental care services.

In certain circumstances, we are required by law to maintain the privacy of your protected health information, to provide you with and to abide by the terms of this Notice. We may change the terms of this Notice at any time. The new Notice will be effective for all protected health information that we maintain at that time.

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USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION WITHOUT YOUR PERMISSION

We may use and disclose your protected health information for certain purposes without your authorization, including the following:

Treatment: We may use and disclose your protected health information to provide, coordinate, or manage your treatment. This includes the coordination or management of your health care with another provider. For example, we may use or disclose your information to perform a medical or dental exam, to perform diagnostic tests, to discuss your plan of care or to prescribe medications. We may also disclose your information to another provider who cares for you, such as a physician who is treating you or another dentist. Your protected health information may be provided to a physician or dentist to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you. Other dentists or manufacturer representative may be present during your treatment to observe or assist with equipment or materials, unless you object. This disclosure may include the use of photographs or videos taken before, during and after treatment as permitted by law.

 

Payment: We may use or disclose your protected health information to obtain payment for health care services we provided to you.

Health Care Operations: We may use or disclose your protected health information for certain administrative and managerial activities that are necessary to support the business activities of the Practice, such as assessment and improvement activities, employee review activities and licensing. We may also use and disclose your protected health information for purposes of teaching our dentists, dental assistants and staff about our clinical and non-clinical practices and techniques. The purpose of such use and disclosure is to improve the knowledge and expertise of those who provide dental implant and prosthetic services or provide supporting services.

Appointment Reminders / Treatment Alternatives: We may also call, write, or email to remind you of routine scheduled appointments or referral appointments. We may also contact you to notify you of other treatments or services available that might help you.

Business Associates: We may disclose your protected health information to persons or entities that perform certain services or health care operations for us and who agree to comply in writing with certain privacy and security obligations.

Others Involved in Your Health Care or Payment for Your Care: Unless you instruct us not to, we may disclose your protected health information to a member of your family, a close friend, or any other person who is involved in your medical and dental care. We may also disclose certain information about you to an entity assisting in a disaster relief effort.

Business Associates: We may disclose your protected health information to persons or entities that perform certain services or health care operations for us and who agree to comply in writing with certain privacy and security obligations.

Others Involved in Your Health Care or Payment for Your Care: Unless you instruct us not to, we may disclose your protected health information to a member of your family, a close friend, or any other person who is involved in your medical and dental care. We may also disclose certain information about you to an entity assisting in a disaster relief effort.

Electronic Disclosures: We may make an electronic disclosure of your protected health information as permitted by law.

Other Uses and Disclosures: We may also use or disclose your protected health information without your permission in some other limited situations if certain conditions are met, but not all of these situations apply to us and some may never occur at all.

Such permitted uses and disclosures are:

• when state or federal law requires that certain information be reported for a specific purpose;

• for public health activities and purposes, such as contagious disease reporting, investigation or surveillance and notices to and from the federal Food and Drug Administration regarding drugs or dental devices;

• for health oversight activities, such as licensing dentists, audits, investigations and inspections;

• to governmental authorities about victims of abuse, neglect, or domestic violence;

• for judicial or administrative proceedings, such as in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in response to a subpoena, discovery request, or other lawful process under certain conditions;

• to avert a serious threat to your health and safety or the health or safety of another person pursuant to applicable law;

• for law enforcement purposes, such as to provide information about someone who is or was suspected to be a victim of a crime or to report information about a crime, or to a correctional institution in certain circumstances;

• to a medical examiner or coroner to identify a dead person or to determine the cause of death, or to funeral directors to aid in burial, or to organizations that handle organ or tissue donations;

• for health-related research that has been approved by an institutional review board or its equivalent;

• for specialized government functions, such as for lawful national intelligence purposes, for military purposes, or for evaluation and health of members of the foreign service; and

• disclosures authorized by an applicable workers’ compensation program.

 

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION WITH YOUR PERMISSION

Before we can use or disclose your protected health information in a manner which is not described above, we will obtain your written authorization. For example, we will obtain your authorization for most uses and disclosures of your health information for marketing purposes and for the sale of your health information. Further, we will not use or disclose psychotherapy notes without your written authorization. You may revoke an authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your protected health information for the reasons covered by your written authorization, except to the extent we have already relied on it or as otherwise permitted by law. You may obtain a Revocation of Authorization form from the Privacy Officer and submit it to the email address noted above.

 

STATE LAWS

Every state has its own set of privacy laws. If your state has a privacy law that provides greater limits on how we may use or disclose your protected health information than what is stated in this Notice, we will abide by that state law. If you have any questions regarding any such laws, you may contact the Privacy Officer at the telephone number or email address noted above.

 

YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION

The following is a list of your rights with respect to your protected health information and a brief description of how you may exercise these rights. You can request to exercise any of these rights by contacting our Privacy Officer at the telephone number or email address shown at the beginning of this Notice.

Access to your records. You have the right to look at or order a copy of the dental/medical records that we maintain. Except in a few limited situations, we will provide you with access to or a copy of your health information within 30 days of your written request. If we need more time, we will notify you in writing. If we have information about you in electronic format, we will provide it to you in an electronic format. As permitted by federal and state law, we may charge you a reasonable cost-based fee for a copy of your records.

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Restriction of your protected health information. You may request restrictions on how we use and disclose your health information.  We will consider such a request, but we are not required to agree to a restriction.

Confidential communications. You may ask us to communicate with you in a confidential way. We will accommodate any reasonable request for you to receive your protected health information by alternative means of communication or. at an alternative location. We will not request an explanation from you as to the basis for the request.

Amendment to your protected health information. You may ask us to amend your protected health information if you think it is incomplete or inaccurate. We will respond within 60 days of such request, unless we notify you in writing we need additional time. Please contact our Privacy Officer if you have questions about amending your medical record.

 

Accounting of certain disclosures of your protected health information. You have the right to request a list of disclosures that we have made of your health information within the past six years (or a shorter period if you want). We will usually respond to your request for a list of disclosures within 30 days if required by law. Additional copies of this Notice. You may request additional copies of this Notice of Privacy Practices even if you agreed to accept this Notice electronically.

 

Notice of a Breach. We will notify you if there is a breach involving your protected health information as required by law.

 

COMPLAINTS

If you believe that your privacy rights have been violated, you may file a complaint with us. For more information on how to file a written complaint with us, call the Privacy Officer at the number listed above. Your privacy is one of our greatest concerns, and you will never be retaliated against if you choose to file a complaint. There may also be a federal or state agency that enforces rules relating to the privacy and security of your health information, and you may have a right to file a complaint with that agency.

 

CHANGES TO THIS NOTICE

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 will make any new Notice available to you. You may request a copy of the Notice currently in effect at any time by contacting the Privacy Officer at the telephone number or email address listed above.

 

EFFECTIVE DATE

This Notice is effective November 5, 2021.

If you want any more information about our privacy practices, contact the Privacy Officer at the telephone number or email address listed at the beginning of this Notice.