HIPAA Privacy Policy
Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
Blossom Orthodontics is required by law to maintain the privacy of your protected health information (“PHI”) and to provide you with this Notice of our legal duties and privacy practices. We are committed to protecting the confidentiality of your medical and dental information.
This Notice explains how we may use and disclose your information and the rights you have regarding your health information.
HOW WE USE AND DISCLOSE YOUR HEALTH INFORMATION
Treatment
We use your health information to provide orthodontic care and related services. Examples include:
- Scheduling appointments
- Performing examinations and orthodontic treatment
- Taking radiographs (x-rays), scans, and photographs
- Referring you to dental or medical specialists
- Communicating with your general dentist or pediatric dentist
- Consulting with laboratories and other healthcare providers
We may also obtain records from other providers who have treated you.
Payment
We may use and disclose your health information to obtain payment for services provided. Examples include:
- Submitting insurance claims
- Verifying insurance benefits
- Collecting payment
- Billing statements and payment plans
- Working with collection agencies if necessary
Healthcare Operations
We may use and disclose your health information for the operation of our practice. Examples include:
- Quality assessment and improvement
- Staff training and education
- Appointment reminders
- Business planning and management
- Legal and auditing activities
- Licensing and credentialing
We may share information with third-party companies (“Business Associates”) who help operate our office (billing services, software providers, imaging platforms). These parties are legally required to protect your information.
OTHER USES AND DISCLOSURES WITHOUT YOUR AUTHORIZATION
In certain situations, the law allows or requires us to disclose your health information without your permission, including:
- Public health reporting
- Suspected abuse or neglect reporting
- Health oversight agencies and licensing boards
- Court orders, subpoenas, or legal proceedings
- Law enforcement investigations
- Medical emergencies
- Preventing serious threats to health or safety
- Workers’ compensation claims
- Identification of deceased persons or funeral arrangements
APPOINTMENT REMINDERS & COMMUNICATIONS
We may contact you by:
- Phone call
- Voicemail
- Text message
- Patient portal
These communications may include appointment reminders, treatment information, or billing notifications.
If you prefer a specific communication method or wish to opt out of electronic communications, please notify our office.
TELEHEALTH & ELECTRONIC COMMUNICATIONS
We may provide virtual consultations and communicate electronically. We use reasonable safeguards to protect your information, but electronic communications carry some inherent risk.
By choosing email or text communication, you acknowledge and accept those risks.
BREACH NOTIFICATION
If a breach occurs involving your unsecured health information, we will notify you as required by law. Notification will include:
- What happened
- Information involved
- Steps we are taking
- How you can protect yourself
USES REQUIRING YOUR WRITTEN AUTHORIZATION
We will never share your health information for marketing purposes or sell your information without your written permission.
You may revoke any authorization at any time in writing.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the right to:
- Access Your Records: You may request copies of your records. We will provide them within 30 days when possible.
- Request Corrections: You may request amendments if you believe information is incorrect or incomplete.
- Request Restrictions: You may ask us not to share certain information for treatment, payment, or operations. We will honor reasonable requests when legally possible.
- Confidential Communications: You may request we contact you at a specific phone number, email, or mailing address.
- Accounting of Disclosures: You may request a list of certain disclosures made within the past six years.
- Paper Copy of This Notice: You may request a printed copy at any time.
- Out-of-Pocket Payment Protection: If you pay in full out-of-pocket for a service, you may request that we not share that information with your insurance provider. We are required to honor this request.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice at any time. Updated notices will be:
- Posted in our office
- Available upon request
- Posted on our website
Changes apply to all health information we maintain.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with us or with:
U.S. Department of Health & Human Services
Office for Civil Rights
We will not retaliate against you for filing a complaint.
To file a complaint with our office, please contact:
Blossom Orthodontics
7130 Dempster Street
Morton Grove, IL 60053
Phone:224-601-6012
Email: [email protected]
QUESTIONS
If you have questions about this Notice or your privacy rights, please contact our office.
