HIPAA Notice of Privacy Practices

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.

All Smiles Dental Studio is required by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") to maintain the privacy of your protected health information ("PHI"), to provide you with this notice of our legal duties and privacy practices, and to abide by the terms of this notice.

How We May Use and Disclose Your Health Information

• Treatment: We may use and share your PHI to provide, coordinate, and manage your dental care — for example, sharing information with a specialist, laboratory, or pharmacy involved in your treatment.
• Payment: We may use and share your PHI to bill and collect payment for services — for example, submitting claims to your dental insurance carrier or verifying your coverage.
• Health Care Operations: We may use your PHI for practice operations such as quality assessment, staff training, licensing, and appointment reminders by phone, email, or text.
• As Required by Law: We will disclose PHI when required to do so by federal, state, or local law, including public health reporting, abuse or neglect reporting, health oversight activities, and lawful requests by law enforcement.

Other uses and disclosures of your PHI — including most uses for marketing purposes and any sale of PHI — will be made only with your written authorization, which you may revoke at any time in writing.

Your Rights Regarding Your Health Information

• Right to Inspect and Copy: You may request to inspect and obtain a copy of your dental and billing records, including an electronic copy where applicable.
• Right to Amend: If you believe information in your record is incorrect or incomplete, you may request an amendment.
• Right to an Accounting of Disclosures: You may request a list of certain disclosures we have made of your PHI.
• Right to Request Restrictions: You may request restrictions on how we use or disclose your PHI, including restricting disclosure to your health plan for services you have paid for in full out of pocket.
• Right to Confidential Communications: You may request that we contact you in a specific way or at a specific location.
• Right to a Paper Copy of This Notice: You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Right to Be Notified of a Breach: We will notify you if a breach occurs that may have compromised the privacy or security of your PHI.

Our Responsibilities

• We are required by law to maintain the privacy and security of your PHI.
• We will not use or share your information other than as described here unless you tell us in writing that we may.
• We must follow the duties and privacy practices described in this notice and give you a copy of it upon request.

Changes to This Notice

We reserve the right to change this notice and to make the revised notice effective for PHI we already have as well as information we receive in the future. The current notice will be posted in our office and on this website with its effective date.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.

Contact Us

• All Smiles Dental Studio — Privacy Officer
• 207 S El Camino Real, Ste D, Encinitas, CA 92024
• Phone: (760) 232-8878
• Email: frontdesk@allsmilesds.com