Parkway Family Dentistry > Notice of Privacy Practices

Notice of Privacy Practices

Notice of Privacy Practices:

This notice describes how medical information about you may be used and disclosed and how you may get access to this information. Please read it carefully.

Protecting your health information is important to us. The law says that we must keep your Protected Health Information (PHI) private, provide you with notice of our legal duties and privacy practices with respect to PHI, follow the current terms of this notice, and notify affected individuals following a breach of unsecured PHI.

Parkway Family Dentistry reserves the right to change the terms of this Notice at any time. Any changes made will apply to all of your health information maintained by Parkway Family Dentistry. If changes are made to this Notice, the new notice will be posted and a paper copy made available upon request. The Notice will also be posted on our website.

How Your Health Information Can Be Used and Disclosed Without Your Permission

Communication Purposes

We may use your protected health information to contact you to remind you about appointments, inform you about treatment options, or advise you about other alternative health-related benefits,treatments and services that may be of interest to you.

Treatment Purposes

We may use your protected health information to provide treatment or services for you. The doctors, hygienists and other team members caring for you may share your health information with a third party to provide, coordinate or manage your health care and any related services. Sometimes, this may mean speaking with health care professionals who are not part of Parkway Family Dentistry, like nursing home staff, therapists, and other specialists. For example, your dentist may need to know if you have other health problems that might complicate your treatment and therefore may request your medical record from another health care provider that has provided treatment to you.We may also share your health information with non-health care personnel in an emergency situation.

Payment Purposes

We may use or disclose your health information so we may receive payment for the treatment and services we have provided to you. We also may contact your insurance company to learn what services are included in your health plan, to get prior approval for certain treatments or services, and to tell them about your treatment to make sure it is a covered service.For example, we may give your insurance company information about your dental surgery so your insurance will pay for the care.

Health Care Operations

We may use and share your health information to operate our facility and make sure that all of our patients receive quality care, to rate the services that you received, or how well our staff cared for you. We may use your health information to see where we can make improvements or to find better ways to provide care. We may use health information for business planning, or disclose it to attorneys, accountants, consultants,billing or legal services and others who assist Parkway Family Dentistry in its activities and to make sure we are following the law.

Family and Friends

We may disclose your protected health information to individuals, such as family and friends, who are involved in your care or who help pay for your care. We may do this if you tell us we can do so, or if you know we are sharing your information with these people and you do not object. If you are unavailable or unable to tell us your preference, we may also disclose your information if, based on our professional judgment, we believe that disclosing the information is in your best interest and you would not object. For example, we may assume you agree to disclose your information to your spouse if your spouse comes with you into the exam room or allow your spouse to pick up prescriptions, dental supplies and X-rays.

If you are a minor, you also may have the right to block parental access to your health information in certain circumstances, if permitted by state law. You can contact your dental provider or our Privacy Officer at the number at the top of this Notice.

Operations

We may use or disclose your protected health information for our health care operations, such as to support our business activities and to ensure that quality dental care is provided. Some of these activities involve quality assessments, peer or employee review, training health care professionals, licensing and accreditation activities, data aggregation, compliance- or audit-related activities, and business planning and development. For example, we may use your information to evaluate the performance of our dentists and staff in providing care to you. We may also disclose your protected health information to another provider, health plan, or health care clearinghouse that has or has had a relationship with you for certain of its health care operations.

Treatment Alternatives and Health-Related Products and Services

We may use or disclose your protected health information to provide you with information about certain products or services including to describe our participation in a dentist network or health plan network, products or services we provide or include in a plan of benefits, and alternative treatments, therapies, dentists or settings of care.

Other Uses and Disclosures of Your Health Information That Do Not Require Your Permission

  • As required by Law – We may use or disclose your protected health information when and as required by federal, state or local law.
  • Public Health – For public health activities, including preventing or controlling disease, injury, or reporting vital events, such as births and deaths,reactions to medications, or problems with products; and to comply with medication or product recalls.
  • Abuse, Neglect, Domestic Violence – Notifying law enforcement or other agencies if we believe a patient has been the victim of abuse, neglect, or domestic violence.
  • Health Oversight – For health oversight activities, such as audits, investigations, licensing, and accreditation by agencies, such as CMS for the Medicaid and Medicare programs.
  • Legal Proceedings, Lawsuits, Administrative Proceedings, and Other Legal Actions – In a legal proceeding if the request for the information is through an order from a court or administrative tribunal. Your health information may also be disclosed in response to a subpoena,discovery request or other lawful process.
  • Law Enforcement – If asked by law enforcement, or if the law says we must, we may disclose medical information:
    •  to report certain wounds or other physical injuries if required by law to do so;
    • to identify or locate a suspect, fugitive, material witness, or missing person;
    • about a suspected victim of a crime if, under certain limited circumstances we are unable to obtain the person’s agreement;
    • about a death suspected to be the result of criminal conduct;
    • about criminal conduct at premises of Parkway Family Dentistry; and
    • in case of a medical emergency, to report a crime, the location of the crime or victims, or the identity, description, or location of the person who committed the crime.
  • Coroners, Funeral Directors, Medical Examiners – To funeral directors as needed, and to coroners or medical examiners to identify a deceased person, determine the cause of death, and perform other functions authorized by law.
  • Organ Donation – If you are an organ or tissue donor, we may disclose your protected health information to organizations that handle organ procurement or organ, eye or tissue donation or transplantation.
  • Research – We may use and disclose your protected health information in preparation for research or for research if and as approved by an institutional review board or privacy board.
  • Serious Threat to Health or Safety; Disaster Relief- We may disclose your protected health information to appropriate individuals or organizations when and as necessary to prevent a serious threat to the health and safety of a person (including yourself) or of the public.  We may also disclose your protected health information to identify, locate or notify your family members or persons responsible for you in a disaster.
  • National Security and Armed Forces – To government officials for national security and intelligence activities, or to military authorities under some circumstances if you are a member of the military.
  • Special Government Functions – To government officials for special investigations or to protect the President of the United States, other authorized persons, or foreign heads of state.
  • Worker’s Compensation -We may disclose your protected health information for workers’ compensation or similar work-related injury programs, to the extent permitted or required by law, to process your claim.
  • Inmates: We may disclose your protected health information to a correctional institution (if you are an inmate) or a law enforcement official (if you are in that official’s custody) as necessary (i) for the institution to provide you with health care; (ii) to protect your or others’ health and safety; or (iii) for the safety and security of the correctional institution.

Parkway Family Dentistry may use or disclose your health information in the following ways unless you object:

  • Coordination of Care – Disclose health information with family members, other relatives, or friends involved with your care.
  • Notification of Location – Use or disclose your information to provide information of your location and general condition to a family member, a personal representative, or another person responsible for your care.
  • Fundraising – Share information about you and/or contact you about activities to raise funds to expand and support health care services, education, and research for Parkway Family Dentistry. You have the right to opt out of receiving these communications.

Other Uses and Disclosures of Your Health Information

Uses or disclosures that require your written permission include the following:

  • Most uses and disclosures of psychotherapy notes
  • Uses and disclosures for marketing purposes, not including:
  • face-to-face communications,
  • when promotional gift of nominal value is provided,
  • refill reminders or communications about a drug currently prescribed as long as any monies received are only for the cost of labor, supplies, and postage, or
  • communications promoting health in general that do not promote a product or service from a particular provider
  • Disclosures that constitute a sale of your health information under applicable law

You may revoke your written permission to use or disclose your health information except to the extent that action has already been taken in reliance on the permission you gave. Your request must be in writing and addressed to 2010 John Rolfe Pkwy, Richmond, Virginia 23238.

Your Rights Regarding Your Protected Health Information

You have the following rights with respect to your health information.You may exercise these rights by submitting a written request to our Privacy Contact.  Please contact our Privacy Contact with any questions about these rights.

  • Right to Inspect and Copy – You may inspect and obtain a copy of your protected health information maintained in your dental chart, including clinical and billing records and any other records that we use to make decisions about you. We may charge you a fee to cover costs of copying, mailing and associated supplies. We may refuse to allow you to inspect or copy certain records, such as information compiled for legal actions and proceedings.  If we deny your request, you may have a right to have this decision reviewed.
  • Right to Amend – You may request an amendment of your protected health information to correct an error or omission. In certain cases, we may deny your request for an amendment.  If we deny your request for an amendment, you have the right to file a statement of disagreement with us. We may prepare a rebuttal to your statement and, if we do, we will provide you with a copy of any such rebuttal.
  • Right to an Accounting of Disclosures- You may request an accounting of certain disclosures of your protected health information made within a period up to six years prior to your request.  This accounting does not include disclosures made to you or with your authorization; for treatment, payment or health care operations; to family members or friends involved in your care or for notification purposes; and certain other disclosures.  The right to receive this information is subject to certain exceptions, restrictions and limitations.
  • Right to Request Restrictions– You may request that we not use or disclose any part of your protected health information for a particular treatment, payment or health care operations-related purpose. You may also request that any part of your protected health information not be disclosed to particular family members or friends who may be involved in your care.

We are not required to agree to a restriction that you may request, unless you request to restrict the disclosure of your protected health information to a health plan for payment or health care operations-related purposes and the protected health information relates only to a health care item or service for which you have paid in full and not through insurance.  If we agree to the requested restriction, we may still use or disclose your protected health information as needed for emergency treatment.

  • Right to Request Confidential Communications- The right to receive communications, such as mails,appointment confirmation calls or reminders from Parkway Family Dentistry in a confidential manner, such as an alternate address or telephone number.
  • Right to Paper copy of this Notice – The right to receive a paper copy of this Notice even if you have agreed to accept this notice electronically.
  • Right to Breach Notification- If we or one of our service providers improperly uses or discloses your protected health information in a way that compromises the privacy or security of that information (a “breach”), we will notify you as required by law.
  • File a Formal Complaint – The right to file a complaint with Parkway Family Dentistry and/or to the United States Department of Health and Human Services if you believe that your privacy rights have been violated.

For More Information,

If you would like more information about your rights or about the uses and disclosures of your medical information, you may contact Parkway Family Dentistry at (804) 750-1284, by email at parkwaydentalva@gmail.com or by writing to 2010 John Rolfe Parkway, Richmond, VA 23238.