HIPAA Notice of Privacy Practices

We are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information. We must follow the privacy practices described in this notice while it is in effect.

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. When we make a significant change in our privacy practices, we will post the new notice clearly and prominently at our practice location and provide copies upon request.

How We May Use and Disclose Health Information About You

We may use and disclose your health information for treatment, payment, and health care operations, and in the additional circumstances described below. Some information, such as HIV-related information, genetic information, and substance abuse records, may be entitled to special confidentiality protections under applicable law, which we will follow.

Treatment. While providing you with health care services, we may share your protected health information with other health care providers, business associates, and their subcontractors involved in your treatment, billing, or administrative support.

Payment. We may use and disclose your health information to obtain reimbursement for treatment and services, including billing, collections, claims management, and eligibility determinations.

Health Care Operations. We will use and disclose your health information to keep our practice operable, including quality assessment, licensing, and business management activities.

Individuals Involved in Your Care. We may disclose your health information to family, friends, or another individual identified by you when they are involved in your care or payment for your care.

Required by Law. We may use or disclose your health information when required to do so by law, such as in response to a court order, subpoena, or discovery request.

Public Health and Safety. We may disclose health information for public health activities, to report suspected abuse, neglect, or domestic violence, or to avert a serious threat to health or safety.

Health Oversight and Legal Proceedings. We may disclose your protected health information for health oversight activities authorized by law, and in judicial or administrative proceedings in response to a lawful order.

Appointment Reminders. We may use your health records to remind you of recommended services, treatment, or scheduled appointments.

Marketing and Fundraising. We will not use your health information for marketing purposes without your written authorization. If we contact you for fundraising purposes, you have the right to opt out of future communications.

Your Health Information Rights

• Access. You have the right to look at or get copies of your health information, with limited exceptions, by submitting a written request.
• Disclosure Accounting. You have the right to receive an accounting of certain disclosures of your health information.
• Right to Request a Restriction. You may ask us to restrict how we use or disclose your protected health information.
• Alternative Communication. You may request that we contact you by alternative means or at an alternative location.
• Amendment. You may request that we amend your health information in writing.
• Right to Notification of a Breach. You will be notified if a breach of your unsecured protected health information occurs.
• You may receive a paper copy of this notice at any time, upon request.

Questions and Complaints

If you want more information about our privacy practices or have questions or concerns, please contact us using the information below. If you believe your privacy rights have been violated, you may file a written complaint with our office or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Contact Information

Privacy Officer: Owner / Office Manager
Telephone: (817) 754-4858
Email: info@compassdentaldfw.com
Address: 12652 Timberland Boulevard, Suite 130, Fort Worth, TX 76244