HIPAA Notice of Privacy Practices

Our Commitment to Your Privacy

Altamar Dental Studio is committed to protecting the privacy of your protected health information (PHI). We are required by law to maintain the privacy of your health information and to provide you with this Notice of our legal duties and privacy practices.

How We May Use and Disclose Your Health Information

1. Treatment

We will use and disclose your health information to provide, coordinate, or manage your dental care and related services. For example:

• Discussing your treatment plan with you
• Coordinating care with specialists or laboratories
• Sending records to another dentist for consultation

2. Payment

We may use and disclose your health information to obtain payment for services. For example:

• Submitting insurance claims on your behalf (as a courtesy)
• Billing you for services rendered
• Verifying insurance coverage

3. Healthcare Operations

We may use and disclose your health information for our healthcare operations, including:

• Quality assessment and improvement activities
• Staff training and competency evaluation
• Business planning and management
• Compliance and legal reviews

4. Appointment Reminders

We may contact you to remind you about appointments or to provide information about treatment alternatives or health-related services.

5. Required by Law

We will disclose your health information when required to do so by federal, state, or local law.

6. Public Health Activities

We may disclose your health information for public health purposes, such as:

• Reporting diseases, injuries, or disabilities
• Reporting suspected abuse or neglect
• Preventing or controlling disease outbreaks

Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of your health information will be made only with your written authorization. You may revoke such authorization in writing at any time. Examples include:

• Marketing purposes
• Sale of protected health information
• Most uses of psychotherapy notes
• Other purposes not described in this Notice

Your Rights Regarding Your Health Information

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your health information. To request copies of your records, please submit a written request to our office. We may charge a reasonable fee for copying and mailing costs.

Right to Request an Amendment

If you believe your health information is incorrect or incomplete, you may request that we amend it. We may deny your request under certain circumstances, and we will provide you with written notice of the denial.

Right to an Accounting of Disclosures

You have the right to receive a list of certain disclosures we have made of your health information. The list will not include disclosures for treatment, payment, or healthcare operations.

Right to Request Restrictions

You have the right to request restrictions on how we use and disclose your health information. We are not required to agree to your request, but if we do, we will comply with the restriction unless the information is needed for emergency treatment.

Right to Request Confidential Communications

You have the right to request that we communicate with you about your health information through alternative means or at alternative locations.

Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically.

Right to File a Complaint

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

Our Responsibilities

We are required by law to:

• Maintain the privacy of your health information
• Provide you with this Notice of our legal duties and privacy practices
• Follow the terms of the Notice currently in effect
• Notify you if we are unable to accommodate a requested restriction or confidential communication
• Notify you in the event of a breach of your unsecured health information

Changes to This Notice

We reserve the right to change the terms of this Notice at any time. Any changes will apply to all health information we maintain. We will post the new Notice in our office and on our website, and you may request a copy at any time.

Contact Information

For more information about our privacy practices, to exercise your rights, or to file a complaint:

Privacy Officer
Altamar Dental Studio
6605 Hillway Circle, Suite 100
Naples, FL 34112
Phone: (239) 260-5968
Email: info@altamardental.com

To file a complaint with the Department of Health and Human Services:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/