Privacy Policy

We may use or disclose your health information for treatment, payment, and healthcare operations, as described below:

Treatment

We may use or disclose your health information to dentists, physicians, specialists, or other healthcare providers involved in your care.

Payment

We may use or disclose your health information to obtain payment for services provided, including billing insurance companies or health plans.

Healthcare Operations

We may use or disclose your health information for practice operations, including quality assessment, staff training, credentialing, licensing, accreditation, audits, and evaluating provider performance.

Michigan Dental Patient Consent

Michigan law may require your written consent before certain disclosures of your health information are made.

Your Authorization

You may authorize us in writing to use or disclose your health information for purposes not described in this Notice. You may revoke your authorization in writing at any time. Revocation will not affect disclosures already made while the authorization was in effect.

Family and Friends

With your agreement, we may disclose relevant health information to family members, friends, or others involved in your care or payment for your care.

Persons Involved in Your Care

We may use or disclose health information to notify or assist in notifying a family member, personal representative, or another person responsible for your care of your location, general condition, or death. If you are present, you will be given the opportunity to object. In emergencies or if you are unable to object, disclosures will be based on our professional judgment and limited to information directly relevant to involvement in your care.

Business Associates

We may disclose health information to business associates who perform services on our behalf. All business associates are contractually required to protect the privacy and security of your health information.

Marketing

We will not use or disclose your health information for marketing purposes without your written authorization.

Required by Law

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

Breach Notification

We may use or disclose your health information to provide legally required notices in the event of a breach of unsecured PHI.

Abuse, Neglect, or Threats to Safety

We may disclose your health information to appropriate authorities if we reasonably believe you are a victim of abuse, neglect, domestic violence, or other crimes, or to prevent a serious threat to health or safety.

National Security and Law Enforcement

We may disclose health information to military authorities, federal officials for national security purposes, or correctional institutions and law enforcement under lawful circumstances.

Appointment Reminders

We may use or disclose your health information to contact you with appointment reminders or information about your care (e.g., voicemail, postcards, text messages, or letters).

Your Rights

You have the following rights regarding your health information:

Access

You may inspect or obtain copies of your health information, with limited exceptions. Requests must be made in writing. Reasonable, cost-based fees may apply.

Accounting of Disclosures

You may request a list of certain disclosures made within the past six (6) years, excluding disclosures for treatment, payment, or healthcare operations. One request per 12-month period is free; additional requests may incur a reasonable fee.

Restrictions

You may request restrictions on certain uses or disclosures of your health information. We are not required to agree, but if we do, we will comply except in emergencies.

Out-of-Pocket Payments

If you pay in full out-of-pocket for a service, you may request that related information not be disclosed to your health plan. We will comply unless prohibited by law.

Alternative Communications

You may request to receive communications in a different manner or at a different location. Requests must be made in writing and specify how payment will be handled.

Amendments

You may request an amendment to your health information if you believe it is incorrect or incomplete. Requests must be in writing and include a reason. We may deny requests under certain circumstances.

Electronic or Paper Copy

If you receive this Notice electronically, you are entitled to a paper copy upon request.

Notice of Breach

You have the right to be notified if there is a breach of your unsecured protected health information.

Questions and Complaints

If you have questions about this Notice or our privacy practices, or if you believe your privacy rights have been violated, you may contact us using the information below.

You may also file a complaint with the U.S. Department of Health and Human Services. We will provide contact information upon request.

We will not retaliate against you for filing a complaint.

Privacy Officer Contact Information

Privacy Officer: Annika M. Schott

Phone: 616-341-7701

Fax: 844-689-1183

Address:

2380 Health Dr SW, Suite 203

Wyoming, MI 49519