Neighborhood Dental
Notice of Privacy Practices
DRAFT FOR LEGAL REVIEW. This notice has not yet been reviewed by an attorney and is not in effect. For our current Notice of Privacy Practices, please ask at our front desk or call (702) 641-8868.
DRAFT: not yet in effect
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.
This notice applies to Harmon and Otteson Dental LLC (dba Neighborhood Dental) (“we,” “us,” or “our”) and our dentists and staff.
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
- Get a copy of your health and claims records. You can ask to see or get a copy of your dental record and other health information we have about you, in paper or electronic form. We will provide a copy (or, if you agree in advance, a summary) usually within 30 days of your request. Nevada law may give you a shorter deadline to inspect your records. We may charge a reasonable, cost-based fee.
- Ask us to correct your record. You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no,” but we will tell you why in writing within 60 days.
- Request confidential communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
- Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree, and we may say “no” if it would affect your care. If you pay for a service or item out of pocket in full, you can ask us not to share that information with your health insurer for payment or operations. We will say “yes” unless a law requires us to share it.
- Get a list of those we have shared information with. You can ask for a list (accounting) of the times we have shared your health information for six years before the date you ask, who we shared it with, and why. It will include all disclosures except those for treatment, payment, and health care operations, and certain others (such as any you asked us to make). We provide one accounting a year for free but may charge a reasonable, cost-based fee if you ask for another within 12 months.
- Get a copy of this notice. You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
- Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority before we take any action.
- File a complaint if you feel your rights are violated. You can complain by contacting us using the information below. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
- You have both the right and choice to tell us to: share information with your family, close friends, or others involved in your care; and share information in a disaster relief situation. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
- We never share your information in these cases unless you give us written permission: marketing purposes and sale of your information.
Our Uses and Disclosures
We typically use or share your health information in the following ways.
- Treat you. We can use your health information and share it with other professionals who are treating you. Example: your dentist refers you to an oral surgeon and shares your X-rays.
- Run our practice. We can use and share your health information to run our practice, improve your care, and contact you when necessary, for example about your appointments. Example: we use information about you to manage your treatment and services.
- Bill for your services. We can use and share your health information to bill and get payment from health plans or other entities. Example: we give information about you to your dental insurance plan so it will pay for your services.
Other Ways We Can Use or Share Your Health Information
We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
- Help with public health and safety issues, such as preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety.
- Do research, when the law allows.
- Comply with the law, including sharing information with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
- Respond to organ and tissue donation requests and work with a medical examiner or funeral director.
- Address workers’ compensation, law enforcement, and other government requests, including for workers’ compensation claims, law enforcement purposes or with a law enforcement official, health oversight agencies for activities authorized by law, and special government functions such as military, national security, and presidential protective services.
- Respond to lawsuits and legal actions, in response to a court or administrative order, or in response to a subpoena.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
Questions and Requests
To ask a question about this notice, to use any of the rights above, or to file a complaint with us, contact our office using the details below.
Contact Us
Neighborhood Dental
5061 E. Sahara Ave., Ste. 1-A, Las Vegas, NV 89142