Effective Date: Jule 1, 2019
At Olive Dental Group, we are committed to protecting the privacy and security of your health information. This Privacy Policy explains how we may use and disclose your protected health information (PHI), your rights regarding your PHI, and our obligations under federal law.
By law, we are required to maintain the confidentiality of your PHI and to provide you with this notice of our legal duties and privacy practices. PHI includes any information that may identify you and that relates to your past, present, or future physical or mental health and related care services.
1. Uses and Disclosures of Protected Health Information
a. For Treatment, Payment, and Health Care Operations
Your PHI may be used or disclosed without your written authorization for the following:
Treatment: We may share your PHI with other healthcare providers to coordinate care or refer you to a specialist.
Payment: Your PHI may be used to obtain payment from you, your insurance provider, or a third party.
Healthcare Operations: We may use your PHI for activities that support the operation of our dental practice, such as quality assurance, staff performance reviews, training, and business planning.
Examples include:
Calling your name in the waiting room.
Using a sign-in sheet at reception.
Reminding you of upcoming appointments via phone, text, or email.
We may also share your PHI with third-party business associates (e.g., billing or IT providers) under contracts that require them to safeguard your information.
b. For Limited Marketing Purposes
We may use your PHI to inform you about products or services that may be beneficial to your health, with certain limitations.
c. Based on Your Written Authorization
Any other uses and disclosures of your PHI not covered in this notice will require your written authorization. You may revoke this authorization in writing at any time, except when we have already relied on it.
2. Your Rights Regarding Your Protected Health Information
You have the right to:
Access and Copy Your Records: You may inspect and obtain a copy of your health and billing records.
Request Restrictions: You may ask us not to use or share certain information for treatment, payment, or operations. While we are not required to agree, we will comply with approved restrictions except in emergencies.
Request Confidential Communications: You may request that we contact you at a specific address or phone number. We will accommodate reasonable requests.
Request an Amendment: If you believe any part of your PHI is incorrect or incomplete, you may request an amendment. If we deny your request, you may submit a statement of disagreement.
Request an Accounting of Disclosures: You can request a list of disclosures we’ve made of your PHI, excluding disclosures for treatment, payment, operations, or those you authorized.
To exercise any of these rights, please submit your request in writing to our Office Manager.
3. Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Olive Dental Group Office Manager
OR with the U.S. Department of Health and Human Services
We will not retaliate against you for filing a complaint.
Contact Information:
For questions or concerns about this policy, or to file a request or complaint, please contact:
Olive Dental Group — Office Manager
281-397-6161
4407 FM 19060 Rd W,
Houston, TX-77068
Info@olivedentaltx.com
We reserve the right to change this Privacy Policy. Any changes will apply to the PHI we currently hold and any future information we receive. You may request a current version of this Policy at any time by contacting our office or asking during your next visit.
Please read this notice carefully and let us know if you have any questions.
Thank you for trusting Olive Dental Group with your dental care.