Legaleeze and Such
Contents
Alabama Dental Association Statement
Notice of our Privacy Policies (HIPAA)
Disclosure and Use of Your Healthcare Information
Patients' Rights
Questions and Complaints
Occupational Health and Saftey Act (OSHA)
Alabama Dental Association
Statement
Just in case the Alabama Dental Association wants to say this is merely a means of advertising, we have included this: the Alabama State Dental Association requires the following statement in all dentist ads.
No representation is made as to the quality of dental services to be provided or the expertise of the dentist performing such services.
Notice of our Privacy Policies
The information shown here describes how your health information may be used and/or disclosed and how you can access this information.
The security and privacy of your health information is important to us.
First, under applicable federal and state laws, we (and all other healthcare providers) are required to maintain the privacy of your health information. Those same statutes require us to give you this Notice about our legal duties, privacy practices, and your rights concerning your healthcare information. We must follow the privacy policies described in this notice, which took effect April 14, 2003, and will remain effective until replaced.
Before making significant changes in our privacy policies or in this notice, we will change this notice which is available to you at all times on this website or by request at our office. We do reserve the right to change our privacy practices and/or the terms of this notice at any time as permitted (or required) by the applicable Federal and state laws. We reserve the right to make any such changes in our privacy practices and in this notice effective for all healthcare information we maintain, including healthcare information obtained or created before the changes were made.
If you have any further questions about our privacy policies, please, contact our office.
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Disclosure and Use of Your
Healthcare Information
- Appointment Reminders: We will use and/or disclose enough of your healthcare and/or personal information to provide you with appointment reminders such as telephone calls, voicemail messages, postcards, letters, or email messages.
- Treatment: We may use and/or disclose your healthcare and/or personal information to other healthcare providers you are using.
- Payment: We may use and/or disclose your healthcare and/or personal information to obtain payment for services we provide to you.
- Legal Requirements: We may use and/or disclose your healthcare and other personal information when required by law to do so.
- Healthcare Operations: We may use and/or disclose your healthcare information and/or personal information in connection with our healthcare operations, including (but not limited to) quality assessment and improvement activities, reviewing and assessing the competence or qualifications of healthcare professionals and/or workers, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.
- Your Authorization: You may provide written authorization and instructions to use and/or disclose your healthcare and/or personal information to anyone for any purpose. Once you have given us this written authorization and instruction, you may revoke it at any time by giving us new written instructions. Such revocation will not, of course, affect any use and/or disclosure that has been made under the original authorization and instructions while they were in effect.
Be aware that unless you give us written authorization and instructions, we cannot use or disclose your healthcare information for any reason to anyone except as noted in this notice. This includes your family members, friends, employer, etc.
- Identification/Extenuating Circumstances: We may use and/or disclose your healthcare and/or personal information to notify or assist in notification of (including identifying or locating) a family member, your personal representative, or another person responsible for your care. Such notification or assistance can include, but is not limited to, your location, your general condition, or your death. Prior to such use and/or disclosure of your healthcare and/or personal information, if you are present and, based solely on our professional discretion and judgment, not incapacitated; we will provide you an opportunity to object to such use and/or disclosures. If, based solely on our professional discretion and judgment, you are incapacitated or if emergency circumstances exist, we will disclose your healthcare information to other healthcare and emergency personnel based solely on our professional discretion and judgment that it is in your best interests to do so. We will disclose only information directly relevant to your care by those healthcare providers or emergency personnel.
We will also use our sole professional discretion and judgment and experience with common practice to make reasonable inferences of your best interests in allowing a person to pick up items related to your healthcare: these include, but are not limited to, filled prescriptions, medical supplies, X-rays, medical records, or other similar forms of healthcare information.
- To Report Neglect or Abuse: We may use and/or disclose your healthcare and/or other personal information if, based solely on our professional discretion and judgment, we reasonably believe you to be a victim of neglect, abuse, domestic violence, or the victim of any other criminal actions. We will disclose information under such circumstances only to the appropriate authorities, only to the extent, based solely on our professional discretion and judgment, we deem necessary to insure your safety and health and to insure the safety and health of others.
- Correctional Institutions: Under certain circumstances, we may use and/or disclose your healthcare and/or personal information to a correctional institution or to other law enforcement officials who have legal custody and/or responsibility for the healthcare of inmate-patients.
- National Security: Under certain circumstances, we may use and/or disclose to military authorities the healthcare and/or personal information of Armed Forces personnel. In addition, we may use and/or disclose to authorized officials of the federal government healthcare and/or personal information required for lawful national security activities including, but not limited to intelligence activities and counter-intelligence activities.
- Marketing: We will not use and/or disclose your healthcare and/or personal information for marketing communications of any kind without your expressed written authorization.
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Patients' Rights
Under the law, every patient has certain rights. These are broadly outlined below:
- Access to Your Information: With limited exceptions, you have the right to view or receive copies of your healthcare information that we maintain. You may request that we provide copies in a format other than photocopies. We will use the format you request if we can do so practically.
You must make a request in writing to obtain access to your healthcare information. You may obtain a form to request access by using the contact information listed at the end the of this notice, using the
"contact us" page on our website, or you can find such a form on our downloads page. You may also request access by sending us a letter at the address on the
"contact us" page of our website.)
If you request copies, we will charge you a reasonable, cost-based fee for expenses incurred as a result of your request. (These will include, but are not limited to such items as copies and staff time. Currently, our charges are
15¢ per page copied, $50.00 per hour for staff time to locate and copy your healthcare information, and the amount of postage required if you request that the copies mailed to you.)
If you request an alternative format, we will charge a cost-based fee for providing your healthcare information in that format. These charges will include $50.00 per hour for staff time to locate and copy your healthcare information, and the amount of postage required if you request that the copies mailed to you, plus the amount of any other expenses we incur while fulfilling your request.
If you prefer, we will prepare a summary or an explanation of your healthcare information for you. We will charge a reasonable cost-based fee for this service. Contact us using the information on the
"contact us" page of our website.
- Accounting of Disclosures: You have the right to receive a list of all instances in which we or our business associates disclosed your healthcare information for purposes other than treatment, payment, health-care operations and certain other activities, during the last six years but not before April 14th, 2003. If you request this accounting more than one time during a twelve-month period, we will charge you a reasonable, cost-based fee for responding to each additional request.
(Said charges will include, but are not limited to such items as copies and staff time. Currently, our charges are
15¢ per page copied, $50.00 per hour for staff time to locate and copy your healthcare information, and the amount of postage required if you request that the copies mailed to you. If another medium is requested, you will be billed for expenses incurred in fulfilling your request.)
- Place Additional Restrictions on Your Information: You have the right to request that we place additional restrictions on the use and/or disclosure of your healthcare and/or personal information. We are not required to agree to these additional restriction requests, but should we agree, we will abide by our agreement except in an emergency when, in our sole discretion and judgment, it may be in your best interests not to do so. You may request additional restrictions on your information using the form found on our website's downloads page, or you may contact us for it using the information on the
"contact us" page of our website. In either event, your request for additional restrictions must be made in writing and will remain in effect until you tell us, in writing, to cancel it.
- Alternative Communications Method/Location: You have the right to request that we communicate with you about your healthcare information by alternative means and/or to an alternative location. You may request this using the form found on our website's downloads page, or you may contact us for it using the information on the
"contact us" page of our website. In either event, your request must be made in writing and will remain in effect until you tell us, in writing, to cancel or change it. In any event, your request must:
- specify the alternative means of communications and/or location
- provide a satisfactory explanation of how payments will be handled under the alternative means of communications and/or location you request.
- Request amendment of Your Healthcare Information: You have the right to make a written request that we amended your healthcare and/or personal information we maintain.
You may request this using the form found on our website's downloads page, or you may contact us for it using the information on the
"contact us" page of our website. In either event, your request for amendment(s) must be made in writing and must explain why the information should be amended. We may deny your request under certain circumstances.
- Electronic Notice: If you received this notice on our website or by electronic mail (email) you are entitled to receive this notice in written form if you so desire. Please note that email is never secure and should not be used to transmit information you would not allow others to see.
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Questions and Complaints
If you have questions or concerns about our privacy practices, please contact us. You may complain to us and/or submit a written complaint to the U.S. Department of Health and Human Services:
- If you believe we may have violated your privacy rights,
- If you disagree with a decision we made about access to your healthcare information,
- If you disagree with a decision we made in response to your request you to amend or restrict the use or disclosure of your healthcare information
- If you disagree with a decision we made in response to your request you to communicate with you by alternative means or at alternative location(s)
We will provide you with the address to file your complain with the U.S. Department of Health and Human Services upon request. We support your right to the privacy of your healthcare information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human services.
For information about who to contact, please, see the contact us page of our website.
©2003 IHS, Incorporated. This form and the information contained herein is, to the best of our knowledge and abilities, fully compliant with the HIPAA of April 14, 2003, however, this form does not constitute legal advice, and covers only federal law. Unauthorized duplication or distribution of this form requires prior written approval from IHS, Incorporated.
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Occupational Health and Safety
Act (OSHA)
Not only are we deeply concerned about the health, safety, and well-being of our staff, we strive to be fully compliant with all federal and state laws. Toward this end, we have endeavored to be fully OSHA compliant. In addition, we have taken all reasonable and proper steps to safeguard the health, safety, and well-being of our staff--often above and beyond what the law requires--and we will continue to do so.
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Phone 205-854-7448
Suite 100
2500 Center Point Road
Center Point, AL 35215
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