NOTICE OF PRIVACY PRACTICES

Effective Date: January 4, 2025

Practice Name: The Hygienist Bar
Address: 255 Detroit Street, Unit 200, Denver, CO 80206
Phone: 303-226-1420
Email: [email protected]

THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

OUR LEGAL DUTY

The Hygienist Bar is required by federal and state law to:

  • Maintain the privacy and security of your Protected Health Information (PHI)
  • Provide you with this Notice of our legal duties and privacy practices
  • Follow the terms of the Notice currently in effect
  • Notify you if a breach occurs that may compromise the privacy or security of your PHI

Protected Health Information (PHI) includes information about your health condition, treatment, and payment for healthcare services that can identify you.

HOW WE MAY USE AND DISCLOSE YOUR INFORMATION

We may use and disclose your PHI without additional written authorization for the following purposes:

1. Treatment

We may use and disclose your PHI to provide, coordinate, or manage your dental hygiene and oral wellness care. This may include communication with dentists, physicians, specialists, laboratories, or other healthcare providers involved in your care.

2. Payment

We may use and disclose your PHI to bill and collect payment for services provided. This may include contacting you, a responsible party, or an insurance carrier.

3. Healthcare Operations

We may use your PHI for business operations necessary to run our practice, including:

  • Quality assessment and improvement activities
  • Staff training and credentialing
  • Compliance and licensing activities
  • Business planning and management

OTHER USES AND DISCLOSURES PERMITTED OR REQUIRED BY LAW

We may disclose your PHI without your authorization when required or permitted by law, including:

  • Public health reporting
  • Health oversight activities
  • Judicial or administrative proceedings
  • Law enforcement purposes
  • Workers’ compensation claims
  • To prevent a serious threat to health or safety

REPRODUCTIVE HEALTH PRIVACY PROTECTIONS (2024 UPDATE)

Federal law provides additional protections related to lawful reproductive health care.

The Hygienist Bar will not use or disclose your PHI for the purpose of investigating or imposing liability related to lawful reproductive healthcare services.

Where required by law, we will obtain appropriate legal attestations before disclosing protected reproductive health information.

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USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION

We will obtain your written authorization before:

  • Using your information for marketing purposes
  • Selling your health information
  • Disclosing information not otherwise described in this Notice
  • Using photographs or videos for promotional purposes

You may revoke any authorization at any time in writing, except to the extent action has already been taken.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the right to:

Access Your Records

Request to inspect or obtain a copy of your health information.

Request an Amendment

Request correction of information you believe is inaccurate or incomplete.

Request Restrictions

Request limitations on how we use or disclose your PHI. We are not required to agree to all requests.

Request Confidential Communications

Request that we contact you at a specific phone number, address, or method.

Request an Accounting of Disclosures

Request a list of certain disclosures made by our practice.

Receive a Copy of This Notice

You may request a paper or electronic copy of this Notice at any time.

OUR RESPONSIBILITIES

We are required to:

  • Protect the privacy of your PHI
  • Provide this Notice
  • Follow the terms currently in effect
  • Notify you of any breach affecting your unsecured PHI

We reserve the right to revise this Notice at any time. Revised Notices will be available upon request and on our website.

QUESTIONS OR COMPLAINTS

If you believe your privacy rights have been violated, you may contact:

Melissa Martin
The Hygienist Bar
255 Detroit Street, Unit 200
Denver, CO 80206
Phone: 303-226-1420
Email: [email protected]

You may also file a complaint with the U.S. Department of Health & Human Services. You will not be retaliated against for filing a complaint.