HIPAA Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION
At Wilkes and Buttenbaum Orthodontics, we are committed to providing you with the highest quality of care. An essential part of this commitment is our dedication to protecting the privacy and confidentiality of your medical information.
The Health Insurance Portability & Accountability Act of 1996 (HIPPA) is a federal program that requires all medical records and other individually identifiable health information used or disclosed by our office be kept properly confidential. We encourage you to read the following information in its entirety.
USES AND DISCLOSURES OF HEALTHCARE INFORMATION
Treatment: We may use and disclose your health information to a physician or other healthcare provider providing treatment to you.
Payment: We may use and disclose your health information to obtain payment for services we provide to you.
Healthcare Operations: We may use and disclose your health Information in connection with our healthcare operations, or to ensure we follow the rules of regulatory agencies regarding quality of care.
Your Authorization: You may give us written authorization to use your health information, or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it at any time.
Family and Friends: We may disclose your health information to a family member, friend, or other person to the extent necessary to help with your healthcare, or with payment for your healthcare, but only if you agree that we may do so.
Required by Law: We may use or disclose your health information when we are required to do so by law.
Appointment Reminders: We may use and disclose your health information to provide you with appointment reminders.
Access: You have the right to review, or obtain a copy of the health information used in your care.
Disclosure Accounting: You have the right to receive a list of individuals, entities, or instances in which Wilkes and Buttenbaum Orthodontics disclosed your health information for purposes other than treatment, payment, or healthcare operations.
Restriction: You have the right to request we place additional restrictions on our use or disclosure of your health information.
Alternative Communication: You have the right to request we communicate with you about your health information by alternative means or to alternative locations.
Amendment: You have the right to request we amend your health information if you believe the information is incorrect or incomplete.
If you have any questions, or would like to report a concern/problem with the handling of your medical information, please contact Barbara at 610-647-5778.
ACKNOWLEDGEMENT OF RECEIPT OF
NOTICE OF PRIVACY PRACTICES