Notice of Privacy Practices
This notice describes how your health information may be used and disclosed and how you can get access to this information. Please review it carefully. The privacy of your health information is important to us.
Our legal duty
Federal and state laws require us to maintain the privacy of your health information. We are also required to provide this notice about our office’s privacy practices, our legal duties and your rights regarding your health information. We are required to follow the practices outlined in this notice while it is in effect. This notice takes effect January 1, 2025, and will remain in effect until we replace it.
We reserve the right to change our privacy practices and the terms of this notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes effective for all health information that we maintain, including health information we created or received before we made the changes. Before we make a significant change to our privacy practices, we will change this notice and make the new notice available upon request. For more information or additional copies of this notice, please call (818) 810-0050.
Uses and disclosures of health information
We use and disclose health information about you for treatment, payment and health care operations.
Treatment: We disclose medical information to our employees and others who are involved in providing the care you need. We may use or disclose your health information to another dentist or other health care providers providing treatment that we do not provide. We may also share your health information with a pharmacist to provide you with a prescription or with a laboratory that performs tests or fabricates dental prostheses or orthodontic appliances.
Payment: We may use and disclose your health information to obtain payment for services we provide to you, unless you request that we restrict such disclosure to your health plan when you have paid out-of-pocket and in full for services rendered.
Health care operations: We may use and disclose your health information in connection with our health care operations. These operations include, but are not limited to, quality assessment and improvement activities, reviewing the competence or qualifications of health care professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities. For example, we may disclose your protected health information to medical school students who see patients at our office. We may also use and disclose medical information about you by asking you to sign an intake sheet at our front desk, calling your name in the waiting room when your dentist is ready to see you, or contacting you to remind you of your appointment.
We may use or disclose your protected health information without your authorization when permitted or required by law, including for public health activities, communicable diseases, health oversight, abuse or neglect, Food and Drug Administration requirements, legal proceedings, law enforcement, criminal activity, inmates, military activity, national security, workers’ compensation and disclosures required by the Secretary of the U.S. Department of Health and Human Services to investigate or determine our compliance with applicable requirements.
Other permitted and required uses and disclosures will be made only with your consent, authorization or opportunity to object, unless required by law. You may revoke an authorization at any time in writing, except to the extent that your dentist or this organization has already acted in reliance on the authorization.
Patient rights
Access: You have the right to look at or obtain copies of your health information, with limited exceptions. You may request that we provide copies in a format other than photocopies. We will use the format you request unless we cannot practicably do so. You must make a written request to obtain access to your health information. You may obtain a request form by contacting our office. We may charge a reasonable cost-based fee for copies and staff time. If you prefer, we may prepare a summary or explanation of your health information for a fee.
Disclosure accounting: You have the right to receive a list of instances in which we disclosed your health information for purposes other than treatment, payment, health care operations and certain other activities for the last six years. If you request this accounting more than once in a 12-month period, we may charge a reasonable cost-based fee for responding to additional requests.
Restriction: You have the right to request additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement except in an emergency. If you pay out-of-pocket and in full for services rendered, you may request that we not share your health information with your health plan. We must agree to this request.
Alternative communication: You have the right to request that we communicate with you about your health information by alternative means or at alternative locations. Your request must be made in writing, specify the alternative means or location and provide a satisfactory explanation of how payments will be handled.
Breach notification: If your unsecured protected health information is breached, we will notify you as required by law.
Amendment: You have the right to request that we amend your health information. Your request must be in writing and explain why the information should be amended. We may deny your request under certain circumstances.
Questions and complaints
For more information about our privacy practices, or if you have questions or concerns, contact Rainbow Dental Health Care:
- Telephone: (818) 810-0050
- Email: rainbowdentalcareclinic@gmail.com
- Address: 14074 Osborne St, Panorama City, CA 91402
If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your health information or a request to amend or restrict the use or disclosure of your health information, you may complain to our office or to the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
Rainbow Dental Health Care complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.
