At Alta Vista Dental, your dental information has been kept secure and confidential. A new law, HIPAA (Health Insurance Portability and Accountability Act), requires us to continue maintaining that privacy, to provide you with this notice, and to follow the terms of this notice. The new law permits us to use or disclose your dental information to those involved in your treatment. For example, a specialist doctor may review the patients file if he/she is involved with your care.

   We may use or disclose your dental information for payment or authorization of your services.  For example, we may send a copy of an x-ray of your teeth to your insurance company. We may use or disclose your dental information in the course of our normal healthcare operations. For example, one of our staff members will enter your information into our computer. We may share your dental information with our business associates, such as billing service.

   We may use or disclose information to contact you. For example, we may call you to confirm an appointment. If you are not at home, we may leave the information on your answering machine or with person who answers the telephone. We also may send a recall card to remind you of your next check-up.

   In the emergency, we may disclose your dental information to a family member or another person responsible for your care.

   We may release some or all dental information when required by law. If this practice is sold, your information will become property of the new owner. Except as described above, or in case of a dental emergency, this practice will not use or disclose your dental information without your written consent.

   You may request in writing that we do not use or disclose your dental information as described above. We will let you know if we can fulfill your request. You have the right to know of any uses of disclosures we make of your dental information beyond the above normal uses.

   As we may need to contact you from time to time, we will use whatever address or telephone number you prefer.

    You have the right to transfer your dental information to another practice. After you sign a written request, we will mail your information to you.

   You have the right to see and receive a copy of your dental information, with a few exceptions. Please submit in writing a request for the information you would like to see. If you also want a copy of your records, we may charge a reasonable fee for the copies.  You have the right to request an amendment or change your dental information. Please request the request in writing, we may or may make the changes requested but we will be happy to include your statement in the file. If we agree to an amendment  or change, we will not be able to remove or alter earlier documents. We will add the new information.

   You have the right to receive a copy of this notice.

   If we change any of the details of this notice, we will notify you of the changes by making prominent note on this page. If we are unable to resolve your concerns to your satisfaction, you have the right to file a complaint with the Department of Health and Human Services:

Department of Health and Human Services

200 Independence Avenue, S.W. Room 509F

Washington, D.C. 20201