Once you give us authorization to release your medical information, we cannot guarantee that the person to whom the information is provided will not disclose the information. Your Authorization: You (or your legal personal representative) may give us written authorization to use your medical information or to disclose it to anyone for any purpose. We may disclose your medical information to another dental or medical provider or to your health plan subject to federal privacy protection laws, as long as the provider or plan has or had a relationship with you and the medical information is for that provider’s or plan’s health care quality assessment and improvement activities, competence and qualification evaluation and review activities, or fraud and abuse detection and prevention. business planning, development, management, and general administration, including customer service, complaint resolutions and billing, de-identifying medical information, and creating limited data sets for health care operations, public health activities, and research.conducting or arranging for medical reviews, audits, and legal services, including fraud and abuse detection and prevention and.reviewing and evaluating dental care provider performance, qualifications and competence, health care training programs, provider accreditation, certification, licensing and credentialing activities.healthcare quality assessment and improvement activities.Health Care Operations: We may use and disclose your medical information, without your prior approval, for health care operations. For example, your insurance plan may request and receive information on dates that you received services at our facility in order to verify and process your insurance claim. Your medical information may be used to seek payment from your insurance plan. For example, your health information may be disclosed to an oral surgeon to determine whether surgical intervention is needed. Treatment: We may disclose your medical information, without your prior approval, to another dentist, a physician or other health care provider working in our facility or otherwise providing you treatment for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. USES AND DISCLOSURES OF YOUR MEDICAL INFORMATION We maintain physical, electronic and procedural security safeguards in the handling and maintenance of our patients’ medical information, in accordance with applicable state and federal standards, to protect against risks such as loss, destruction or misuse. We collect and maintain oral, written and electronic information to administer our business and to provide products, services and information of importance to our patients. You may request a copy of the current notice at any time. ![]() A copy of the current notice in effect will be available in our facility. ![]() The effective date of a revised notice will be noted. Any revised notice will be effective for all health information that we maintain. If we make a material change to our policy practices, we will provide to you with the revised notice. We may amend the terms of this notice at any time. ![]() We reserve the right to make any change in our privacy practices and the new terms of our notice applicable to all medical information we maintain, including medical information we created or received before we made the change. 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. This notice takes effect on the date set forth at the top of this page, and will remain in effect unless we replace it. We must follow the privacy practices that are described in this notice while it is in effect. We are also required to give you this notice about our privacy practices, our legal duties, and your rights concerning your medical information. We are required by law to protect the privacy of your protected health information (“medical information”). ![]() THE PRIVACY OF YOUR MEDICAL INFORMATION IS IMPORTANT TO US.įor more information about our privacy practices, to discuss questions or concerns, or to get additional copies of this notice, please contact our Privacy Officer.Įmail: 4329 S Peoria Ave, Ste 335, Tulsa, OK 74105 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
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