Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.

Our Commitment to Your Privacy

Whiteland Dental is committed to protecting the privacy and security of your health information. This Notice describes how we may use and disclose your Protected Health Information (PHI) and your rights under the Health Insurance Portability and Accountability Act (HIPAA).

We are required by law to:

• Maintain the privacy of your PHI
• Provide you with this Notice of our legal duties and privacy practices
• Notify you following a breach of unsecured PHI
• Follow the terms of this Notice currently in effect

How We May Use and Disclose Your Information

We may use and disclose your health information for the following purposes:

1. Treatment

We may use your information to provide, coordinate, or manage your dental care. Examples include:

• Sharing information with specialists, laboratories, or referring providers
• Reviewing your health history to plan treatment
• Coordinating care with other healthcare professionals

2. Payment

We may use and disclose your information to obtain payment for services. Examples include:

• Submitting claims to your dental insurance
• Verifying coverage and benefits
• Billing and collection activities

3. Healthcare Operations

We may use your information to support our practice operations. Examples include:

• Quality assessment and improvement
• Staff training and credentialing
• Business management and administrative activities

Additional Uses and Disclosures

We may also use or disclose your information:

• Appointment reminders (phone, text, or email)
• Treatment alternatives or health-related benefits/services
• To family or individuals involved in your care, unless you object
• As required by law, including public health reporting
• For health oversight activities, audits, or investigations
• To prevent or reduce a serious threat to health or safety
• For workers' compensation or law enforcement purposes, when applicable

Uses Requiring Your Authorization

We will obtain your written authorization before:

• Using or disclosing psychotherapy notes (if applicable)
• Using your information for marketing not otherwise permitted by HIPAA
• Selling your health information

You may revoke your authorization at any time in writing.

Your Rights Regarding Your Health Information

You have the following rights under HIPAA:

1. Right to Access

You may request a copy of your health records.

• Requests must be in writing
• Reasonable fees may apply
• Records will be provided within legally required timeframes

2. Right to Request Amendment

If you believe your information is incorrect or incomplete, you may request a correction.

3. Right to Request Restrictions

You may request limits on how we use or disclose your information.

• We are not required to agree, except in limited circumstances
• We will comply when required by law

4. Right to Confidential Communications

You may request that we contact you in a specific way (e.g., phone, email, alternative address).

5. Right to an Accounting of Disclosures

You may request a list of certain disclosures made outside of treatment, payment, or operations.

6. Right to a Paper Copy

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

Our Responsibilities

We are required to:

• Maintain appropriate safeguards to protect your information
• Limit use and disclosure to the minimum necessary
• Notify you of any breach affecting your unsecured PHI
• Train staff on privacy and confidentiality practices

Business Associates

We may share your information with trusted third-party service providers ("Business Associates") who assist in operating our practice (such as billing companies, labs, or IT providers). These entities are required to protect your information in accordance with HIPAA.

Changes to This Notice

We reserve the right to update this Notice at any time. Any changes will apply to all information we maintain and will be posted on our website with an updated effective date.

Complaints

If you believe your privacy rights have been violated, you may file a complaint:

With Our Office:

Whiteland Dental
670 W Lincoln Hwy, Exton, PA 19341
Phone: 610-873-4003
Email: info@whitelanddental.com

Or With the U.S. Department of Health & Human Services:

Office for Civil Rights (OCR)
You may file a complaint electronically at: https://www.hhs.gov/ocr/privacy/hipaa/complaints/

You will not be penalized or retaliated against for filing a complaint.

Acknowledgment of Receipt

We will request that you sign an acknowledgment confirming that you have received this Notice of Privacy Practices.