We Protect Your Privacy

Your privacy rights are very important to us. A Melville Kids Dentistry and Melville Dentistry we are committed to safeguarding the information you entrust to us. Information about our patients will not be disclosed without express permission unless the release of said information is required by federal law.

HIPPA Privacy Notice
Noitce 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 Legal Duty — We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect Ajugust 7, 2009, and will remain in effect until we replace it.

We protect your Personal Health Information from inappropriate use or disclosure. Our employees, and those of companies that help us service your dental health, are required to comply with our requirements that protect the confidentiality of Personal Health Information. They may look at your Personal Health Information only when there is an appropriate reason to do so, such as to administer our services.

We will not disclose your Personal Health Information to any other parties for their use in marketing their products to you. However, as described below, we will use and disclose Personal Health Information about you for purposes relating to your Dental care.

For Payment — We may use and disclose your health information to others for purposes of processing and receiving payment for treatment and services provided to you. This may include:

  • billing and collection activities and related data processing;
  • actions by a health plan or insurer to determine or fulfill its responsibilities for coverage and provision of benefits under its health plan or insurance agreement, determinations of eligibility or coverage, adjudication or subrogation of health benefit claims;
  • medical necessity and appropriateness of care reviews, utilization review activities; and
  • disclosure to consumer reporting agencies of information relating to collection of payments.

For Health Care Operations — We may use and disclose health information about you for operational purposes. For example, your health information may be disclosed to members of staff to:

  • evaluate the performance of our professional staff;
  • assess the quality of service, product and care in your case and similar cases;
  • Learn how to improve our facilities and services;
  • conduct training programs or credentialing activities; and
  • determine how to continually improve the quality and effectiveness of the products, service and care we provide.

Appointments, Treatment and Quality Assurance — We may use your information to provide appointment reminders or recall notices (such as voicemail messages, postcards or letters) or information about treatment alternatives or other health-related benefits, products and services that may be of interest to you. We may also contact you to conduct our own surveys about the quality of the products and services we provide.

To You, Your Family and Friends — We must disclose your health information to you, as described in the Your Health Information Rights section of this Notice. 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 or, if you are not able to agree, if it is necessary in our professional judgment.

Persons Involved in Care — We may use or disclose health information to notify, or assist in the notification of (including identifying or locating) a family member, your personal representative or another person responsible for your care, of your location or your general condition. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination using our professional judgment disclosing only health information that is directly relevant to the person's involvement in your healthcare. We will also use our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, photos, or other similar forms of health information.

Required by Law — We may use and disclose information about you as required by law. For example, we may disclose information for the following purposes:

  • for judicial and administrative proceedings pursuant to legal authority;
  • to report information related to victims of abuse, neglect or domestic violence;
  • to assist law enforcement officials in their law enforcement duties; or
  • to assist public health officials avert a serious threat to the health or safety of you or any other person

Decedents — Health Information may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties.

Organ/Tissue Donation — Your health information may be used or disclosed for cadaveric organ, or tissue donation purposes.

Government Functions — Specialized government functions such as protection of public officials or reporting to various branches of the armed services that may require use or disclosure of your health information.

Workers Compensation — Your health information may be used or disclosed in order to comply with laws and regulations related to Workers Compensation.

Marketing Health Products or Services — We will not use your health information for marketing communications without your prior written authorization. We may provide you with information regarding products or services that we offer related to your health care needs. We will never sell your health information without your prior authorization.

Your Authorization — In addition to our use of your health information for treatment, payment or healthcare operations, 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 in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in this Notice.

Your Health Information Rights

  • Access — You have the right to review or get 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 may be asked to make a request in writing to obtain access to your health information. You may obtain a form to request access by using the contact information listed at the end of this Notice. We will charge you a reasonable cost-based fee for expenses such as copies and staff time. You may also request access by sending us a letter to the address at the end of this Notice setting forth the specific information to which you desire access. If you request an alternative format, provided that it is practicable for us to produce the information in such format, we will charge a cost-based fee for providing your health information in that format. If you prefer, we will prepare a summary or an explanation of your health information for a fee. Contact us using the information listed at the end of this Notice for a full explanation of our fee structure.
  • Disclosure Accounting — You have the right to receive a list of instances in which we or our business associates disclosed your health information for purposes other than treatment, payment, healthcare operations, where you have provided an authorization and certain other activities, for the last 6 years, but not for disclosures made prior to April 14, 2003. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.
  • Restriction — You have the right to request that we place 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).
  • Alternative Communication — You have the right to request in writing that we communicate with you about your health information by alternative means or to alternative locations. Your request must specify the alternative means or location, and provide satisfactory explanation how payments will be handled under the alternative means or location you request.
  • Amendment — You have the right to request that we amend your health information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request under certain circumstances. You may obtain a form to request an amendment to your health information by using the contact information listed at the end of this Notice.
  • Electronic Notice — If you receive this Notice on our Web site or by electronic mail (e-mail), you are entitled to receive this Notice in written form.