Notice of Privacy Practices

Your rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get a copy of your dental and medical record

You can ask to see or get an electronic or paper copy of your record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your record

You can ask us to correct health information about you that you think is incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say yes to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment or our operations. We are not required to agree, and we may say no if it would affect your care. If you pay for a service or item out of pocket in full, you can ask us not to share that information with your health insurer for payment or our operations. We will say yes unless a law requires us to share it.

Get a list of those with whom we have shared information

You can ask for a list (accounting) of the times we have shared your health information for six years before the date you ask, who we shared it with and why. We will include all disclosures except those about treatment, payment and health care operations, and certain others (such as any you asked us to make). We provide one list a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically. Ask at the front desk of either office.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority before we take any action.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting us using the information at the end of this notice. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends or others involved in your care
• Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information

If we contact you for fundraising efforts, you can tell us not to contact you again.

Our uses and disclosures

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you. Example: we share X-rays with an oral surgeon or specialist you are referred to.

Run our practice

We can use and share your health information to run our offices, improve your care and contact you when necessary. Example: we use your information to send appointment reminders and to manage your treatment plan.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities. Example: we give information about you to your dental insurance plan so it will pay for your services.

How else can we use or share your health information?

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see hhs.gov/hipaa.

• Help with public health and safety issues, such as preventing disease, reporting adverse reactions to medications, reporting suspected abuse, neglect or domestic violence, and preventing or reducing a serious threat to anyone's health or safety
• Do research, under the conditions the law allows
• Comply with the law, including sharing information with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law
• Respond to organ and tissue donation requests and work with a medical examiner or funeral director
• Address workers' compensation, law enforcement and other government requests, such as for workers' compensation claims, for law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law, and for special government functions such as military, national security and presidential protective services
• Respond to lawsuits and legal actions, such as in response to a court or administrative order, or in response to a subpoena

Substance use disorder records

If we receive or keep records about you that are protected by the federal confidentiality rules for substance use disorder treatment records (42 CFR Part 2), those records have extra protection. We will not use or share them in a civil, criminal, administrative or legislative investigation or proceeding against you unless you give written consent, or a court orders it after giving you notice and a chance to be heard and the order is accompanied by a subpoena or similar legal requirement. We will not use them for fundraising without first giving you a clear chance to opt out.

Maryland law

Maryland law, including the Maryland Confidentiality of Medical Records Act, may give you more protection than federal law in some situations. When it does, we follow the stricter law.

Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

Changes to the terms of this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in both of our offices and on this website.

Questions and complaints

If you have questions about this notice or want to exercise any of your rights, contact:

Privacy Officer, Rao Dental
Pikesville Dental Associates · 3635 Old Court Rd, Suite 510, Baltimore, MD 21208 · (443) 898-6788
Today's Dental at Eldersburg · 2030 Liberty Rd, Ste 1, Eldersburg, MD 21784 · (410) 781-7188
Email: office@raodental.com