Privacy Policy
NOTICE OF PRIVACY PRACTICES
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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.__________________________
We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give
you notice of our privacy practices. This Notice describes how we protect your health information and what rights you
have regarding it.
TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS
The most common reason why we use or disclose your health information is for treatment, payment or health care
operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for
you; examining your teeth; prescribing medications and faxing them to be filled; referring you to another doctor or clinic for
other health care or services; or getting copies of your health information from another professional that you may have
seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about
your health or dental care plans, or other sources of payment; preparing and sending bills or claims; and collecting unpaid
amounts (either ourselves or through a collection agency or attorney). "Health care operations" mean those administrative
and managerial functions that we have to do in order to run our office. Examples of how we use or disclose your health
information for health care operations are: financial or billing audits; internal quality assurance; personnel decisions;
participation in managed care plans; defense of legal matters; business planning; and outside storage of our records.
We routinely use your health information inside our office for these purposes without any special permission. If we
need to disclose your health information outside of our office for these reasons, we usually will not ask you for special
written permission.
Unless you object, we will also share relevant information about your care with your family or friends who are helping
you with your dental care.
USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION
In some limited situations, the law requires us to use or disclose your health information without your permission.
Not all of these situations will apply to us; some may never come up at our office at all. Such uses or disclosures are:
when a state or federal law mandates that certain health information be reported for a specific purpose;
for public health purposes, such as contagious disease reporting, investigation or surveillance; and notices to and
from the federal Food and Drug Administration regarding drugs or medical devices;
disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence;
uses and disclosures for health oversight activities, such as for the licensing of doctors; for audits by Medicare or
Medicaid; or for investigation of possible violations of health care laws;
disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or
administrative agencies;
disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected
to be a victim of a crime; to provide information about a crime at our office; or to report a crime that happened
somewhere else;
disclosure to a medical examiner to identify a dead person or to determine the cause of death; or to funeral
directors to aid in burial; or to organizations that handle organ or tissue donations;
uses or disclosures for health related research;
uses and disclosures to prevent a serious threat to health or safety;
uses or disclosures for specialized government functions, such as for the protection of the president or high
ranking government officials; for lawful national intelligence activities; for military purposes; or for the evaluation
and health of members of the foreign service;
disclosures of deidentified information;
disclosures relating to worker's compensation programs;
disclosures of a "limited data set" for research, public health, or health care operations;
incidental disclosures that are an unavoidable byproduct of permitted uses or disclosures;
disclosures to "business associates" who perform health care operations for us and who commit to respect the
privacy of your health information.
APPOINTMENT REMINDERS
We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We
may also call or write to notify you of other treatments or services available at our office that might help you. Unless you
tell us otherwise, we may mail you an appointment reminder on a post card, and/or leave you a reminder message on
your home answering machine or with someone who answers your phone if you are not home.
OTHER USES AND DISCLOSURES
We will not make any other uses or disclosures of your health information unless you sign a written "authorization
form." The content of an "authorization form" is determined by federal law. Sometimes, we may initiate the authorization
process if the use or disclosure is our idea. Sometimes, you may initiate the process if it's your idea for us to send your
information to someone else. Typically, in this situation you will give us a properly completed authorization form, or you
can use one of ours. If we initiate the process and ask you to sign an authorization form, you do not have to sign it. If you
do not sign the authorization, we cannot make the use or disclosure. If you do sign one, you may revoke it at any time
unless we have already acted in reliance upon it. Revocations must be requested in writing to the office.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
The law gives you many rights regarding your health information. You can:
ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment or
health care operations. We do not have to agree to do this, but if we agree, we must honor the restrictions that
you want. To ask for a restriction, send a written request to the office contact person at the address listed below
ask us to communicate with you in a confidential way, such as by phoning you at work rather than at home, by
mailing health information to a different address, or by using E mail to your personal E Mail address. We will
accommodate these requests if they are reasonable. If you want to ask for confidential communications, send a
written request to the office contact person at the address listed below
ask to see or to get photocopies of your health information. By law, there are a few limited situations in which we
can refuse to permit access or copying. For the most part, however, you will be able to review or have a copy of
your health information within 30 days of asking us (or sixty days if the information is stored offsite). You may
have to pay for photocopies in advance. If we deny your request, we will send you a written explanation, and
instructions about how to get an impartial review of our denial if one is legally available. By law, we can have one
30 day extension of the time for us to give you access or photocopies if we send you a written notice of the
extension. If you want to review or get photocopies of your health information, send a written request to the office
office contact person at the address listed below
ask us to amend your health information if you think that it is incorrect or incomplete. If we agree, we will amend
the information within 60 days from when you ask us. We will send the corrected information to persons who we
know got the wrong information, and others that you specify. If we do not agree, you can write a statement of your
position, and we will include it with your health information along with any rebuttal statement that we may write.
Once your statement of position and/or our rebuttal is included in your health information, we will send it along
whenever we make a permitted disclosure of your health information. By law, we can have one 30 day extension
of time to consider a request for amendment if we notify you in writing of the extension. If you want to ask us to
amend your health information, send a written request, including your reasons for the amendment, to the office
contact person at the address listed below.
get a list of the disclosures that we have made of your health information within the past six years (or a shorter
period if you want). By law, the list will not include: disclosures for purposes of treatment, payment or health care
operations; disclosures with your authorization; incidental disclosures; disclosures required by law; and some
other limited disclosures. You are entitled to one such list per year without charge. If you want more frequent lists,
you will have to pay for them in advance. We will usually respond to your request within 60 days of receiving it,
but by law we can have one 30 day extension of time if we notify you of the extension in writing. If you want a list,
send a written request to the office.
get additional paper copies of this Notice of Privacy Practices upon request. It does not matter whether you got
one electronically or in paper form already. If you want additional paper copies, send a written request to the
office contact person at the address listed below.
OUR NOTICE OF PRIVACY PRACTICES
By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. We reserve the
right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to
your health information that we already have as well as to such information that we may generate in the future. If we
change our Notice of Privacy Practices, we will post the new notice in our office, have copies available in our office, and
post it on our Web site.
COMPLAINTS
If you think that we have not properly respected the privacy of your health information, you are free to complain to us
or the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you
make a complaint. If you want to complain to us, send a written complaint to the office contact person at the address listed
below. If you prefer, you can discuss your complaint in writing or by phone:
Kennedy Dental, ATTN: Security Officer
Bellevue, NE 68005
402-291-3535 Extension 1—Leave message with front desk for Security Officer
This privacy notice discloses the privacy practices for this website. This privacy notice applies solely to information collected by this web site. It will notify you of the following:
- What personally identifiable information is collected from you through the web site, how it is used and with whom it may be shared.
- What choices are available to you regarding the use of your data.
- The security procedures in place to protect the misuse of your information.
- How you can correct any inaccuracies in the information.
Information Collection, Use, and Sharing
We are the sole owners of the information collected on this site. We only have access to/collect information that you voluntarily give us via email or other direct contact from you. We will not sell or rent this information to anyone.
We will use your information to respond to you, regarding the reason you contacted us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request, e.g. to ship an order.
Unless you ask us not to, we may contact you via email in the future to tell you about specials, new products or services, or changes to this privacy policy.
Your Access to and Control Over Information
You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the contact form on our website:
- See what data we have about you, if any.
- Change/correct any data we have about you.
- Have us delete any data we have about you.
- Express any concern you have about our use of your data.
Security
Please do not use our contact form to email us confidential information. While we will not disclose this information to anyone, it could possibly be intercepted by unauthorized entities.
Cookies
We use "cookies" on this site. A cookie is a piece of data stored on a site visitor's hard drive to help us improve your access to our site and identify repeat visitors to our site. For instance, when we use a cookie to identify you, you would not have to log in a password more than once, thereby saving time while on our site. Cookies can also enable us to track and target the interests of our users to enhance the experience on our site. Usage of a cookie is in no way linked to any personally identifiable information on our site.
Links
This web site contains links to other sites. Please be aware that we are not responsible for the content or privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of any other site that collects personally identifiable information.
If you feel that we are not abiding by this privacy policy, you should contact us immediately.