Patient Privacy and Health Information Protection

At Atchison Dental Associates, we are committed to protecting the privacy and security of our patients' health information. Federal law requires healthcare providers to maintain strict standards regarding how patient information is collected, used, and shared.

This Notice of Privacy Practices explains how our office may use and disclose your protected health information for treatment, payment, and healthcare operations, as well as your rights regarding access to and control of your health records.

We believe transparency and trust are essential to providing exceptional dental care. If you have any questions about how your information is protected or how your privacy rights apply to your care, our team is always available to help.

What Is Protected Health Information (PHI)?

Protected Health Information (PHI) is information that identifies you and relates to your past, present, or future physical or mental health condition, the healthcare services you receive, or payment for those services.

How We May Use and Disclose Your Information

Treatment

We may use and disclose your health information to provide, coordinate, or manage your dental care. For example, we may share information with specialists, dental laboratories, physicians, pharmacies, or other healthcare providers involved in your care.

Payment

We may use and disclose your health information to obtain payment for services we provide. This may include sharing information with insurance companies, third-party payers, and billing services.

Healthcare Operations

We may use your information for activities necessary to run our practice. These activities include quality improvement, staff training, licensing, auditing, accreditation, and general administrative functions.

Appointment Reminders and Health Communications

We may contact you by phone, text message, email, or mail to:

• Remind you of upcoming appointments
• Provide information about treatment alternatives
• Inform you about health-related services or benefits offered by our practice

You may request restrictions on how we communicate with you.

Individuals Involved in Your Care

Unless you object, we may disclose relevant health information to family members, guardians, or others involved in your care or payment for your care.

Required by Law

We may disclose your health information when required by federal, state, or local law.

Public Health and Safety

We may disclose your information to public health authorities to help prevent or control disease, injury, or disability, or to report abuse or neglect when required by law.

Legal Proceedings and Law Enforcement

We may disclose health information in response to a court order, subpoena, or other lawful process when permitted under HIPAA.

Special Protections for Substance Use Disorder Records (42 CFR Part 2)

Certain records related to substance use disorder diagnosis or treatment receive additional federal protections under 42 CFR Part 2.

These records:

• Generally cannot be disclosed without your written authorization, even for treatment, payment, or healthcare operations, unless a specific legal exception applies.
• Cannot be used in legal proceedings against you without a court order.
• Must be handled under stricter privacy standards if they are received from another provider.

You may revoke your authorization for the disclosure of these records at any time in writing, except to the extent that action has already been taken.

Your Rights Regarding Your Health Information

You have the following rights regarding your protected health information:

Right to Access and Obtain Copies

You may request to inspect or obtain a copy of your health records in paper or electronic form.

Right to Request Amendments

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

Right to Request Restrictions

You may request limits on certain uses or disclosures of your information. While we are not required to agree to every request, we will comply when required by law.

Right to Request Confidential Communications

You may request that we contact you in a specific way, such as only at a certain phone number or mailing address.

Right to an Accounting of Disclosures

You may request a list of certain disclosures of your health information made by our practice.

Right to Receive a Paper Copy

You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

Right to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Our Responsibilities

Atchison Dental Associates 2, PA is required to:

• Maintain the privacy and security of your protected health information
• Provide you with this Notice of our privacy practices
• Notify you promptly if a breach occurs that may compromise your information
• Follow the duties and privacy practices described in this Notice

Changes to This Notice

We reserve the right to change this Notice at any time. Any revised Notice will apply to all health information we maintain. The most current version will always be available:

• At our office
• On our website at https://www.atchisondental.com

Contact Information

If you have questions about this Notice or wish to exercise your privacy rights, please contact:

You may also file a complaint with: