Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

This notice explains how medical information about you may be used and shared, and how you can access this information. Please review it carefully. We take your health information privacy seriously.

Our Legal Duty

• We are required by federal and state law to protect your health information.
  
• We must provide you with this Notice outlining our privacy practices, legal duties, and your rights.
  
• We follow the practices described here while this Notice is in effect.
  
• This Notice takes effect on 03/01/2025 and remains until replaced.
  
• We may update our privacy practices and this Notice as allowed by law.

How We Use and Share Your Information

We use and share your health information for treatment, payment, and healthcare operations. Examples include:

• Treatment: Sharing information with doctors or healthcare providers involved in your care.
  
• Payment: Using information to get payment for services.‍
• Healthcare Operations: Activities like quality reviews, professional evaluations, training, and licensing.

Other uses and disclosures:

• Authorization: You can give written permission for other uses. You may revoke this at any time.
  
• Family and Friends: We may share information with family or friends involved in your care, but only with your agreement.
  
• Persons Involved in Care: We may notify or assist in notifying family or others about your location, condition, or death. You can object if present.
  
• Marketing: We will not use your information for marketing without your written permission.
  
• Required by Law: We disclose information when legally required.
  
• Abuse or Neglect: We may report suspected abuse, neglect, or violence to authorities.
  
• National Security: Disclosures may occur for military or national security purposes.
  
• Appointment Reminders: We may contact you with reminders by phone, email, or mail.
  
• Public Health and Safety: Sharing information to prevent disease, report recalls, or reduce health threats.
  
• Medical Examiner or Funeral Director: Sharing information after death.
  
• Workers’ Compensation and Law Enforcement: Sharing information as required for claims or legal processes.
  
• Legal Proceedings: We may disclose information in response to court orders or subpoenas.

Your Rights

You have rights regarding your health information. Here is what you can do:

• Access Your Records: Request an electronic or paper copy of your medical records. We usually respond within 30 days and may charge a reasonable fee.
  
• Correct Your Records: Ask us to fix any incorrect or incomplete information. We may deny your request but will explain why within 60 days.
  
• Confidential Communications: Request that we contact you in a specific way or send mail to a different address. We will honor reasonable requests.
  
• Limit Use and Sharing: Ask us to limit how we use or share your information. We may deny requests if it affects your care. If you pay out-of-pocket, you can request we not share information with your insurer.
  
• Accountings: Request a list of when and why we shared your information in the past six years (excluding routine uses). One free accounting per year; fees apply for additional requests.
  
• Copy of This Notice: Request a paper copy anytime, even if you agreed to receive it electronically.
  
• Choose Someone to Act for You: If you have a medical power of attorney or guardian, that person can act on your behalf.
  
• File a Complaint: If you believe your rights were violated, contact us or file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you.

Your Choices

For some information, you can decide what we share:

• You can tell us to share information with family, friends, or others involved in your care.
  
• You can tell us to share information in disaster relief situations.
  
• If you cannot express your preference, we may share information in your best interest or to prevent serious threats.
  
• We never share your information for marketing or sales without your written permission.

Our Responsibilities

• We follow the law to protect your health information privacy and security.
  
• We will notify you promptly if there is a breach of your information.
  
• We will follow the terms of this Notice.
  
• We will only use or share your information as described here unless you give written permission. You may revoke that permission at any time.

Contact Information

Privacy Officer: Tanya Flatt
Email: tflatt@marqueedental.com
Phone: 615-620-5990

For more information, visit:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

U.S. Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue, S.W.
Washington, DC 20201
Phone: 202-619-0257
Toll-free: 1-877-696-6775

Changes to This Notice

• We may change this Notice at any time.
• Changes apply to all your information we have.
• The new Notice will be available upon request, in our office, and on our website.
• This Notice is effective as of 05/01/2025.