Privacy Policy

We are committed to protecting the privacy of your health information. This Notice of Privacy Practices outlines how we collect, use, and disclose your protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act of 1995 (HIPAA), California state law, and other applicable privacy laws. Please read it carefully to understand how your health information is protected and your rights concerning it.

OUR COMMITMENT TO YOUR PRIVACY

We understand that your health information is personal and confidential. We are committed to safeguarding your privacy and ensuring that your health information is protected. This notice explains how your health information may be used and shared, and how you can access and control it.

HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION

We are permitted to use and disclose your health information for the following purposes:

• Treatment: We may use and disclose your health information to provide, coordinate, or manage your dental care. For example, we may share your health information with specialists, laboratories, or other healthcare providers who are involved in your care.
• Payment: We may use and disclose your health information to obtain payment for services provided. This includes disclosing information to insurance companies, health plans, and other third parties for billing purposes.
• Healthcare Operations: We may use and disclose your health information for our office’s operational purposes. These activities include quality assessments, staff training, and improving the efficiency and effectiveness of our services.
• Appointment Reminders: We may use and disclose your health information to remind you of scheduled appointments and treatment plans via telephone, email, or text.
• Communication with Family and Friends: We may disclose your health information to a family member, friend, or other individual involved in your care or payment for care, provided you have agreed to this disclosure, or the person is involved in the coordination or payment of your treatment.
• Health-Related Benefits and Services: We may use and disclose your health information to inform you about health related products or services that may be of interest to you.
• Required by Law: We may disclose your health information to comply with local, state, or federal laws, such as to report communicable diseases to public health authorities, or in response to a court order or subpoena.
• Law Enforcement and Public Health Activities: We may disclose your health information to law enforcement agencies and public health authorities as required or permitted by law.
• Research: Under certain circumstances, we may use and disclose your health information for medical research purposes. If you are part of a research study, we will obtain your consent before using or disclosing your health information for research.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

As a patient, YOU have the following rights regarding your protected health information:

• Right to Inspect and Copy: You have the right to inspect and obtain a copy of your health information in our records. To request a copy, you must submit a written request. We may charge a fee for the cost of copying and mailing your records.
• Right to Request Amendments: You have the right to request that we amend your health information if you believe it is incorrect or incomplete. We may deny your request if the information is accurate or if we are not required by law to amend it.
• Right to Request Restrictions: You have the right to request restrictions on how we use or disclose your health information. While we are not required to agree to your request, we will make reasonable efforts to accommodate it when possible.
• Right to an Accounting of Disclosures: You have the right to request an accounting of disclosures of your health information made by our office for reasons other than treatment, payment, or healthcare operations. To request an account, you must submit a written request specifying the time-period of the disclosures.
• Right to Request Confidential Communications: You have the right to request that we communicate with you in a particular way or at a certain location (e.g., by phone, email, or mail). To request this, please make your request in writing, and we will accommodate your request when possible.
• Right to Receive a Paper Copy of This Notice: You have the right to receive a copy of this notice at any time. If you would like an additional copy, please ask for one at the reception desk.

You have the right to: Request an “Accounting of Disclosures of your PHI” for yourself or persons you have the legal guardianship over. Request Form available at front desk.

REQUESTS MUST BE IN WRITING AND INCLUDE: The form of disclosure is requested in. For Example, photocopies or disk. A time-period (not more than six years back). How do you want to be contacted once the request is fulfilled.

HOW TO EXERCISE YOUR RIGHTS

To exercise any of your rights, please submit a written request to our office at:

• Dental Office of Dr. Robert Lacrampe, DDS
• Periodontics of Orange County
• 801 N. Tustin Ave, STE 504 Santa Ana, CA 92705
• Phone: (657) 232-0169
• Email: info@pofoc.com

CHANGES TO THIS NOTICE

We reserve the right to amend or update this Notice of Privacy Practices at any time. Any changes will be posted in our office and on our website. The revised notice will apply to all health information we maintain, including health information created or received prior to the effective date of the revised notice.

COMPLAINTS

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

• U.S. Department of Health and Human Services
• Office for Civil Rights
• 200 Independence Avenue, S.W.
  Washington, D.C. 20201
• Phone: 1-800-368-1019
• Fax: 1-800-537-7697
• Website: www.hhs.gov/ocr