Notice of Privacy Practices

Our pledge regarding your information

Apex Implant Center is committed to protecting the privacy of your medical and dental information. We are required by law to maintain the privacy of protected health information (PHI), to give you this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.

How we may use and disclose your information

The following describes the ways we may use and disclose PHI without specific authorization from you. Not every use or disclosure is listed; however, all permitted uses fall into one of these categories.

Treatment

We use and disclose PHI to provide, coordinate, or manage your dental and surgical care. For example, your provider may share your CT scan and treatment plan with our oral surgeon, dental lab, or anesthesiologist when needed for your care.

Payment

We use and disclose PHI to bill and collect payment for services. For example, we may share limited information with your dental insurance carrier or financing provider (CareCredit, Sunbit, Cherry) to verify benefits and submit claims.

Health care operations

We use and disclose PHI for activities required to operate the practice, including quality improvement, training, credentialing, accreditation, audits, legal services, and general administration.

Appointment reminders and follow-up

We may contact you by phone, text message, or email to remind you of appointments, follow up after surgery, share post-operative instructions, or inform you about other treatment options or services that may benefit you.

As required by law

We will disclose PHI when required to do so by federal, state, or local law, including reporting to public health authorities, mandatory reporting of suspected abuse or neglect, court orders, subpoenas, and law enforcement requests authorized under HIPAA.

Other uses and disclosures

We may disclose PHI to avert a serious threat to health or safety, to coroners or medical examiners, to organ donation organizations, for research approved by an institutional review board, for workers' compensation purposes, or to military and veterans authorities for members of the armed forces, all as permitted by HIPAA.

Uses requiring your written authorization

We will obtain your written authorization before using or disclosing your PHI for any purpose not described above, including:

• Most uses and disclosures of psychotherapy notes
• Marketing communications, except for face-to-face communications and promotional gifts of nominal value
• Sale of PHI
• Disclosures to employers for employment-related decisions

You may revoke any authorization in writing at any time. The revocation will not apply to information already used or disclosed in reliance on the authorization.

Your rights regarding your information

Right to inspect and copy

You have the right to inspect and obtain a copy of your PHI maintained by Apex, including in electronic format if requested and reasonably available. Submit your request in writing. We may charge a reasonable fee for copying and mailing.

Right to amend

If you believe information in your record is incorrect or incomplete, you may request an amendment in writing. We may deny the request in limited circumstances; if we do, you may submit a written statement of disagreement.

Right to an accounting of disclosures

You have the right to a list of certain disclosures we have made of your PHI in the six years prior to your request, excluding those made for treatment, payment, health care operations, or those you authorized.

Right to request restrictions

You may request restrictions on certain uses and disclosures of your PHI. We are not required to agree, except where you pay for a service in full out of pocket and request that we not disclose information about that service to your health plan, in which case we must comply.

Right to confidential communications

You may request that we communicate with you about medical matters in a specific way or at a specific location, for example by mail to a different address. We will accommodate reasonable requests.

Right to a paper copy of this notice

You have the right to a paper copy of this Notice at any time, even if you previously agreed to receive it electronically. Ask the front desk or contact us using the information below.

Right to be notified of a breach

You will be notified in writing if a breach of unsecured PHI affecting your information occurs, as required under federal law.

Changes to this notice

We reserve the right to change this Notice and to make the new Notice provisions effective for all PHI we maintain. The current version is always posted at apeximplantcenters.com and available at the front desk. The effective date appears at the top of this Notice.

Complaints

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

Apex Implant Center, Privacy Officer
9340 W Stockton Blvd, Suite 120
Elk Grove, CA 95758
Phone: (916) 886-1806
Email: privacy@apeximplantcenters.com

U.S. Department of Health & Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Web: hhs.gov/hipaa/filing-a-complaint

This Notice is provided pursuant to 45 CFR 164.520. It does not constitute legal advice. Apex Implant Center recommends consulting with legal counsel regarding your specific compliance requirements.