Dear Patient:

It is our desire to inform you that we are taking the new Federal (HIPAA - Health Insurance Portability and Accountability Act) laws written to protect the confidentiality of your health information seriously.  We do not want to delay treatment because you are afraid your personal health history might be unnecessarily made available to others outside of our office.

How your health information may be used

To Provide Treatment
We will use your health information within our office to provide you with the best orthodontic care possible.  This may include administrative and clinical office procedures designed to optimize scheduling and coordination of care between orthodontic assistants, orthodontist, and business office staff.  In addition, we may share your health information with physicians, referring dentists, clinical and dental laboratories, and other health-care personnel providing you treatment.

To Obtain Payment
We may include your health information with an invoice used to collect payment for treatment you receive in our office.  We may do this with insurance forms filed for you in the mail or sent electronically.  We will make every attempt to only work with companies with a similar commitment to the security of your health information.

To Conduct Healthcare Operations
Your health information may be used during performance evaluations of our staff. As a result, health information may be included in training programs for students, interns, associates, and business and clinical employees.  It is also possible that health information will be disclosed during audits by insurance companies or government appointed agencies as part of their quality assurance and compliance reviews.  Your health information may be reviewed during the routine processes of certification, licensing or credentialing activities.

In Patient Reminders
Because we believe regular visits are very important to your overall

treatment, we will remind you that it is time to make an appointment. Additionally, we may contact you to follow up on your care and inform you of treatment options or services that may be of interest to you or your family.  They may include postcards, letters, telephone calls.

Abuse or Neglect
We will notify government authorities if we believe a patient is the victim of abuse, neglect, or domestic violence.  We will make this disclosure only when we are compelled by our ethical judgment, when we believe we are specifically required or authorized by law or with the patient's agreement.

Public Health and National Security
We may be required to disclose to federal officials or military authorities health information necessary to complete an investigation related to public health or national security.  Health information could be important when the government believes that the public safety could benefit when the information could lead to the control or prevention of an epidemic or the understanding of new side effects of a drug treatment or medical device.

For Law Enforcement
As permitted or required by state or federal law, we may disclose your health information to a law enforcement official for certain limited circumstances, if you are a victim of a crime or in order to report the crime.

Family, Friends and Caregivers
We may share your health information with those you tell us will be helping you with your home hygiene, treatment, medications, or payment.  In case of an emergency, where you are unable to tell us what you want, we will use our best judgment when sharing your health information only when it will be important to those participating in providing your care.

Authorization to Use or Disclose Health Information
Other than is stated above, or where Federal, State or Local law requires us, we will not disclose your health information other than with your written permission.  You may revoke that authorization in writing at anytime.