1. Treatment, Payment, and Healthcare Operations

• Treatment means providing, coordinating or managing healthcare related services by one or more healthcare providers. An example of this would include teeth cleaning services.
• Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment
• Healthcare Operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, and cost management analysis and customer service. An example would be an internal quality assessment review.

2. Pursuant to an individual’s written authorization that meets HIPAA’s criteria (i.e. specifying who is to receive the IIHI)

3. As required for compliance with the HIPAA Administrative Simplification Rules.

Nor again is there anyone who loves or pursues or desires to obtain pain of itself, because it is pain, but because

undertakes laborious physical exercise, except to obtain some advantage from it? But who has any right to find fault with a man who chooses to enjoy a pleasure that has no annoying consequences, or one who avoids a pain that produces no resultant pleasure?»

Public Health Risks
Our practice may disclose your IIHI to public health authorities that are authorized by law to collect information for the purposes of:

Health Oversight Activities 
Our practice may disclose your IIHI to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure, and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.

Lawsuits and Similar Proceedings 
Our practice may use and disclose your IIHI in response to a court or administrative order if you are involved in a lawsuit or similar proceeding. We also may disclose your IIHI in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.

Law Enforcement 
We may release IIHI if asked to do so by a law enforcement official

• Regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement
• Concerning a death we believe has resulted from criminal conduct
• Regarding criminal conduct at our office
• To identify/locate a suspect, material witness, fugitive, or missing person
• In an emergency, to report a crime (including the location or victim(s) of the crime, or the description, identity, or location of the perpetrator.)

Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

Individual Rights 
You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the privacy officer. The privacy office is Sharalyn Fichtl, and she may be reached at 214-543-8600.

1. The right to request restrictions on certain uses and disclosures of health information. Please note we are not required to agree with your request. For example, you may designate family members, relatives, close personal friends or any other person identified by you to receive disclosures and/or specify persons who will not receive any health information.
2. The right to reasonably request to receive confidential communications of protected health information from us in a particular manner or at a specified location. For example, you may request that we contact you only at home and not work, for appointment reminders or any other communication.
3. The right to inspect and copy your protected health information.
4. The right to amend your protected health information that you believe is incorrect or incomplete, by following specific procedures set forth in HIPAA. We may deny your request in certain situations, e.g., the information is accurate or was provided by a third party, such as a laboratory
5. The right to receive an accounting of certain disclosures of protected health information upon written request and by meeting the conditions set forth in HIAA.
6. The right to obtain a paper copy of this Notice.