Make a Smile

HIPAA and Medical Privacy

Notice of Privacy Practices

This notice outlines how your health information may be used, disclosed, and how you can access it. Please review it carefully.

Your health information privacy is important to us.

Our Legal Duty

At Make A Smile Dental (“we”, “our”, “us”), we are committed to safeguarding the privacy and security of your health information. We are bound by federal and state laws, including the Health Insurance Portability and Accountability Act (HIPAA) of 1996, which require us to protect your personal health data. If there are state or federal regulations that are more stringent than HIPAA, we will comply with those laws.

In the event of a breach of your health information, we are required to notify you promptly if the breach compromises the security or privacy of your information.

This notice explains our privacy practices, our legal duties, and your rights regarding your health information. We must follow the practices outlined in this notice as long as it is in effect. This notice went into effect on October 23, 2025, and it may be updated as needed. Any significant changes will be communicated to you, and you may request a copy of the updated notice at any time.

Your Rights

You have several rights concerning your health information, including the following:

  1. Access: You have the right to access your health information and request a copy in electronic or paper format. We will provide your records within 30 days, and we may charge a reasonable fee for copying your records, as permitted by law.

     

  2. Amendment: If you believe any of your health information is incorrect or incomplete, you may request an amendment. This request must be made in writing and must specify why the information should be amended. We will notify you if we deny the request, and you will be informed of the reason for denial.

     

  3. Alternative Communication: You may request that we communicate with you in a way that is more convenient for you (e.g., by phone or email). Please submit your request in writing, specifying the preferred communication method, and we will accommodate your reasonable requests.

     

  4. Restriction: You may request that we restrict how we use or disclose your health information. While we are not required to agree to all requests, we will comply with any restrictions we do agree upon unless an emergency arises. For services paid out-of-pocket, you can request that we do not share this information with your insurer.

     

  5. Accounting of Disclosures: You have the right to request a record of disclosures we have made of your health information, excluding those related to treatment, payment, or healthcare operations, within the past six years.

     

  6. Copy of Notice: You may request a paper copy of this notice at any time, even if you have agreed to receive it electronically. We will provide it promptly.

     

  7. File a Complaint: If you believe we have violated your privacy rights or disagree with how we have handled your health information, you may file a complaint with our Privacy Officer at [Contact Information] or with the U.S. Department of Health and Human Services Office for Civil Rights.

     

Your Choices

For certain health information, you can specify your preferences regarding how we share your information:

  1. To Your Family and Friends: You may direct us to share your health information with a family member, friend, or others involved in your care or payment for your care.

     

  2. Disaster Relief Situations: In an emergency or if you are unable to communicate, we may share your information if it is necessary for your care or safety.

     

  3. Persons Involved in Your Care: We may share health information with individuals involved in your care or payment for your care, such as family members or personal representatives. If you are present, we will ask for your consent before sharing your information unless it is an emergency.

     

We Will Never Share Your Information For:

  • Marketing Purposes: We will not share your health information for marketing purposes without your explicit consent.

     

  • Sale of Information: We do not sell your personal health information.

     

  • Fundraising Efforts: You may be contacted for fundraising purposes, but you can opt-out at any time.

     

Our Uses and Disclosures of Health Information

We use and disclose health information for treatment, payment, and healthcare operations. Below are the key ways in which your health information may be used:

  1. Treatment: We may use and share your health information with other healthcare providers who are treating you, such as specialists or pharmacists.

     

  2. Payment: We may share your health information with your insurance provider or others to bill for services provided and collect payment.

     

  3. Healthcare Operations: Your information may be used for purposes such as quality assurance, staff training, or to improve our services.

     

  4. Authorization: In addition to the uses described above, you can provide us with written consent to use or disclose your health information for purposes not listed in this notice. You may withdraw this consent at any time, and we will honor your request moving forward.

     

Other Uses and Disclosures of Health Information

In certain cases, we may be required to disclose your health information for public health or legal reasons, including:

  • Public Health and Safety: To prevent disease or injury, report adverse medication reactions, or assist in public health emergencies.

     

  • Research: For health-related research, provided legal requirements are met.

     

  • Medical Examiner/Funeral Director: For death-related purposes, such as informing a medical examiner or funeral director.

     

  • Law Enforcement and Legal Requests: To comply with legal processes like subpoenas or court orders, or to report information for law enforcement purposes.

     

Marketing and Communications

We may use your health information to contact you with information about products or services that might interest you, such as new dental care options. You can opt out of receiving promotional emails or texts at any time. Additionally, we may use third-party services to send you communications on our behalf.

Questions and Concerns

If you have any questions or need further information about our privacy practices, please contact our Privacy Officer at:

Make A Smile Dental
Privacy Officer

Lucy Davtyan
Email: [email protected]
Phone: (916) 984-0304

We are committed to ensuring the privacy of your health information and will not retaliate against you for filing a complaint.