NOTICE OF PRIVACY PRACTICES
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This notice describes how health information about you may be used and disclosed and how you can get access to this information.
The privacy of your health information is important to us.

OUR LEGAL DUTY

We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give
you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We must follow
the privacy practices that are described in this notice while it is in effect. This Notice takes effect 01/01/2024 and will remain in
effect until we replace it. We reserve the right to change our privacy practices and the terms of this notice at any time, provided
such changes are permitted by applicable law. Before we make a significant change in our privacy practices, we will change this
notice and make the new notice available upon request. You may request a copy of our notice at any time.

USES AND DISCLOSURES OF HEALTH INFORMATION

We use and disclose health information about you for treatment, payment, and healthcare operations. For example:
Treatment: We may use or disclose your health information to other healthcare provider providing treatment to you.
Healthcare Operations: We may use and disclose your health information in connection with our healthcare operations.
Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of
healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditations,
certification, licensing, or credentialing activities.
To Your Family and Friends: We must disclose your health information to you, as described in the Patient Rights section of this
notice. We may disclose your health information to a family member, friend or other person to the extent necessary to help with
your healthcare or with payment for your healthcare, but only if you agree that we may do so.
Marketing Health-Related Services: We will not use your health information for marketing communications.
Required by Law: We may use or disclose your health information when we are required to do so by law.
Appointment reminders: We may use or disclose your health information to provide you with appointment reminders (such as
voicemail messages, texts, or postcards)
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ePHI

The HIPAA Security Rule requires dentists/physicians to protect patients' electronically stored, protected health information (known
as “ePHI”) by using appropriate administrative, physical and technical safeguards to ensure the confidentiality, integrity and security of this information. We follow all HIPAA Security Rule, which specifies that health care-related providers, vendors, and IT
companies follow standards to restrict unauthorized access to PHI. The HIPAA Security Rule helps maintain the confidentiality to
prevent illegal disclosure, integrity required to authorize and authenticate use by medical personnel, and availability that allows
patient access of ePHI.
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PATIENT RIGHTS

Access: You have the right to look at or get copies of your health information, with limited exceptions. You must make a request in
writing to obtain access to your health information. You may obtain a form to request access by using the contact information listed
at the end of this notice. We will charge you a reasonable cost-based fee for expenses such as copies and staff time. If you prefer,
we will prepare a summary or an explanation of your health information for a fee. Contact us using the information listed at the end
of this Notice for a full explanation of our fee structure. (info@bydentalsquare.com)