HIPAA · Patient Privacy
Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
This is a summary of our Notice of Privacy Practices. A full printed copy is provided to every patient at their first visit and is available from the front desk on request. The full notice may include additional detail required by federal and California law.
Our pledge regarding your health information
Cusp Dental is required by federal law (the Health Insurance Portability and Accountability Act, "HIPAA") and California law to maintain the privacy of your protected health information (PHI), to provide you with this notice describing how we may use and disclose your PHI, and to follow the terms of the notice currently in effect.
How we may use and disclose your PHI
We use and disclose your PHI for routine purposes related to your dental care, billing, and the operation of our practice, typically grouped as "Treatment, Payment, and Health Care Operations."
- Treatment. We use PHI to provide dental care, coordinate with specialists when a referral is needed, and confer with other providers involved in your care.
- Payment. We use PHI to bill and collect payment from you, your insurance company, or another payer.
- Healthcare operations. We use PHI to run our practice, scheduling, quality review, training, and similar administrative activities.
Other uses and disclosures permitted or required by law
In limited circumstances, federal and California law may require or permit us to use or disclose PHI without your authorization, for example, public health activities, suspected abuse or neglect, judicial and administrative proceedings, law enforcement, organ donation, or to avert a serious threat to health or safety.
Uses and disclosures that require your written authorization
Most uses and disclosures of PHI that aren't covered above require your written authorization. Specifically, your written authorization is required for: marketing communications, sale of PHI, and most uses or disclosures of psychotherapy notes (where applicable). You may revoke any authorization in writing at any time, except where we have already relied on it.
Your rights regarding your PHI
You have the right to:
- Inspect and copy. Request access to and a copy of your PHI we maintain.
- Request amendments. Ask us to amend PHI you believe is inaccurate or incomplete.
- Receive an accounting. Request a list of certain disclosures we have made of your PHI.
- Request restrictions. Ask us to restrict certain uses or disclosures, including a right to restrict disclosures to your health plan for services you paid for in full out of pocket.
- Confidential communications. Request that we communicate with you in a specific way or at a specific location.
- Receive a paper copy. Request a printed copy of this notice at any time.
- Be notified of a breach. Be notified following a breach of your unsecured PHI, as required by law.
To exercise any of these rights, contact our HIPAA Privacy Officer using the information at the bottom of this page. Some requests must be in writing; we will provide the appropriate form.
Our obligations
We are required to maintain the privacy of your PHI, provide you with this notice of our legal duties and privacy practices, follow the terms of the notice currently in effect, and notify you if a breach of your unsecured PHI occurs.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below or with the Secretary of the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at www.hhs.gov/ocr/.
Changes to this notice
We reserve the right to change this notice and to make the revised notice effective for all PHI we maintain. The most current version will be posted on this page and available at the front desk.
Contact our HIPAA Privacy Officer
Please contact our HIPAA Privacy Officer with any questions about this notice or to exercise any of the rights described above:
- Cusp Dental, HIPAA Privacy Officer
- 1 Scripps Drive, Suite 302, Sacramento, CA 95825
- Phone: (916) 451-4856
- Email us