HIPAA and Your Privacy
HIPAA Privacy
NOTICE OF PRIVACY PRACTICES
Alpine Dental Health
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.
Purpose & Delivery: Federal law requires us
to provide this Notice to you no later than your first date of service. We will
make a good-faith attempt to obtain your written acknowledgement of receipt.
This Notice is available on request, posted prominently in our offices, and
available on our practice websites.
Our Legal Duty: We are required by federal and
state law (Colorado) to maintain the privacy of your Protected Health
Information (PHI) and to notify you following a breach of unsecured PHI. We
must follow the practices described in this Notice and reserve the right to
change them; any changes will apply to all PHI we maintain.
I. Uses and Disclosures of Health Information
We use and disclose your PHI for treatment, payment, and
healthcare operations:
- Treatment: Coordinating care with other healthcare providers (e.g., your general dentist, other
dental specialists, or physicians). - Payment: Billing and collecting payment from you or your insurance provider or any third-party
payor. - Healthcare Operations: Quality assessment, training, accreditation, facility
and practice management.
Special Protections (2026 Updates):
- Substance Use Disorder (SUD) Records: Under 42 CFR Part 2, SUD records
received from federal programs are strictly protected. They will not be
used in civil, criminal, administrative, or legislative proceedings
against you without your specific written consent or a court order. - Reproductive Health Care Privacy: We will not use or disclose your PHI to
investigate or impose liability on any person for the act of seeking,
obtaining, providing, or facilitating reproductive health care that is
lawful under the circumstances in which it is provided. - Notice of Redisclosure: Once we disclose PHI to a third party per your
authorization, that information may be subject to redisclosure by the
recipient and may no longer be protected by federal HIPAA regulations. - State-Specific Law (Colorado): Highly sensitive information (such as HIV/AIDS
status or specific mental health records) is subject to stricter state
laws in Colorado and will only be disclosed with your specific
written authorization or as required by law.
Other Permitted Uses: We may disclose PHI
without authorization for public health issues, law enforcement, national
security, or if we believe you are a victim of abuse/neglect. We may also use
PHI for appointment reminders (text, email, or phone).
II. Your Individual Rights
- Access: You have the right to inspect and copy your records. We may charge a
reasonable fee for copies, processing, and mailing or transferring your
records. In Colorado we will
comply with your request within 7 days, per Colorado Law. - Accounting: You may request a list of certain disclosures we have made of your PHI over
the last 6 years. - Restrictions: You may request additional restrictions on how we use your PHI. If you
pay for a service in full out-of-pocket, we must honor your request to not
share that information with your health insurer. - Amendments: You may request in writing that we amend PHI, which you believe is incorrect.
- Confidential
Communications: You may request that we communicate with you via
alternative means or locations (e.g., a specific phone number or address).
III. Questions and Complaints
If you believe your privacy rights have been violated, you
may file a complaint with our Privacy Official or the U.S. Department of Health
and Human Services. Residents of Colorado may also seek legal relief
for privacy violations under their respective state statutes. We will not
retaliate against you for filing a complaint.
Privacy Contact Officer(s): Dr. Michael McDill DDS,
Dr. Todd Rosenzweig DDS & Dr. Mesa Roth DDS
Fort Collins Office:
950 S Taft Hill Road Ft. Collins CO 80524
P:970-484-5297
F:970-493-2003