Effective Date: April, 2025

Introduction

At Heavenly Smiles in Lynnwood, we are committed to protecting the privacy and security of your Protected Health Information (PHI). This Privacy Policy outlines how we collect, use, safeguard, and disclose your PHI in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable state laws. Our goal is to ensure that your personal health information is handled with the utmost care and confidentiality.

Information We Collect

We may collect and maintain the following types of information:

• Personal Identification Information: Name, date of birth, contact details, and other demographic information.
• Medical and Dental Information: Health history, treatment records, diagnostic images, and other clinical data.
• Payment Information: Insurance details, billing records, and financial information related to your care.

This information is collected during your interactions with our practice—whether in person, over the phone, or via our secure online portals.

How We Use Your Information

Your PHI is used for purposes including, but not limited to:

• Providing Dental Care: Diagnosing, treating, and managing your dental needs.
• Billing and Insurance Processing: Submitting claims, processing payments, and managing related financial transactions.
• Administrative Functions: Scheduling appointments, maintaining records, and managing quality assurance and compliance.
• Communication: Keeping you informed about your treatment, including appointment reminders, treatment plans, and follow-up care instructions.
• Legal and Regulatory Compliance: Complying with legal requirements, such as public health reporting and audits.

Disclosure of Your Information

We may disclose your PHI under the following circumstances:

• With Your Consent: When you authorize us to share your information with other healthcare providers or for specified purposes.
• For Treatment, Payment, and Healthcare Operations: To coordinate your care, process claims, and perform routine practice management activities.
• As Required by Law: In response to subpoenas, court orders, or other legal processes, or as otherwise mandated by federal or state law.
• To Protect Our Rights and Safety: If necessary to protect the rights, safety, or property of our patients, staff, or the public.

How We Safeguard Your Information

We implement a range of administrative, technical, and physical safeguards to protect your PHI from unauthorized access, alteration, disclosure, or destruction. These safeguards include:

• Secure Storage: Using encrypted systems and secure servers for electronic records.
• Access Controls: Limiting access to PHI to authorized personnel who require it to perform their duties.
• Training and Policies: Regular staff training on privacy practices and strict policies for handling sensitive information.
• Physical Security: Protecting our facilities and any physical records to prevent unauthorized access.

Your Rights Regarding Your PHI

Under HIPAA, you have the right to:

• Access Your Information: Request copies of your health records.
• Request Amendments: Ask for corrections to your information if you believe it is inaccurate or incomplete.
• Obtain an Accounting of Disclosures: Receive a report of instances when your PHI has been shared for purposes other than treatment, payment, or healthcare operations.
• Request Restrictions: Ask for limits on how your information is used or disclosed, where applicable.
• Request Confidential Communications: Ask to be contacted in a specific manner or at a specific location.
• File a Complaint: If you believe your privacy rights have been violated, you may file a complaint with us or with the appropriate regulatory authority.

Changes to This Privacy Policy

We reserve the right to update this Privacy Policy periodically to reflect changes in our practices or applicable law. Any significant changes will be communicated to you through appropriate channels and will be posted on our website with an updated effective date.

Contact Us

If you have any questions or concerns about this Privacy Policy or our privacy practices, please contact our Privacy Officer at:

Heavenly Smiles in Lynnwood

6610 208th St SW, Lynnwood, WA 98036
Phone: (425) 774-5596
Email: leann@nicholemartindmd.com

Your trust is important to us, and we are committed to protecting your health information while delivering exceptional care.