HIPAA Privacy Notice of Just Smile Miami

1. Introduction

This Notice describes the privacy practices of Just Smile Miami, our staff, and affiliated health care providers. We are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information.

2. How We May Use and Disclose Health Information

Here are several ways we might use or disclose your health information:

• Treatment: We can use your health information and share it with other professionals who are treating you.
• Payment: We can use and disclose your health information to bill and get payment from health plans or other entities.
• Health Care Operations: We can use and share your health information to run our practice, improve your care, and contact you when necessary.
• Appointment Reminders and Health-Related Benefits: We may use and disclose health information to contact you as a reminder that you have an appointment for treatment or medical care at Just Smile Miami. We may also use and disclose health information to tell you about health-related benefits or services that may be of interest to you.

3. Your Rights

You have the right to:

• Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care.
• Request Amendments: You may ask us to correct health information about you that you think is incorrect or incomplete.
• Request Restrictions: You may request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations.
• Request Confidential Communications: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• Get a List of Disclosures: You have the right to request a list of the instances in which we have disclosed your health information for purposes other than treatment, payment, or operations.

4. Changes to This Notice

We reserve the right to change this notice and make the new notice apply to health information we already have as well as any information we receive in the future. The new notice will be available upon request, in our office, and on our web site.

5. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, contact:

Just Smile Miami
Phone: 305-930-7745
Email: info@justsmilemiami.com

You will not be penalized for filing a complaint.

6. Contact Information

For more information about our privacy practices, or for additional copies of this notice, please contact us using the information above.