Thank you for choosing Carpe Diem Dental Spa for your healthcare needs. This Notice of Privacy Practices outlines how we handle your protected health information (PHI) in compliance with the Health Insurance Portability and Accountability Act (HIPAA).

I. Uses and Disclosures of Protected Health Information (PHI)

Your PHI may be used and disclosed for the following purposes:

Treatment: We may use and disclose your PHI to provide, coordinate, or manage your healthcare and any related services. This includes communication between healthcare providers involved in your care.

Payment: Your PHI may be used for billing and payment purposes, including insurance claims, verification, and coordination of benefits.

Health Care Operations (TPO): We may use and disclose your PHI for healthcare operations, such as quality assessment and improvement activities, staff training, accreditation, and other essential operational functions.

Permitted or Required by Law:We may disclose your PHI as required or permitted by federal, state, or local law.

II. Your Rights Regarding Your Protected Health Information

As our patient, you have the following rights:

Right to Access: You have the right to access and obtain copies of your PHI within 30 days of your request. A reasonable fee may apply for copying.

Right to Request Amendments: If you believe that your PHI is inaccurate or incomplete, you may request amendments to your records. We will respond within 60 days.

Right to Restrict Disclosures: You may request restrictions on certain uses and disclosures of your PHI, although we may not always be able to accommodate these requests.

Right to Confidential Communications: You have the right to request confidential communications, such as receiving information at a specific address or phone number.

III. Our Commitment to Privacy Practices

We are dedicated to protecting the privacy and security of your PHI through the following practices:

Safeguards: We employ physical, technical, and administrative safeguards to protect your PHI from unauthorized access, use, or disclosure.

Authorized Personnel: Only authorized personnel, including healthcare providers and staff, have access to your PHI on a need-to-know basis.

Breach Notification: In the event of a breach compromising the privacy or security of your PHI, we will notify you as required by law.

IV. Contact Information

If you have any questions or concerns about this notice or the privacy of your PHI, please contact:

Carpe Diem Dental Spa

34570 Aurora Road, Solon Ohio 44139

Ph (440) 589-4930

operations@carpediemdentalspa.com

V. Changes to this Notice

We reserve the right to amend this notice to reflect changes in our privacy practices. Any modifications will be promptly communicated to you, and you may request a revised notice at any time.

By receiving healthcare services from us, you acknowledge that you have received and understood this HIPAA Privacy Notice.

Carpe Diem Dental Spa

Effective as of 01 01, 2024