Notice of Privacy Practices
This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Our Legal Duty
Anantuni Family Dental & Aesthetics is required by applicable federal and Arizona law to:
- Maintain the privacy of your protected health information (PHI)
- Provide you with this Notice of our legal duties and privacy practices
- Follow the terms of this Notice while it is in effect
This Notice applies to all health information we create, receive, or maintain about you. We reserve the right to change our privacy practices and the terms of this Notice as permitted by law. Any revised Notice will apply to all PHI we maintain, including information created or received before the change. When a material change is made, the updated Notice will be made available upon request and posted in our office and, if applicable, on our website. You may request a paper copy of this Notice at any time.
Uses and Disclosures of Health Information
Treatment
We may use or disclose your health information to dentists, physicians, hygienists, specialists, or other healthcare providers involved in your care.
Payment
We may use or disclose your health information to obtain payment for services provided to you, including billing insurance companies or other third-party payers.
Healthcare Operations
We may use or disclose your health information for healthcare operations, which include quality improvement activities, staff training, accreditation, licensing, credentialing, and business management activities.
Uses and Disclosures That May Be Made Without Your Authorization
Persons Involved in Your Care
We may disclose your health information to a family member, friend, or other person involved in your care or payment for your care, as long as you agree or do not object. If you are unable to agree or object, we may disclose information based on our professional judgment and your best interest.
Appointment Reminders
We may use or disclose your health information to contact you with appointment reminders, including voicemail messages, text messages, postcards, or letters. Message frequency may vary. Message and data rates may apply.
Required by Law
We may use or disclose your health information when required to do so by federal, state, or local law.
Abuse, Neglect, or Domestic Violence
We may disclose your health information to appropriate authorities if we reasonably believe you are a victim of abuse, neglect, domestic violence, or other crimes, or to prevent a serious threat to health or safety.
National Security and Law Enforcement
We may disclose health information to military authorities for Armed Forces personnel, to authorized federal officials for lawful intelligence, national security, or protective services, and to correctional institutions or law enforcement officials for individuals in lawful custody, as permitted by law.
Uses and Disclosures Requiring Your Authorization
Authorization
Any use or disclosure of your health information not described in this Notice will be made only with your written authorization. You may revoke an authorization in writing at any time. Revocation will not apply to information already used or disclosed before the revocation was received.
Marketing
We will not use or disclose your protected health information for marketing purposes without your written authorization, except as permitted by law.
SMS/Text Messaging Privacy
Mobile information will not be shared with third parties or affiliates for marketing or promotional purposes.
Anantuni Family Dental We respect your privacy. We use information you provide to send and respond to your mobile messages. This includes sharing it with platform providers, phone companies, and other vendors who help us deliver messages. We won't share mobile information with third parties for marketing. Text messaging originator opt-in data and consent are exempt from this. We may disclose information to satisfy legal, regulatory, or governmental requests, avoid liability, or protect our rights or property. This policy applies to your use of the Text Message Service and doesn't modify our general Privacy Policy, which may govern our relationship with you in other contexts.
Electronic Communication
We may communicate with you using electronic methods such as voicemail, text message, or email regarding appointments, treatment information, billing, or other healthcare-related matters.
Electronic communications may not be fully secure. By choosing to communicate with us electronically, you acknowledge and accept these risks. You may opt out of electronic communications at any time by contacting our office or, for text messages, replying STOP.
Payment Card Information
When you make a payment online, your credit or debit card information is collected and processed directly by our PCI DSS-compliant third-party payment processor, LQpay (Liquid Payments, Inc.). We do not store your full card number, expiration date, or security code on our systems or website.
We may retain a tokenized reference and the last four digits of cards you authorize us to keep on file for future payments. Tokens are non-sensitive identifiers that cannot be used to make payments outside of our payment processor's environment. You may revoke a card-on-file authorization at any time by calling our office at (480) 660-4598.
Payment card information is not protected health information (PHI) under HIPAA, but we treat it with the same level of confidentiality and apply the safeguards required by the Payment Card Industry Data Security Standard (PCI DSS).
Your Rights Regarding Your Health Information
You have the right to:
Access
Inspect and obtain a copy of your health information, with limited exceptions. You may request a paper or electronic copy and may request that we send an electronic copy to a third party of your choosing where feasible. Requests must be made in writing.
Accounting of Disclosures
Receive a list of certain disclosures of your health information made in the past six (6) years, excluding disclosures for treatment, payment, healthcare operations, and certain other exceptions. One request per 12 months is free; additional requests may incur a reasonable fee.
Request Restrictions
Request restrictions on how your health information is used or disclosed. We are not required to agree to all requests, but if we do, we will comply unless an emergency requires otherwise.
Alternative Communications
Request confidential communications by alternative means or at alternative locations. Requests must be made in writing and specify how payment will be handled.
Amendment
Request an amendment to your health information if you believe it is incorrect or incomplete. Requests must be in writing and explain the reason for the amendment.
Paper Copy
Receive a paper copy of this Notice at any time, even if you agreed to receive it electronically.
Questions and Complaints
If you have questions about this Notice or our privacy practices, please contact our office.
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. We will provide contact information for HHS upon request. We will not retaliate against you for filing a complaint.
Acknowledgment of Receipt: You may be asked to sign an acknowledgment that you received or were offered a copy of this Notice. You are not required to sign this acknowledgment.
