Notice of Privacy Practices
Lavin Family Dental

Effective Date: 10/20/2024
This notice explains how Lavin Family Dental may use and disclose your health information, your rights regarding your health information, and our responsibilities to protect your health information. Please review this notice carefully.

Introduction

At Lavin Family Dental, we are committed to protecting the privacy of your health information. Both federal laws (such as HIPAA) and Florida State laws (specifically Florida Statutes 456.057) require us to maintain the privacy of your health information. We are obligated to provide you with this Notice of Privacy Practices and follow its terms.

This Notice applies to the protected health information (PHI) we maintain about you. This Notice will take effect on the Effective Date above and will remain in effect until we amend or replace it.

We reserve the right to change our privacy practices and the terms of this Notice as allowed by law. When we make a significant change, we will update this Notice and make the new version available to you upon request. The revised Notice will apply to all health information we maintain, including information created or received before any changes were made.

You may request a copy of this Notice at any time by contacting our Privacy Officer at the contact information provided below.

1. How We Use and Disclose Your Health Information

Lavin Family Dental uses and discloses your health information for treatment, payment, and healthcare operations purposes. Here’s how we handle your protected health information (PHI):

Treatment

We may share your health information with other healthcare providers or professionals who are involved in your care. This may include dentists, specialists, or medical professionals, as well as business partners who assist in delivering services related to your treatment, billing, or administrative support.

Payment

We may use your health information to obtain payment for services we provide. This may include communicating with insurance companies, collections agencies, or other third parties responsible for paying for your care, including family members. Per Florida law, if your health insurance company or another third party is paying for your care, we may disclose your health information as required for billing and collection purposes.

Healthcare Operations

We may use and disclose your health information for healthcare operations, including managing our practice, conducting quality assessments, and training staff. These activities are essential to keeping our practice running smoothly and ensuring quality patient care.

Disclosure to Family and Friends

We may disclose information about your care to family members or friends involved in your treatment, with your consent. You have the right to object to this disclosure, and we will only release such information if you agree, unless we believe it is in your best interest.

Emergencies

In emergencies or if you are unable to provide consent, we may use professional judgment to disclose health information to family members or others involved in your care. We will only share information relevant to your care under these circumstances.

2. Your Rights Regarding Health Information

You have the following rights concerning your health information:

Right to Access and Copies

You have the right to inspect and receive copies of your health information. You may request a copy in the format you prefer, and we will provide access to your information in that format if it is available. There may be a reasonable fee charged for copying or mailing the information. In Florida, you are entitled to access your health records within 30 days of your request. If electronic copies are requested, you may receive them at a reasonable cost, not to exceed $6.50 (including labor, supplies, and postage).

Right to Request an Amendment

You have the right to request an amendment if you believe the information we have about you is incorrect or incomplete. Requests for amendments must be in writing and include an explanation of why the amendment is necessary. Under certain circumstances, we may deny your request.

Right to an Accounting of Disclosures

You can request an accounting of disclosures of your health information that were made for purposes other than treatment, payment, or operations. These disclosures can be tracked for up to 6 years before the date of your request, and you may request a copy of these disclosures in electronic format if the information is stored electronically. For electronic requests, there may be a reasonable fee for providing copies.

3. Required Disclosures and Legal Obligations

We may disclose your health information when required by law, including in response to subpoenas, court orders, or other lawful processes. Florida law also requires certain mandatory disclosures of health information to report abuse, neglect, and domestic violence, or when necessary to prevent or address public health concerns such as communicable diseases.

Public Health Disclosures

We may disclose your health information to public health authorities for purposes such as reporting disease outbreaks, injuries, product recalls, and adverse reactions to medications.

National Security and Law Enforcement

We may disclose your health information when required by national security agencies or law enforcement, including situations involving military personnel or intelligence operations.

4. Marketing and Fundraising

We will not use or disclose your health information for marketing purposes without your written authorization. However, we may use certain demographic information (such as your name and address) for fundraising activities. You have the right to opt out of receiving such communications.

5. Sale of Health Information

We are prohibited from selling your health information for compensation without your written consent, in accordance with Florida and federal law.

6. Breach Notification

If there is a breach of your health information, we will perform a risk assessment as required by the Health Information Technology for Economic and Clinical Health (HITECH) Act and
inform you of the breach. You will be notified of the breach and any necessary steps to protect yourself from harm.

7. Complaints and Concerns

If you believe that your privacy rights have been violated or you have concerns about how your health information has been handled, you can file a complaint with our Privacy Officer. You may also file a complaint with the U.S. Department of Health and Human Services (HHS). We support your right to privacy and will not retaliate against you for filing a complaint.

8. Contact Information

For questions or concerns regarding this Privacy Notice or to exercise any of your rights, please contact our Privacy Officer: Shane Lavin at:

Lavin Family Dental
1531 S Tamiami Trail, Suite 701, Venice, Florida, 34285
Phone: 941-441-9295
Email: lavinfamilydental@gmail.com