Alessandra L.S. Ritter, DDS, MS

Practice limited to Endodontics

501 Eastowne Drive Suite 155, Chapel Hill, NC   27514

Notice of Privacy Practices

 

This notice describes how your protected health information may be used and disclosed and how you can get access to this information. Please review it carefully.  The privacy of your protected health information is important to us.

 

Our Legal Duty

We are required by federal and state law to maintain the privacy of your health information.  We are also required to give you this notice about our privacy practices, our legal duties, and your rights concerning your health information.  We must follow the privacy practices described in this Notice while it is in effect.  This notice takes effect February 20, 2008, and will remain in effect until we replace it.

 

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by application law.  We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information we maintain, including health information we created or received before we make the changes.  Before we make significant changes in our privacy practices, we will change this Notice and make the new Notice available upon request.

 

You may request a copy of our Notice at any time.  For more information about our privacy practices, or for additional copies of this Notice, please contact us (contact information is at the end of this Notice).

 

Uses and Disclosures of Health Information

We use and disclose health information about you for treatment, payment, and healthcare operations.  For example:

Treatment: We may use or disclose your health information to a physicians or other healthcare professional providing treatment to you.

Payment: We may use or disclose your health information to obtain payment for services we provided to you.

Healthcare operations: We may use or disclose your health information in connection with our healthcare operations.  Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, or licensing or credentialing activities.

HITECH: Health information technology (health IT) We may use or disclose your health information in connection with our healthcare operations involving the exchange of health information in an electronic environment.

Your authorization: In addition to your health information for treatment, payment or healthcare operations, you may give us additional written authorization to use your health information or to disclose it to anyone for any purpose.  If you give us an authorization you may revoke it in writing at any time.  Your revocation will not affect any use or disclosure permitted by your authorization while it was in effect.  Unless you give us written authorization, we cannot use or disclose your health information of any reason except those described in this Notice.

To your family and friends: We must disclose your health information to you, as described in the Patient Rights section of this Notice.  We may disclose your health information to a family member, friend or other person to the extent necessary to help with your healthcare or with payment for your healthcare, but only if you agree we may do so.

Persons involved in care: We may use or disclose your health information to notify, or assist in the notifications of (including identifying or locating) a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death.  If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures.  In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination using our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays, or other similar forms of health information.

Marketing health-related services: We will not use your health information for marketing communications without your written authorization.

Abuse or neglect: We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes.  We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.

National security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances.  We may disclose to authorize federal officials health information required for lawful intelligence, counterintelligence, and other national security activities.  We may disclose to correctional institutions or law enforcement officials having lawful custody of protected health information of inmates or patients under certain circumstances.

Appointment reminders: We may use or disclose your health information to provide you with appointment reminders (such as voicemail messages, postcards, letters, or email text messages

 

Patients Rights

Access: You have the right to look at or get copies of your health information, with limited exceptions.  You may request we provide copies in a format other than printed copies.  We will use the format you request unless we cannot practically do so.  You must make a request in writing to obtain access to your health information.  You may obtain a request form using the contact information at the end of this Notice.  We will charge you a reasonable cost-based fee for expenses such as copies and staff time.  You may also request access by sending us a letter to the address at the end of this Notice.  If you request mailed copies, we will charge you $10.00 and postage.  If you prefer, we will prepare a summary or an explanation of your health information for a fee.  Contact us for a full explanation of our fee structure.

Disclosure accounting: You have the right to receive a list of instances in which we or our business associates disclosed your health information for purposes other than treatment, payment or healthcare operations and certain other activities for the last 6 years, but not before February 20, 2008.  If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee $25.00 for responding to these additional requests.

Restriction: You have the right to request that we place additional restrictions on our use or disclosure of your health information.  We are not required to agree to these additional restrictions, but if we do we will be handled under the alternative means or location you request.

Amendment: You have the right to request that we amend your health information.  Your request must be in writing and it must explain why the information should be amended.  We may deny your request under certain circumstances.

Electronic notice: If you receive this Notice on our website or by e-mail, you are entitled to receive this Notice in written form from our office.

Security Breaches 
We may use or disclose your PHI when determining whether a security breach has occurred for purposes of the HIPAA Breach Notification Rules as set forth in 45 C.F.R. § 164, subpart D. We may also use or disclose your PHI in responding to a breach, as required under the HIPAA Breach Notification Rules. For example, if an individual hacks into our computer network, we would investigate the incident to determine the extent of the breach and if PHI had been accessed, used or 
disclosed in violation of the HIPAA Privacy Rule. If a breach for purposes of HIPAA has occurred, we would notify you of the breach. We may also be required to notify the media and North Carolina Department of Health & Human Services and/or U.S. Department of Health and Human Services of the breach but your PHI will not be disclosed when such entities are notified of the breach. 

 

Questions and Complaints

If you want more information about our privacy practices, or have questions or concerns, please contact us.

If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your health information or in response to a request that you made to amend or restrict the use or disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may complain to us using the contact information at the end of this Notice.  You may also submit a written complaint to the US Department of Health and Human Services.  We will provide you with that address upon request.

 

We support your right to the privacy of your health information.  We will not retaliate in any way if you choose to file a complaint with us or with the US Department of Health and Human Services.

 

Our HIPAA Officers contact information:

            Marie Roberts / Office Manager

            Phone: 919-403-5000     Fax: 919-403-5001

            Address: 501 Eastowne Drive, Suite 155, Chapel Hill, NC 27514 

Website: www.ritterendo.com     Email: [email protected]