This notice describes how medical information about your patients may be used and disclosed, and how you can get access to this information.

Please review it carefully.

This Notice of Privacy Practices describes how we may use and disclose protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your patients’ rights to access and control protected health information. “Protected health information” is information about patients, including demographic information that may identify you and that relates to your past, present or future physical or mental health or condition and related health services.

Uses and Disclosures of Protected Health Information

Protected health information may be used and disclosed by our customers, the health care providers, their office staff and others outside of their office that are involved in patient care and treatment. The PHI may be used for the purpose of providing health care services to their own patients, to pay health office care bills, to support the operation of their practices, and any other use required by law.

Treatment

Treatment is the care provider’s responsibility. Treatment policies must be provided in the care providers’ own HIPAA statements for their own patients. OnSiteDentistry is not a care provider and therefore will not participate in treatment of patients. OnSite Dentistry resources are used for treatment only as a third party provider of technology resources.

Payment

Payment information management is the care provider’s responsibility. Payment policies must be provided in the care providers’ own HIPAA statements for their own patients. OnSiteDentistry is not a care provider and therefore will not participate in the billing, collecting, and management of patient payments. OnSiteDentistry resources are used for payment information only as a third party provider of technology resources.

Health Care Operations

As a third-party provider of technology, OnSiteDentistry will not disclose patient information to any company or additional third party organization.

Our customers, the health care providers, disclose protected health care information in the following situations without prior authorization. These situations include: as Required By Law, Public Health issues as required by law, Communicable Disease: Health Oversight Abuse or Neglect: Food and Drug Administration requirements: Legal Proceeding: Law Enforcement: Coroners, Funeral Inmates: Required Uses and Disclosures: Under the law, those providers must disclose these scenarios to their patients and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500.

Other Permitted and Required Uses and Disclosures Will Be Made Only with Patient Consent, Authorization, or Opportunity to Object, unless required by law.

Patients may revoke use of protected health care information at any time, but they must do so directly with their health care provider. If there is a dispute that requires intervention of OnSiteDentistry, patients can contact OnSiteDentistry directly by phone or email to notify us of the dispute so appropriate actions can be taken to protect the protected health care information appropriately.

Patient Rights

Following is a statement of patient rights with respect to their protected health information.

Patients have the right to inspect and copy their own protected health information.

Under federal law, however, patients may not inspect or copy the following records; psychotherapy notes; information compiled in reasonable anticipation of or use in. a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information.

Patients have the right to request a restriction of their own protected health information

This means patients may ask their providers not to use or disclose any part of their protected health information for the purposes of treatment, payment, or health care operations. Patients may also request that any part of their protected health information not he disclosed to family members or friends, who may he involved in care or for notification purposes as described in this Notice of Privacy Practices. Patient request must be presented directly to the health care provider.

The health care provider is not required to agree to a restriction that patients may request. If a provider believes it is in a patient’s best interest to permit use and disclosure of protected health information, that protected health information may not be restricted. Patients have the right to go to a new health care provider.

Patients have the right to request to receive confidential communications from their providers by alternative means or at an alternative location. Patients also have the right to obtain a paper copy of this notice from us, upon request.

Patients may have the right to have their health care providers amend their own protected health information.

Patients may request ammendments to their protected health care information from their providers directly. OnSiteDentistry will not negotiate, ammend, or change provider policies.

We reserve the right to change the terms of this notice and will inform our customers, the health care providers, by Mail of any changes. Patients then have the right to object or withdraw as provided in this notice.

Complaints

Patients may complain to us, their health care providers, or to the Secretary of Health and Human Services if they believe their own privacy rights have been violated. We will not retaliate against patients for filing a complaint.

This notice was published and becomes effective on/or before December 1, 2006.