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Your information, your rights, our responsibilities — Effective Date: 01/06/2025
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
You can request to see or get an electronic or paper copy of your medical record and other health information we have about you. Please contact our office to submit a request. We will provide a copy or a summary of your health information, usually within 30 days of your request. A reasonable, cost-based fee may apply.
You may request corrections to health information you believe is incorrect or incomplete. We may deny your request but will notify you in writing within 60 days.
You may request that we contact you through specific means (e.g., home or office phone, alternative mailing address). We will accommodate all reasonable requests.
You may request limitations on the use or disclosure of certain health information for treatment, payment, or operations. We are not required to agree, but will consider your request. If you have paid for a service or healthcare item out-of-pocket in full, you may request that we not disclose that information to your health insurer, unless legally required to do so.
You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights.
To file a complaint, please contact us at: - Keystone Oral Surgery & Implant Center - Phone: (570) 884-8321 - Email: hippa@keystoneomfs.com
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
You may instruct us on sharing information in certain circumstances: - Share information with family, close friends, or others involved in your care - Share information in a disaster relief situation
We may share your information if you are unable to express your preferences and sharing is deemed to be in your best interest or necessary to lessen serious health or safety threats.
We will not share your information without written permission for: - Marketing purposes - Sale of your information - Most uses of psychotherapy notes
We may contact you for fundraising purposes, but you may opt out.
We typically use or share your health information in the following ways:
Treat you: We may use your health information and share it with other healthcare professionals involved in your care.
Run our organization: We may use and share your information to operate our practice, improve care, and manage administrative functions.
Bill for your services: We may use and share your health information to obtain payment from insurance companies and other payers.
We are allowed or required to share your information for public good and legal reasons, including: - Public health activities such as preventing disease, reporting adverse drug reactions, and reporting suspected abuse or neglect - Health research under federal guidelines - Compliance with federal or state law and regulatory agencies - Organ and tissue donation requests - Work with medical examiners or funeral directors - Workers' compensation claims - Law enforcement or government functions - Lawsuits and legal proceedings
Keystone Oral Surgery & Implant Center may use email, text messaging (SMS), or other electronic means to communicate with patients for appointment reminders, scheduling, billing, pre- and post-operative instructions, and other healthcare-related communications.
By providing your email address and/or mobile phone number, you are consenting to receive electronic communications from our practice.
Risks of Electronic Communication: - Email and text messaging are not fully secure methods of communication - There is a risk that messages may be intercepted, misdirected, or read by unintended recipients - Electronic communications may not always be encrypted or fully HIPAA-secure depending on the device, platform, or network used
Patient Responsibilities: - You are responsible for providing accurate and current contact information - You may revoke your consent to receive electronic communications at any time by notifying our office in writing
Use of Electronic Communication is Limited: - We will not use email or text to discuss sensitive clinical information unless explicitly requested and consented to by the patient - Emergency or urgent matters should not be communicated via email or text. In case of emergency, please call 911 or visit the nearest emergency facility
Opt-Out: You may opt out of electronic communication at any time by contacting our office: - Phone: (570) 884-8321 - Email: hippa@keystoneomfs.com
- We are required by law to maintain the privacy and security of your protected health information - We will notify you promptly if a breach occurs - We will only use or share your information as outlined unless you authorize otherwise - You may revoke consent in writing at any time
We reserve the right to amend this notice. Updated versions will be available at our office and on our website.
This website is provided for information and education purposes only. No doctor/patient relationship is established by your use of this site. No diagnosis or treatment is being provided. The information contained here should be used in consultation with a dentist or doctor of your choice. No guarantees or warranties are made regarding any of the information contained within this website. This website is not intended to offer specific medical, dental, or surgical advice to anyone.
We collect personally identifiable information, like names, postal addresses, email addresses, etc., when voluntarily submitted by our visitors. The information you provide is used to fulfill your specific request. This information is only used to fulfill your specific request, unless you give us permission to use it in another manner, for example, to add you to one of our mailing lists.
The site may use cookie and tracking technology depending on the features offered. Cookie and tracking technology are useful for gathering information such as browser type and operating system, tracking the number of visitors to the site, and understanding how visitors use the site. Cookies can also help customize the site for visitors. Personal information cannot be collected via cookies and other tracking technology; however, if you previously provided personally identifiable information, cookies may be tied to such information.
This website uses Google Analytics, a web analytics service provided by Google, Inc. Google Analytics uses cookies to help the website analyze how users use the site. The information generated by the cookie about your use of the website (including your IP address) will be transmitted to and stored by Google on servers in the United States.
We may share information with governmental agencies or other companies assisting us in fraud prevention or investigation. We may do so when: (1) permitted or required by law; or, (2) trying to protect against or prevent actual or potential fraud or unauthorized transactions; or, (3) investigating fraud which has already taken place. The information is not provided to these companies for marketing purposes.
Your personally identifiable information is kept secure. Only authorized employees, agents, and contractors (who have agreed to keep information secure and confidential) have access to this information. All emails and newsletters from this site allow you to opt out of further mailings.
We are working to improve the accessibility of the content on our website. We recommend using the accessibility features of modern smartphones, tablets, computers, or laptops. You can use your computer to read web pages out loud, use the keyboard to navigate screens, increase text size, magnify your screen, and change background and text colors.
If you are deaf or hard of hearing, closed captioning and volume controls are available for video content. If the recommendations above do not meet your needs, we invite you to contact us via phone, email, or by visiting the office during our business hours for assistance.