Privacy Policy

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.

We respect our legal obligation to keep health information that identifies you private.  We are obligated by law to give you notice of our privacy practices.  This Notice describes how we protect your health information and what rights you have regarding it.

TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS

The most common reason why we use or disclose your health information is for treatment, payment or health care operations.  Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you; examining your teeth, mouth and oral health; prescribing medications and faxing them to be filled; prescribing dental appliances and dental prosthesis; showing you treatment options; referring you to another dentist for specialty care; or getting copies of your health information from another professional that you may have seen before us.  Examples of how we use or disclose your health information for payment purposes are: asking you about your dental or medical care plans or other sources of payment; preparing and sending bills or claims; and collecting unpaid amounts (either ourselves or through a collection agency or attorney).  “Health care operations” mean those administrative and managerial functions that we have to do in order to run our office.  Examples of how we use or disclose your health information for health care operations are: financial or billing audits; internal quality assurance; personal decisions; participation in managed care plans; defense of legal matters; business planning; and outside storage of our records.

We routinely use your health information inside our office for these purposes without any special permission.  If we need to disclose your health information outside of our office for these reasons, we usually will not ask you for special written permission.

We will ask for special written permission in the following situations: anything related to HIV/AIDS status, any sale of information, any use of information for marketing or fundraising purposes, and photos displayed.

USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION

In some limited situations, the law allows or requires us to use or disclose your health information without your permission.  Not all of these situations will apply to us; some may never come up at our office at all.  Such uses or disclosures are:

APPOINTMENT REMINDERS

We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment.  We may also call or write to notify you of other treatments or services available at our office that might help you.  Unless you tell us otherwise, we will mail you an appointment reminder on a post card, and/or leave you a reminder message on your home answering machine or with someone who answers your phone if you are not home.

OTHER USES AND DISCLOSURES

We will not make any other uses or disclosures of your health information unless you sign a written “authorization form.”  The content of an “authorization form” is determined by federal law.  Sometimes, we may initiate the authorization process if the use or disclosure is our idea.  Sometimes, you may initiate the process if it’s your idea for us to send your information to someone else.  Typically, in this situation you will give us a properly completed authorization form, or you can use one of ours.

If we initiate the process and ask you to sign an authorization form, you do not have to sign it.  If you do not sign the authorization, we cannot make the use or disclosure.  If you do sign one, you may revoke it at any time unless we have already acted in reliance upon it.  Revocations must be in writing.  Send them to the office contact person named at the beginning of this Notice.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

The law gives you many rights regarding your health information.  You can:

OUR NOTICE OF PRIVACY PRACTICES

By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it.  We reserve the right to change this notice at any time as allowed by law.  If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to such information that we may generate in the future.  If we change our Notice of Privacy Practices, we will post the new notice in our office, have copies available in our office, and post it on our Website.

COMPLAINTS

If you think that we have not properly respected the privacy of your health information, you are free to complain to us or the U.S. Department of Health and Human Services, Office for Civil Rights.  We will not retaliate against you if you make a complaint.  If you want to complain to us, send a written complaint to the office contact person at the address, fax or email shown below.  If you prefer, you can discuss your complaint in person or by phone.

Jennifer Kluth DMD
1006 Union Street
Schenectady, NY 12308
Office: 518-374-6845
Fax: 518-377-4112
jenniferkluthdmd@gmail.com

FOR MORE INFORMATION

If you want more information about our privacy practices, call or visit the office contact person at the address or phone number shown above.