Patient Privacy Policy

Our oral surgeons and staff understand that your medical and health information is confidential. Protecting your health information is important. We follow strict federal and state laws that require us to maintain the confidentiality of your health information.

How We Use Your Health Information

When you receive care from our oral surgeons, we may use your health information for treating you, billing for services, and conducting our normal business (known as “health care operations”).

Examples of how we use your information include:


We keep records of the care and services provided to you. Health care providers use these records to deliver quality care to meet your needs. For example, your doctor may share your health information with a specialist who will assist in your treatment. Some health records, including some confidential communications with a mental health professional, some substance abuse treatment records, some genetic test results, and some health information of minors, may have additional restrictions for use and disclosure under state and federal law.


We keep billing records that include payment information and documentation of the services provided to you. Your information may be used to obtain payment from you, your insurance company, or a third party. We may also contact your insurance company to verify coverage for your care or to notify them of upcoming services that may need prior notice or approval. For example, we may disclose information about the services provided to you to claim and obtain payment from your insurance company or Medicare.

Health Care Operations

We use health information to improve the quality of care by training staff, providing customer service, managing costs, and conducting required business duties.

Other Services We Provide

We may also use your health information to:

  • Recommend treatment alternatives
  • Tell you about health services and products that may benefit you
  • When consent is provided, to share information with family or friends involved in your care or payment
  • Share information with third parties who assist us with treatment, payment, and health care operations. Our business associates must protect your information by following our privacy practices
  • Remind you of an appointment. If you do not wish to be reminded, please notify our scheduler

Our Privacy Responsibilities

Our surgeons are required by law to:

  • Maintain the privacy of your health information
  • Follow the terms of any current notices

We reserve the right to make changes to this notice at any time and make new privacy practices effective for all information we maintain. Current notices will be posted in our offices. You may also request a copy of any notice from any member of our staff.

Sharing Your Health Information

There are limited situations when we are permitted or required to disclose health information without your signed authorization. These situations are:

  • For public health purposes such as reporting communicable diseases, work-related illnesses, or other diseases and injuries permitted by law; and reporting reactions to drugs and problems with medical devices;
  • To protect victims of abuse, neglect or domestic violence;
  • For health oversight activities such as investigations, audits, and inspections;
  • When requested by law enforcement as required by law or court order;
  • For workers’ compensation or other similar programs if you are injured at work;
  • For specialized government functions such as intelligence and national security.

All other uses and disclosures not described in this notice require your signed authorization. You may revoke your signed authorization at any time with a written statement.

Your Individual Rights

You have the right to:

  • Request restrictions on how we use and share your health information. We will consider all requests for restrictions carefully but are not required to agree to any restrictions.
  • Request that we use a specific telephone number or address to communicate with you.
  • * Request a copy of your health information, including medical and billing records. Fees may apply.
  • Under limited circumstances, we may deny your access to a portion of your health information, and you may request a review of the denial.
  • * Request corrections or additions to your health information.
  • * Request an account of certain disclosures of your health information made by us. The accounting does not include disclosures made for treatment, payment and health care operations, and some disclosures required by law. Your request must state the period of time desired for the accounting which must be within the six years prior to your request. The first accounting is free, but a fee will apply if more than one request is made in a 12-month period.
  • Request a paper copy of this notice

(*) Requests marked with a star must be made in writing. Contact a staff member for the appropriate form for your request.