Privacy Practice

Effective Date: 01/01/2025

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.

Treatment: We may use and disclose your information to provide and coordinate your dental care. For example, we may share information with a specialist, dental laboratory, or another healthcare provider involved in your treatment.

Payment: We may use and disclose your information to bill for services and obtain payment. For example, we may provide your insurance company with treatment information to process a claim or determine benefits.

Healthcare operations: We may use and disclose your information to manage our practice and improve patient care. For example, we may review records to evaluate treatment quality or train our staff.

People involved in your care: When permitted by law, we may share information relevant to a family member’s, friend’s, or another person’s involvement in your care or payment for your care. We will give you an opportunity to agree or object when required. If you are unavailable or unable to express your wishes, we may share relevant information when our professional judgment determines it is in your best interest.

Business associates: We may share information with organizations that provide services for our practice, such as billing and technology support. When required by law, these organizations must enter into agreements requiring them to safeguard your information.

Other permitted or required disclosures: Subject to applicable legal requirements, we may disclose information:

• To comply with federal, state, or local law.
• For public health activities, including certain disease reporting, product recalls, and adverse-event reporting.
• To report suspected abuse, neglect, or domestic violence.
• For authorized health oversight activities, including audits, inspections, and investigations.
• For judicial or administrative proceedings when applicable legal requirements are met.
• For certain law enforcement purposes.
• To help prevent or lessen a serious and imminent threat to health or safety.
• For research when legally required safeguards are satisfied.
• For organ, eye, or tissue donation.
• To coroners, medical examiners, and funeral directors as authorized by law.
• For workers’ compensation or similar programs.
• For certain specialized government functions, including authorized military, national security, and correctional activities.

Where another applicable law provides greater protection or places additional limits on disclosure, we will follow those requirements.

If we receive substance use disorder records protected by 42 CFR Part 2, additional restrictions may apply to their use and disclosure.

These records, or testimony describing their contents, may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a qualifying court order issued after the required notice and opportunity to be heard. Before disclosure under such an order, the order must also be accompanied by a subpoena or other legal requirement compelling disclosure.

We will obtain your written authorization for uses and disclosures that require authorization under applicable law, including most uses and disclosures of psychotherapy notes, if we maintain them, certain marketing communications, and disclosures constituting a sale of protected health information.

Other uses and disclosures not described in this notice will be made only with your written authorization.

You may revoke your authorization by submitting a written request to our Privacy Officer. Revocation will not affect actions we have already taken in reliance on your authorization.

Information disclosed under HIPAA may be redisclosed by the recipient and may no longer be protected by HIPAA. Other laws may continue to protect that information, including applicable protections for substance use disorder records.

Access your records: You may request to inspect or obtain a paper or electronic copy of health information in your designated record set, subject to applicable exceptions. Contact our Privacy Officer to make a request. We will respond within the time required by law and may charge a reasonable, cost-based fee when permitted. If access is denied, we will explain the denial and any available review rights.

Request a correction: You may request an amendment to information you believe is incorrect or incomplete. Submit your request in writing with the reason for the requested amendment. We may deny the request in certain circumstances. If we do, we will provide a written explanation and explain your right to submit a statement of disagreement.

Request confidential communications: You may ask us to contact you in a particular way or at a different location. We will accommodate reasonable requests.

Request restrictions: You may request limits on certain uses or disclosures for treatment, payment, healthcare operations, or to people involved in your care. We generally are not required to agree.

However, we must agree to a qualifying request not to disclose information to your health plan for payment or healthcare operations when the information relates solely to a service you, or someone on your behalf other than the health plan, paid for in full out of pocket, unless disclosure is required by law.

Receive an accounting of disclosures: You may request an accounting of certain disclosures made during the six years before your request. This does not include all disclosures, such as most disclosures for treatment, payment, healthcare operations, or disclosures made with your authorization. One accounting in a 12-month period is free. We may charge a reasonable, cost-based fee for additional requests after notifying you and allowing you to withdraw or modify your request.

Receive a paper copy: You may obtain a paper copy of this notice at any time, even if you agreed to receive it electronically.

Use a personal representative: A person authorized under applicable law may exercise your rights on your behalf. We will verify that person’s authority, subject to applicable legal exceptions.

To exercise your rights, contact our Privacy Officer. We may require requests in writing and verification of your identity.

For questions about this notice, to exercise your rights, or to file a privacy complaint, contact:

Privacy Officer - Lindsay Swink
Practice/legal entity: South Hills Dental Arts USC
Mailing address: 70 Fort Couch Rd, Pittsburgh Pa 15241
Telephone: 412-833-6166

Privacy Officer - Lindsay Swink
Practice/legal entity: South Hills Dental Arts Ingram
Mailing address: 2725 Center Street Pittsburgh Pa 15205
Telephone: 412-922-9292

Privacy Officer - Lindsay Swink
Practice/legal entity: South Hills Dental Arts Sewickley
Mailing address: 201 Ohio river Blvd Sewickley Pa 15143
Telephone: 412-741-6350

Privacy Officer - Lindsay Swink
Practice/legal entity: South Hills Dental Arts McMurray
Mailing address: 807 E. McMurray, Venetia Pa 15367
Telephone: 724-395-3995

You may file a complaint with our Privacy Officer by telephone or in writing using the contact information above.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. Instructions are available at:

https://www.hhs.gov/hipaa/filing-a-complaint/index.html

We will not retaliate against you for filing a complaint.

We reserve the right to change this notice and make the revised terms apply to information we already maintain and information we receive in the future, as permitted by law.

A revised notice will include its effective date and will be available on our website and at our office. You may request a copy at any time.