HIPAA Notice of Privacy Practices

Effective Date: 15/12/2025

This notice describes how medical and dental information about you may be used and disclosed, and how you can access this information. Please review it carefully.

We maintain protected health information (PHI) about you as part of your medical and dental records. PHI includes any information that identifies you and relates to your past, present, or future physical or mental health condition, treatment, or payment for healthcare services.

Our practice is required by law to maintain the confidentiality of your PHI and follow specific rules regarding how your information may be used or disclosed. This Notice explains your rights regarding your PHI and how we use or disclose it for treatment, payment, healthcare operations, and other purposes permitted or required by law.

• Right to Receive This Notice
  You have the right to receive, and we are required to provide, a copy of this Notice of Privacy Practices. We may update this Notice at any time, and updated versions will be available upon request and posted in our office and on our website.
• Right to Authorize Uses and Disclosures
  Any use or disclosure of your PHI not included in this Notice requires your written authorization. You may revoke an authorization at any time, except when we have already acted in reliance on it.
• Right to Confidential Communication
  You may request that we contact you using an alternative method (such as email or a different phone number). Requests must be made in writing, and we will accommodate all reasonable requests.
• Right to Inspect and Copy Your PHI
  You may inspect or request a copy of your health records. If the records are maintained electronically, you may request an electronic copy. We may charge a reasonable fee as permitted by law.
• Right to Request Restrictions
  You may request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations. Although we are not required to agree to most restrictions, we must honor your request to restrict disclosure to your health plan when you pay out-of-pocket in full for a service.
• Right to Request Amendments
  If you believe your PHI is incorrect or incomplete, you may request a correction. We may deny the request in certain circumstances.
• Right to an Accounting of Disclosures
  You may request a list of certain disclosures of your PHI to persons outside our office, except for those made for treatment, payment, healthcare operations, or those authorized by you.
• Right to Notification of a Breach
  You have the right to be notified in writing if a breach of your unsecured PHI occurs.

• Treatment
  We may use and disclose your PHI to provide and coordinate your dental care. For example, we may share information with specialists, labs, pharmacies, or other healthcare providers involved in your treatment.
• Special Notices
  We may contact you regarding appointments, treatment options, test results, or health-related services offered by our practice. You may opt out of certain notices.
• Payment
  We may use your PHI to obtain payment for dental services, including insurance claims, eligibility verification, or prior authorizations.
• Healthcare Operations
  We may use or disclose your PHI for business operations, including quality assessment, staff training, auditing, and compliance activities.
• Health Information Exchange
  We may participate in secure electronic exchanges of PHI to improve coordination of care.
• Family and Others Involved in Your Care
  Unless you object, we may disclose PHI to family members or others involved in your care. If you are unable to agree or object, we may use our professional judgment.

We may also use or disclose your PHI without your authorization for:

• Public health and safety
• Health oversight activities
• Abuse or neglect reporting
• FDA-related activities
• Legal proceedings or law enforcement
• Coroners, funeral directors, organ donation
• Research (under strict requirements)
• Workers’ compensation
• Military or national security
• Compliance reviews by the Department of Health and Human Services

If you believe your privacy rights have been violated, you may file a complaint with us or directly with the U.S. Department of Health and Human Services. We will not retaliate against you for making a complaint.

Privacy Officer, J Family Dental

• 2438 W 60th St, Hialeah, FL 33016
• (305) 558-6832