Our Commitment to Your Privacy

At Sun Dental Miami, we are committed to protecting the privacy of your Protected Health Information (PHI) in accordance with federal and state law. This notice applies to all records of your care created or received by our practice, including our employees, staff, volunteers, and providers.

Your PHI includes information that identifies you and relates to your past, present, or future physical or mental health, the care you receive, or payment for that care. This notice explains how we may use and disclose your information and outlines your rights.

How We May Use and Disclose Your PHI

Treatment

We may use and disclose your information to provide and coordinate your dental care. For example, we may share details with specialists, laboratories, or pharmacies involved in your treatment.

Payment

We may use and disclose your information to bill and collect payment for services provided, including submitting necessary details to your insurance company for reimbursement.

Health Care Operations

We may use and disclose your information for activities necessary to operate our practice and ensure quality care, including:

• Quality assessment and improvement
• Provider performance reviews and credentialing
• Training and education of staff
• Licensing, accreditation, and compliance activities

Other Uses & Disclosures Permitted by Law

• Appointment Reminders: Contacting you by call, text, or email about upcoming visits.
• Individuals Involved in Your Care: Sharing information with family or caregivers when appropriate or in emergencies.
• Emergencies: Disclosing information as needed for immediate treatment.
• Public Health & Safety: Reporting certain diseases, exposures, or suspected abuse/neglect as required by law.
• Health Oversight: Disclosures for audits, inspections, or investigations by government agencies.
• Legal Proceedings & Law Enforcement: Responding to court orders, subpoenas, or lawful requests.
• Research: Under approved protocols with privacy safeguards.
• Workers’ Compensation: For claims related to work-related injuries or illnesses.
• Coroners, Medical Examiners, Funeral Directors & Organ Donation: As permitted by law for identification, cause of death, or authorized donations.

Other uses and disclosures not described in this Notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

Your Rights Regarding Your PHI

Right to Inspect and Copy

You may review or obtain a copy of your health and billing records. Reasonable fees may apply for copying, mailing, or supplies, as permitted by law.

Right to Amend

If you believe your information is inaccurate or incomplete, you may request an amendment. If we deny your request, you may submit a written statement of disagreement to be included in your record.

Right to an Accounting of Disclosures

You may request a list of certain disclosures of your PHI made by our office, excluding those for treatment, payment, and health care operations, among other exclusions allowed by law.

Right to Request Restrictions

You may ask us to limit the use or disclosure of your PHI for treatment, payment, or operations. While we are not required to agree, we will consider all reasonable requests. If you pay in full out-of-pocket for a service, you may request that we not disclose that service to your health plan, and we will honor that request unless disclosure is required by law.

Right to Request Confidential Communications

You may request that we contact you in a specific way (for example, only at work, by mail, or at an alternate address). We will accommodate reasonable requests.

Right to a Paper or Electronic Copy

You may request a paper copy of this notice at any time, even if you agreed to receive it electronically. You may also request electronic copies of your records where available.

Changes to This Notice

We reserve the right to revise this Notice at any time. Any updates will apply to existing and future medical information. A current version will always be available in our office and on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.

Questions?

For questions about this Notice or how your information may be used, please contact our Office Manager at the number below.

Contact: (305) 555-1234  | 
www.sundentalmiami.com