Utah Oral and Facial Surgery – Notice of Privacy Practices

 

Utah Oral & Facial Surgeons

Notice of Privacy Practices


This notice describes how health information about you may be used and disclosed and how you can get access to this information.


Our Legal Duty

We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties and your rights concerning your health information.  We must follow the privacy practices that are described in this Notice while it is in effect.  This Notice takes effect 1/1/2015 and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this Notice at any time, proved such changes are permitted by applicable law.  We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all the health information that we maintain, including health information we created or received before we made the changes.  Before we make a significant change in our privacy practices, we will change this Notice and make the new notice available upon request.  You may request a copy of our Notice at any time.


Uses and Disclosures of Health Information

We use and disclose health information about you for treatment, payments and healthcare operations. For example:

Treatment:  We may use or disclose your health information to a physician or other healthcare provider providing treatment to you.

Payment:  We may use and disclose your health information to obtain payment for services we provide to you.

Healthcare Operations:  We may use and disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.

Your Authorization:  In addition to our use of your health information for treatment, payment or healthcare operation, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in the notice.

To Your Family and Friends: We must disclose your health information to you, as described in the Patient Rights sections of this Notice. We may disclose your health information to a family member, friend or other person to the extent necessary to help with your healthcare or with payment for your healthcare, but only if you agree that we may do so.

Persons Involved in Care: We may use or disclose your health information to notify, or assist in the notification of (including identifying or locating) a family member, our personal representative or another person responsible for your care, of your location, your general condition, or death. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination using our professional judgement disclosing only health information that is directly relevant to the person’s involvement in your healthcare. We will also use our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays, or other similar forms of health information.

Marketing Health-Related Services: We will not use your health information for marketing communications.

Required by Law:  We may use or disclose your health information when we are required to do so by law.

Abuse or Neglect: We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.

National Security:  We may disclose to military authorities the health information of

Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institution or law enforcement official having lawful custody of protected health information of inmate or patient under certain circumstances.

Appointment Reminders:  We may use or disclose your health information to provide you with appointment reminders (such as voicemail messages, postcards, or letters).


Patient Rights

Access:  You have the right to look at or get copies of your health information, with limited exceptions. You must make a request in writing to obtain access to your health information. You may obtain a form to request access by contacting our office. We will charge you are reasonable cost-based fee for expenses such as copies and staff time. We will charge $0.80 for each page, $20.00 for staff time to locate and copy your healthcare information, and postage if you want the copies mailed to you.

Disclosure Accounting:  You have the right to receive a list of instances in which we or our business associates disclosed your health information for purposes, other than treatment, payment,. Healthcare operations and certain other activities, for the last 6 years, but not before April 13, 2003. If you request this accounting more than once in a 12 month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.

Restriction:  You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency).

Alternative Communication: You have the right to request that we communicate with you about your health information by alternative means or to alternative locations. (You must make your request in writing.) Your request must specify the alternative means or locations, and provider satisfactory explanation how payments will be handled under the alternative means or location you request.

Amendment: You have the right to request that we amend your health information. (Your request must be in writing, and it must explain why the information should be amended.) We may deny your request under certain circumstances.

Advanced Directives: The medical staff and administration at Utah Oral and Facial Surgeons does not honor advanced directives. All lifesaving efforts will be made in order to transfer patient to proper emergency care.

Electronic Notice:  If you receive this Notice on our Web site or by electronic mail (e-mail) you are entitled to receive this Notice in written form.


Questions and Complaints

If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your health information or in response to a request you made to amend or restrict the use or disclosure or your health information or to have us communicate with you by alternative means or at alternative locations,  you may complain to us using the contact information listed at the end of this notice. You also may submit a written complaint to the U.S. Department of Health and Human Services.

We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.

Contact Office:  Mary Stosich

Telephone: 801-566-5117

Fax: 801-566-5119

Address:  6268 South 900 East, Suite 100, Salt Lake City, UT  84121



Please call 801-783-3645 today to set up a consultation!
Our friendly office staff will help you find the perfect time to meet with our experienced Utah Oral & Facial Surgeons.



Murray Location


6268 S 900 E
Murray, UT 84121

801-783-3645

Draper Location


114 E 12450 S #104
Draper, UT 84020

801-576-5910