Notice of Privacy Practices
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.
Our Commitment to Your Privacy
Professional Smile Aesthetics is required by law to maintain the privacy of your protected health information (“PHI”), to provide you with this notice of our legal duties and privacy practices, and to notify you following a breach of unsecured PHI.
How We May Use and Disclose Your Health Information
Treatment. We may use and disclose your health information to provide, coordinate, or manage your dental care, for example, sharing information with a dental lab fabricating a crown or veneer.
Payment. We may use and disclose your health information to obtain payment for services, including billing insurance or verifying coverage.
Healthcare Operations. We may use your health information for activities like quality assessment, staff training, and practice management.
Appointment Reminders. We may contact you to remind you of upcoming appointments, by phone, text, or email.
Required by Law. We may disclose your health information when required to do so by federal, state, or local law.
Your Rights Regarding Your Health Information
You have the right to:
- Request a copy of your dental records
- Request corrections to your health information
- Request restrictions on certain uses or disclosures
- Request confidential communications at an alternate location or by an alternate method
- Receive an accounting of certain disclosures we have made
- Obtain a paper copy of this notice at any time
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.
To file a complaint with our office, contact:
3100 Professional Plaza Dr, Germantown, TN 38138
Phone: (901) 295-2995