Patient Privacy (HIPAA Compliance)

Notice of Privacy Practices


Patient Privacy

At Children & Teen Dental, your privacy is a priority. We follow strict federal and state guidelines to maintain the confidentiality of your medical (protected health) information.

Protected Health Information

Protected health information (PHI) is any information about your past, present or future healthcare, or payment for that care that could be used to identify you.

Members of our workforce and our business associates may only access the minimum amount of PHI that they need to complete their assigned tasks.

Uses and disclosures of PHI

When you visit Children & Teen Dental, we use and disclose your PHI to treat you, to obtain payment for services, and to conduct normal business known as healthcare operations. We may also share information with a contracted business associate who must meet our privacy requirements. Examples of how we use and disclose your information include:

  • Treatment – We document each visit. This documentation may include your test results, diagnoses, medications and your response to medications. This allows your provider, medical assistants and other clinical staff to provide the best care to meet your needs.
  • Payment – We document services and supplies you receive at each visit so that you, your insurance company or another third party can pay us. We may tell your health plan about upcoming treatment or services that require prior approval.
  • Healthcare operations – Medical information may be used in an effort to continually improve the quality and effectiveness of the healthcare and service that we provide.

We may also use information to:

  • Recommend treatment alternatives
  • Tell you about health benefits and services
  • Communicate with family or friends involved in your care, with your permission
  • Contact you about health education events

There are several circumstances when we are permitted or required to disclose medical information without your signed permission. These situations may include:

  • For public health activities, such as tracking diseases or medical devices
  • To protect victims of abuse or neglect
  • For federal and state health oversight activities such as fraud investigations
  • For judicial or administrative proceedings
  • If required by law or for law enforcement
  • To coroners, medical examiners and funeral directors
  • To avert serious threat to public health or safety
  • For specialized government functions, such as national security and intelligence
  • To workers’ compensation if you are injured at work
  • To a correctional institution if you are an inmate
  • For research following strict review to ensure protection of information

Other uses and disclosures not previously described may only be done with your signed authorization. You may revoke your authorization, in writing, at any time.

Our Responsibilities

Children & Teen Dental is required by law to maintain the privacy of your medical information, provide this notice of our duties and privacy practices, and abide by the terms of the notice currently in effect.

We reserve the right to change privacy practices and make the new practices effective for all information we maintain. Revised notices will be posted in our facility and our website, and will be available from your healthcare provider.

Your Rights

You have the right to:

  • Request that we restrict how we use or disclose your medical information (we are not required to abide by your request)
  • Request that we use a specific telephone number or address to communicate with you
  • Inspect and copy your medical information (fees will apply)*
  • Request amendment to your medical information (reason required)*
  • Choose not to bill your health insurance for any test or office visit
  • Receive an accounting of how your medical information was disclosed (excludes disclosure for treatment, payment, healthcare operations and some required disclosures; fees may apply)*
  • Obtain a paper copy of this notice even if you receive it electronically
  • Register a complaint – see below

*Request must be in writing

To Contact Us

If you have questions about this notice or if you would like to exercise your rights or if you feel your privacy right has been violated, contact our office manager at 770-415-8439. All complaints will be investigated and you will not suffer retaliation for filing a complaint. You may also file a complaint with the Secretary of Health and Human Services in Washington, DC.

Revised September 2013

Schedule Your Appointment Now

Children & Teen Dental, provides specialized, comprehensive oral health care for infants, children, and adolescents in a fun, stress-free environment that focuses on prevention and education. Our goal is to help your child be healthy and enter adulthood free of dental diseases and dental fears – with good oral health habits that will last a lifetime.

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About Us

Children & Teen Dental is a group of dedicated professionals who believe in building lasting relationships in our communities and with our patients. Our priority is to make a positive impact in your child’s life by enhancing self-confidence, self-esteem and overall dental health.

A Division of Children and Teen Dental Group

Children & Teen Dental maintains this website as a service to our patients as well as our community. While Children & Teen Dental and our affiliates strive to keep the information contained in this site current, no warranty or guarantee concerning accuracy of content is made. Some of the information contained in this site relates to medical topics and issues; however, no information in the site should be construed as medical advice. All questions regarding your health or possible health problems should be directed to your provider. In addition, this site includes links to other websites; however, Children & Teen Dental does not endorse the linked sites, and takes no responsibility for the content or information contained in the linked sites. All rights reserved. No part of this website may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of Children & Teen Dental.

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We are providing this Contact Us form as a convenience but your message to us should not imply the creation of a doctor-patient relationship (which only happens when you come to our office for a visit). We therefore ask that you not include personal health information in your message. Please call us if you’d like to send us personal information so that we can make sure it’s handled securely.