HIPPA Information

The Health Insurance Portability and Accountability Act (HIPAA) provide safeguards to protect your privacy as a patient. Implementation of HIPAA requirements officially began on April 14, 2003. While we have found these policies for years there have been a few updates that we  wanted you to be aware of. This is a shortened version of the HIPAA policy. The full policy is available for your review in the reception area.  There are rules and right restrictions on who may see or be notified of your protected health information (PHI). These restrictions do not  include the normal exchange of information within our office. HIPAA provide certain rights and protections to you as a patient. We follow  these guidelines and provide you with the quality care you deserve. Additional information is available from the US Department of Health and  Human Services. You can find them online at www.HHS.gov. 

This summarizes our policy here at Kevin W Fryer DDS Inc.

Patient information will be kept confidential except when it is necessary to provide services or to ensure that all administrative matters related to your care handled properly. This may include, but not limited to, the sharing of information with other healthcare providers, laboratories,  and health insurance companies. Patient information (treatment plans, insurance forms, EOB's etc.) may be stored in file cabinets not  accessible by patients. Preparing for and during your dental visit such records maybe left, at least temporarily, in administrative areas such  as the front office, doctor's desk, examination room, etc. Those records will not be available to persons other than office staff. You agree to  the normal procedures utilized within the office for the handling of charts, patient records, (PHI) and other documents or information.  We send out reminders to our patients we do this by one or more of the following: email, calling and sending postcards. We try to make every effort to remind you of your appointment and any treatment that you need. We may send you other communications informing you of  changes to office policy and new technology that you might find valuable or informative we may also send out newsletter or special  promotions that we are offering. 

Please initial each of the following.

By providing your contact information (phone numbers, home address, email etc) on any of our office forms, you agree to let us use that information to contact you.

You agree to us sending electronic e-referrals to specialists, which include your PHI information and x-rays if needed. We also sent electronically to your dental insurance which include submitting protected health information to receive payment for services provided.

You give us permission to remind you to take pre-medication prior to appointments if applicable.

You give us permission to call in any prescriptions you may need and share your protected health information with the pharmacist.

The practice utilizes a number of vendors in the conduct of business. These vendors may have access to protected health information but must agree to abide by the confidentiality rules of HIPAA.

You understand and agree to inspections at the office and review of documents which may include protected health  information by government agencies or insurance payers a normal performance of their duties.

You agreed to bring any concerns or complaints regarding privacy to the attention of the office manager or the doctor  and I understand you have the right to file a complaint we can help you with this and you will not be penalized for filing a complaint.

Your confidential information will not be used for the purposes of marketing or advertising of products goods or  services without your permission.

We agree to provide patient with access to the records in accordance with state and federal laws we may update this  policy is needed to better serve the needs of our patients and practice.

By signing below I agree that I have been offered the HIPAA policy and understanding of knowledge my agreement to the terms set forth in  the HIPAA information and consent forms and any future updates to this policy.


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