HIPAA Notice of Privacy Practices Updated Statement
David W Regiani DDS PC d/b/a/ Regiani Holistic Dental Center
10435 Ortonville Rd, Suite B – Clarkston MI 48348
How We Collect Information About You: David W. Regiani, DDS, PC (DWR-PC) and its employees collect data through a variety of means including but not necessarily limited to letters, phone calls, emails, voice mails, faxes and from the submission of forms that are either necessary for your care or required by law.
What We Do Not Do With Your Information: Information about your dental/medical conditions and financial information that you provide us in writing, via email, on the phone (including information left on voice mails), contained in or attached to applications, or directly or indirectly given to us, is held in strictest confidence.
We do not give out, exchange, barter, rent, sell, lend or disseminate anything about clients that is considered “protected health information”(PHI).
How We Do Use Your Information: Information is only used as is reasonably necessary to provide you with dental services which may require communication between DWR-PC and other health care providers, specialists, dental laboratories, pharmacies, insurance companies, and others necessary to: verify your information is accurate; determine certain dental health care services you need; or to obtain supplies, devices, medications, insurance.
If you provide information with the intent or purpose of fraud or that results in either an actual crime of fraud for any reason including willful or un-willful acts of negligence whether intended or not, or in any way demonstrates or indicates attempted fraud, your non-medical information can be given to legal authorities including police, investigators, courts and/or attorneys or other legal professionals, as well as any other information as permitted by law.
Right to Limit Disclosure: When you pay for specific service or product out-of-pocket, you may request in writing at the time of service (and DWR-PC must honor), that the specific health care item or service not to be disclosed to a dental or health plan for purpose of payment.
Provision of Electronic Copies of Dental/Medical Records: You may request an electronic copy of your PHI if DWR-CP has such records in electronic format.
Limited Right to Use Non-Identifying Personal Information From Letters, Notes, and Other
Sources: Any pictures, stories, letters, or thank you notes sent to us become the exclusive property of DWR-PC. We reserve the right to use non-identifying information about our clients for promotional purposes that are directly related to our practice. Clients will not be compensated for use of this information.
You may specifically request that NO information be used whatsoever for promotional purposes, but you must identify any requested restrictions in writing. We respect your right to privacy and assure you no identifying information or photos that you send us will ever be publicly used without your direct consent.
Revision Date: 12/01/2014