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Notice of Privacy Practices
This Notice of Privacy Practices describes the ways in which medical information about you may be used and disclosed, and how you can obtain access to it. Please review it carefully.
Understanding Your Health Information Each time you visit a dentist or other health care provider, a record of your visit is made in order to manage the care you receive. Vita Dental understands that the medical information that is recorded about you and your health is personal. The confidentiality of your health information is also protected under both state and federal law.
This Notice of Privacy Practices describes the ways that Vita Dental may use and disclose your information and the rights that you have regardingyour health information. The Notice applies to all Vita Dental.It also applies to dentists and dental auxiliaries at Vita Dental.
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 (12/18/2011). 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, provide such changes are permitted by applicable law.
We reserve the right to make changes in our privacy practices and in the new terms of our Notice effective for all 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. For more information about our privacy practices, or for additional copies of the Notice, please contact Ma Dental.
Uses and Disclosures of Health Information
We may use or disclose health information about you for treatment. payment. and healthcare operations. For example:
Treatment: We may use or disclose your health information to a physician or other healthcare providers pending treatment to you.
Payment: We may use or disclose your health information to obtain payment for services we provided to you.
Healthcare Operations: We may use or disclose your health information in connection with our healthcare operations. Healthcare operations includes quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, and certification licensing or credentialing activities.
Our Authorization: In addition to our use of your health information for treatment. payment or healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us authorization, you may revoke it in writing at any time. Your revocation will not affect any use of disclosures permitted by your authorization while it was in effect. Unless you give us written authorization, we cannot use or disclose your health information for any reason except those described in this note.
To Your Family and Friends: We must disclose your health information to you, as described in the Patient Rights section of the 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 you healthcare, but only if you agree that we may do so.
Persons Involved in Care: We may use or disclose health information to notify, or assist in the notification of (including identifying or locating) a family member, your 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 judgment disclosing only health information that is directly relevant to the person's involvement in you healthcare. We will also use our professional judgment and our experience with common practice to make responsible inferences of your best interest in allowing a person to pick up filled prescriptions. medical supplies, x-rays, or forms of health information.
Marketing Health-Related Services: We will not use your health information for marketing communications without your written authorization.
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 safety of others.
National Security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose the authorized federal officials health information required for lawful intelligence, counter intelligence. and other national security activities. We may disclose to correctional institution or law enforcement officials having 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).
- 1799 N. Fry Rd
- Katy, TX 77449
- (713) 714-4143
NO SHOW AND CANCELLATION POLICY
Cancellation of an Appointment
In order to be respectful of the medical needs of our Community, please be courteous and call promptly if you are unable to attend an appointment. This time will be relocated to someone who is in urgent need of treatment. This is how we can best serve the needs of our Community. If it is necessary to cancel your scheduled appointment, we require that you call 24 hours in advance. Appointments are in high demand, and your early cancellation will give another person the possibility to have access to timely dental care.
How to Cancel Your Appointment
To cancel appointments, please call (713) 714-4143. If you do not reach the receptionist, you may leave a detailed message on the voicemail which is revised daily.
will be considered as a "no show"
No Show Policy
A "no show" is someone who misses an appointment without cancelling it 24 hours prior to their scheduled appointment. No-shows inconvenience those individuals who need access to dental care in a timely manner. A failure to present at the time of a scheduled appointment will be recorded in your chart as a "no show". The first time there is a "no show", you will be sent a letter or receive a phone call alerting you to the fact that you have failed to show up for an appointment and did not cancel the appointment. A copy of the letter will be placed in your file. If there is a second "no show", a fee of $75 will be billed to your account. This fee covers administrative tasks associated with your appointment. This fee will need to be paid in full before or on your next scheduled appointment. Please sign that you have read, understand, and agree to this Cancellation and No show policy.