HIPAA Notice of Privacy Practices

Effective date: July 18, 2026

This notice describes how medical and dental information about you may be used and disclosed and how you can obtain access to this information. Please review it carefully.

Your rights

You have the following rights concerning your health information. Contact us using the information at the end of this notice to exercise these rights.

Obtain an electronic or paper copy of your record

• You may ask to inspect or obtain an electronic or paper copy of your dental record and other health information we maintain about you.
• We generally will provide a copy or summary within 30 days of your request. We may charge a reasonable, cost-based fee as permitted by law.

Ask us to correct your record

• You may ask us to correct health information that you believe is incorrect or incomplete.
• We may deny the request in certain circumstances, but we will explain the reason in writing, generally within 60 days.

Request confidential communications

• You may ask us to contact you in a specific way, such as only at a particular phone number, or to send mail to a different address.
• We will accommodate reasonable requests.

Ask us to limit what we use or disclose

• You may ask us not to use or disclose certain information for treatment, payment, or our operations. We are not required to agree to every request, and we may decline if the requested restriction could affect your care.
• If you pay for a service or item in full out of pocket, you may ask us not to disclose information about that service or item to your health plan for payment or health care operations. We will agree unless the law requires disclosure.

Receive a list of certain disclosures

• You may ask for an accounting of certain disclosures of your health information made during the six years before your request, including who received it and why.
• We will provide one accounting each year at no charge. We may charge a reasonable, cost-based fee for additional requests within the same 12-month period.

Receive a copy of this notice

You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information. We will verify the person’s authority before taking action.

File a complaint

• You may complain to us if you believe we violated your privacy rights. Use the Privacy Officer contact information at the end of this notice.
• You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by mailing a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting the HHS HIPAA complaint process website.
• We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you may tell us your preferences about what we disclose. If you have a clear preference in the situations below, tell us what you want us to do.

• Share information with family members, close friends, or others involved in your care or payment for your care.
• Share information in a disaster-relief situation.
• Contact you about fundraising efforts. You may tell us not to contact you again.

If you are unable to tell us your preference, such as if you are unconscious, we may disclose information if we believe it is in your best interest. We may also disclose information when necessary to lessen a serious and imminent threat to health or safety.

We will not use or disclose your information for marketing purposes or sell your information without your written authorization when authorization is required by law. We will not share psychotherapy notes without written authorization except as permitted by law. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

How we typically use and disclose your information

Treatment

We may use your health information and disclose it to dentists, physicians, specialists, laboratories, pharmacies, and other professionals involved in your care. For example, we may send dental records or X-rays to a specialist who is treating you.

Payment

We may use and disclose your health information to bill and obtain payment from health plans or other responsible parties. For example, we may provide information to a dental benefit plan so it can determine coverage and pay a claim.

Health care operations

We may use and disclose your health information to operate our practice, improve care, train staff, conduct quality assessment, manage risk, and contact you when necessary. For example, we may review treatment outcomes to improve the quality of care.

Appointment reminders, treatment alternatives, and services

We may contact you with appointment reminders and information about treatment alternatives or health-related benefits and services that may be of interest to you, as permitted by law.

Other uses and disclosures permitted or required by law

We may use or disclose your health information without written authorization in other circumstances permitted or required by law. These may include:

• Helping with public-health and safety activities, including preventing disease, reporting suspected abuse or neglect, reporting adverse reactions to products, and preventing or reducing a serious threat to health or safety.
• Complying with federal, state, or local law, including disclosures to the U.S. Department of Health and Human Services for HIPAA compliance review.
• Conducting research when the research satisfies applicable legal requirements.
• Responding to organ and tissue donation organizations.
• Working with a coroner, medical examiner, or funeral director when an individual dies.
• Addressing workers’ compensation, law-enforcement, health-oversight, military, national-security, and other authorized government requests.
• Responding to lawsuits and legal proceedings, such as in response to a court or administrative order or a lawful subpoena.

Some types of information may receive additional protection under federal or Missouri law. When another law provides greater privacy protection, we will follow the more protective law.

Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in the notice currently in effect and provide you with a copy upon request.
• We will not use or disclose your information other than as described here unless you authorize us in writing. You may change your mind at any time by notifying us in writing.

Changes to this notice

We may change the terms of this notice, and the changes will apply to all health information we maintain. A revised notice will be available upon request, in our office, and on this website. The effective date will appear at the top of the revised notice.

Privacy questions, requests, or complaints

Privacy Officer
Odessa Family Dental
404 N 4th Street
Odessa, MO 64076
Phone: (816) 633-5393
Email: info@odessabestdentist.com