Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed, and how you can access that information. Please review it carefully.

1. Our Responsibilities

Elite Orthodontics & Pediatric Dentistry respects the privacy of our patients and families. We are required by law to protect the privacy and security of your protected health information (PHI), provide this Notice of our legal duties and privacy practices, follow the Notice currently in effect, and notify affected individuals following a breach of unsecured PHI as required by law.

This Notice applies to medical and dental information maintained by our practice, including patient histories, examinations, X-rays, digital scans, photographs, orthodontic and pediatric dental treatment plans, appointment records, insurance claims, and payment records. Additional federal or New Jersey protections may apply to particular categories of health information.

2. Routine Uses and Disclosures

Treatment

We may use and disclose PHI to provide or coordinate dental and orthodontic treatment. For example, we may share relevant clinical information with a referring dentist, oral surgeon, dental laboratory, or other provider involved in your care.

Payment

We may use and disclose PHI to bill for services, verify coverage, seek prior authorization, process claims, and collect payment. Disclosures may be made to dental insurers, Medicaid, NJ FamilyCare, CHIP, or other payers, as applicable.

Healthcare operations

We may use and disclose PHI to operate our practice, improve quality and patient safety, train authorized staff, conduct audits, evaluate our services, and meet licensing or administrative requirements.

Business associates

Certain vendors (including practice management, billing, IT, hosting, or records-support providers) may handle PHI on our behalf. Where HIPAA requires it, we obtain appropriate business associate agreements and require safeguards for the information.

Appointment reminders and treatment communications

We may contact you about appointments, follow-up care, treatment instructions, and services related to your care by phone, voicemail, mail, email, or text where permitted. You may request a reasonable alternative method of communication.

3. Your Choices in Certain Disclosures

You may tell us whether to share relevant information with family members, friends, or other people involved in your care or payment for your care, subject to applicable law. Where you are unable to express a preference, we may make limited disclosures based on professional judgment and your best interests. Information may also be shared for disaster relief as permitted by law.

We generally require written authorization for uses or disclosures of PHI for marketing, the sale of PHI, and most uses or disclosures of psychotherapy notes, subject to legal exceptions. We will obtain appropriate written permission before using identifiable patient photographs, treatment images, testimonials, or videos for promotional purposes where required by law. You may revoke an authorization in writing, except to the extent we have already relied on it.

If we use PHI for permitted fundraising, you may opt out of future fundraising communications. We will not retaliate against you for exercising privacy rights.

4. Other Uses and Disclosures Allowed or Required by Law

Subject to legal conditions and any stricter protections that apply, we may use or disclose PHI for the following purposes:

• Public health activities, including disease control, product recalls, adverse-event reporting, and permitted reports of suspected abuse or neglect.
• Health oversight, licensing, inspections, audits, investigations, and legally required reporting.
• Compliance with federal or state law, including disclosures to the U.S. Department of Health and Human Services for HIPAA enforcement.
• Court orders, subpoenas, other lawful proceedings, and certain law enforcement requests, subject to required legal safeguards.
• Authorized research conducted under legally applicable approvals or safeguards.
• Prevention or reduction of a serious threat to health or safety when legally permitted.
• Workers’ compensation claims, certain government functions, and disclosure to coroners, medical examiners, or funeral directors as authorized by law.
• Organ and tissue donation requests when applicable and legally permitted.

5. Special Protections for Sensitive Records

Additional confidentiality rules may apply to information concerning HIV, genetic testing, mental health services, substance use disorder treatment, or other sensitive conditions under applicable federal and New Jersey laws. We follow any legally applicable stricter limits.

Substance use disorder records under 42 CFR Part 2

If we receive or maintain records protected by 42 CFR Part 2, we handle them subject to the additional consent and confidentiality protections that apply to those records. If you provide a valid consent permitting uses and disclosures for treatment, payment, and healthcare operations, qualifying Part 2 information may be used and disclosed and subsequently redisclosed as permitted by law.

Part 2 records may not be used or disclosed in civil, criminal, administrative, or legislative proceedings or investigations against you without your written consent or an appropriate court order together with a subpoena or other legal mandate meeting Part 2 requirements. If Part 2 information would be used for fundraising, you will receive required notice and an opportunity to opt out.

6. Children’s Records and Personal Representatives

We care for children and teenagers as well as adults. Parents and legal guardians generally may exercise a minor patient’s health privacy rights when authorized by law. Some minor-consented services and other circumstances are subject to additional confidentiality limits. We will follow HIPAA and applicable New Jersey law when evaluating a parent’s, guardian’s, or representative’s request for access. We may verify legal authority before releasing records.

7. Your Rights

Access your records

You may request to inspect or receive a paper or electronic copy of your health information in our designated record set, subject to limited legal exceptions. We generally respond within 30 days and may charge a reasonable, cost-based fee where allowed.

Request an amendment

You may ask us to correct inaccurate or incomplete records. We may deny a request when legally permitted and will explain the reason in writing, typically within 60 days.

Request confidential communications

You may ask us to contact you in a specific way or at a different address. We will accommodate reasonable requests.

Request restrictions

You may ask us to limit certain uses and disclosures. We are generally not required to agree. However, when you or someone other than your health plan pays in full out of pocket for an item or service, we will honor your request not to disclose information about that item or service to your health plan for payment or healthcare operations, unless disclosure is otherwise required by law.

Receive an accounting of disclosures

You may request an accounting of certain disclosures made during the preceding six years. Treatment, payment, healthcare operations, and other permitted exceptions generally are not included. One accounting in a 12-month period is ordinarily free; additional accountings may involve a reasonable cost-based fee.

Receive a copy of this Notice

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

Designate a personal representative

An authorized personal representative may exercise your rights on your behalf, subject to verification and applicable law.

File a complaint

You may complain to our Privacy Official or the U.S. Department of Health and Human Services Office for Civil Rights if you believe your privacy rights have been violated. We will not retaliate.

8. Digital Communication and Website Information

Our website provides service information and appointment inquiries. Do not send sensitive medical details, insurance identifiers, or confidential treatment records through a general website form or standard email unless we have provided an approved secure method. Website cookies, analytics, and nonclinical information are addressed separately in our Website Privacy Policy. PHI remains subject to HIPAA and this Notice whenever those rules apply.

9. Changes to This Notice

We may revise this Notice as permitted by law. Updated terms may apply to PHI already maintained by our practice. We will post the revised Notice at the office and on our website, and provide a copy upon request.

10. Privacy Contact and Complaints

Privacy Official
Elite Orthodontics & Pediatric Dentistry
61 Berdan Avenue, Wayne, NJ 07470
Telephone: (973) 706-8339 | General email: info@eliteod.com

For confidential health-record requests, call the office to obtain secure submission instructions.

You may also file a complaint with U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, DC 20201; telephone 1-877-696-6775; or online through the HHS complaint page.