Important notice
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice applies to pediatric dental, orthodontic, and related services provided by Little Teeth Pediatric Dentistry & Orthodontics. It applies to protected health information maintained by the practice in paper, electronic, oral, image, billing, and other formats.
Our duties
Little Teeth Pediatric Dentistry & Orthodontics is required by law to maintain the privacy of protected health information, provide notice of our legal duties and privacy practices, notify affected individuals following a breach of unsecured protected health information when required by law, and follow the terms of the notice currently in effect.
We may change this notice and make the new notice apply to health information we already maintain as well as information we receive in the future. The current notice will be available on this website and at the office.
How we may use and disclose health information
- Treatment: We may use or share health information with dentists, orthodontists, specialists, laboratories, pharmacies, or other providers involved in a patient's care.
- Payment: We may use or share information to bill and collect payment from a parent, guardian, dental or medical plan, or another responsible party.
- Health care operations: We may use or share information for practice administration, quality review, training, licensing, credentialing, audits, and business management.
- Appointment reminders and care communications: We may contact parents, guardians, or patients about appointments, treatment options, benefits, or services related to care.
- Family, friends, and care coordination: With agreement or when permitted by law, we may share relevant information with a parent, guardian, family member, personal representative, or other person involved in care or payment for care.
- Business associates: We may share information with vendors who help us operate the practice, if they agree to protect the information as required by law.
- As required or permitted by law: We may disclose information for public health, health oversight, abuse or neglect reporting, law enforcement, court orders, workers compensation, serious threats to health or safety, and other situations allowed by law.
Your choices about certain information
In some situations, a parent, guardian, patient, or personal representative may tell us preferences about how we share information, such as whether we share information with family members, caregivers, schools, referring providers, or others involved in care or payment for care. If a preference cannot be provided, we may share information when we believe it is in the patient's best interest and permitted by law.
Uses requiring written authorization
Uses and disclosures not described in this notice will be made only with written authorization when required by law. Authorization may be revoked in writing, except to the extent we have already relied on it. We will not sell protected health information, use it for marketing where HIPAA requires authorization, or use or disclose psychotherapy notes if maintained by us, unless authorized in writing or the law permits the use or disclosure.
Special protections and attestations
When federal or Connecticut law gives certain information additional protection, we will follow the stricter rule. This may include HIV-related information, genetic information, mental health records, alcohol or substance use disorder treatment records, and other specially protected information. If a requested disclosure requires a signed attestation under HIPAA, we will require that attestation before disclosing the information.
Substance use disorder records
Federal law provides heightened confidentiality protections for certain substance use disorder treatment records. If we receive or maintain records governed by 42 CFR Part 2, those records generally will not be used or disclosed without written consent or a qualifying court order, except in limited circumstances permitted by law.
Your rights
- Request to inspect or receive a paper or electronic copy of certain health information we maintain. We may charge a reasonable, cost-based fee where permitted by law.
- Request that we amend health information you believe is incorrect or incomplete.
- Request an accounting of certain disclosures.
- Request restrictions on certain uses or disclosures. We are not required to agree to every request, except where required by law.
- Request that we not share information with a health plan for payment or health care operations if the related service was paid out of pocket in full and the disclosure is not otherwise required by law.
- Request confidential communications, such as contact at a different phone number or address.
- Receive a paper copy of this notice upon request.
- Revoke a previously given authorization in writing. Revocation does not affect prior uses or disclosures made in reliance on the authorization.
- Choose someone to act for the patient if that person has legal authority to make health care decisions for the patient.
How to exercise your rights
To exercise a privacy right, contact the Privacy Officer listed below. Some requests must be made in writing so we can verify the request and respond properly. We may deny certain requests when permitted by law, and we will explain the reason when required.
Other permitted disclosures
In limited circumstances, we may disclose protected health information without authorization or without an opportunity to object when permitted or required by law. Examples may include disclosures required by law, military or national security requests, coroners or medical examiners, workers compensation, public health activities, correctional institutions, law enforcement, health oversight activities, judicial or administrative proceedings, and serious threats to public safety.
Safeguards and breach notification
We maintain physical, administrative, and technical safeguards to protect health information, including electronic protected health information. If a breach compromises unsecured protected health information, we will follow applicable federal HIPAA and Connecticut breach notification requirements.
Connecticut privacy protections
Little Teeth Pediatric Dentistry & Orthodontics is a Connecticut dental practice. Where Connecticut law provides greater privacy protection than federal law, we follow the stricter Connecticut standard. Connecticut law may provide additional protections for mental health records, HIV-related information, substance use records, health insurance information, biometric data, online account credentials, and other personal information.
Complaints
If you believe privacy rights have been violated, you may contact Little Teeth, file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, or contact the Connecticut Attorney General's Office. We will not retaliate against you for filing a complaint.
Website privacy
Website cookies, analytics, advertising tags, appointment links, referral links, and general website forms are addressed in our Website Privacy Policy. If information submitted through online tools becomes part of a patient record, this Notice of Privacy Practices may also apply.
Contact for privacy questions
Practice name: Little Teeth Pediatric Dentistry & Orthodontics
Privacy Officer: HIPAA Privacy Officer
Address: 2900 Main Street Suite 2E, Stratford, CT 06614
Phone: 203-551-9020
Email/website: info@littleteethct.com / https://www.littleteethct.com