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1835 Cynthia Ln
Merrick, NY 11566
Practice Logo
[GTranslate]
1835 Cynthia Ln
Merrick, NY 11566

HIPAA Policy

HIPAA Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities. 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.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record
  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
  • You can ask us not to use or share certain health information for treatment, payment, or our operations.
  • We are not required to agree to your request, and we may say “no” if it would affect your care.
  • If you pay for a service or health care item out- of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.
  • We will say “yes” unless a law requires us to share that information.
Get a copy of this privacy notice
  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
  • You can complain if you feel we have violated your rights by contacting us using the information on the back page.
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696- 6775, or visiting the Privacy Complaints Article.
  • We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:
  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • Include your information in a hospital directory

If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:
  • Marketing purposes
  • Sale of your information
  • Most sharing of psychotherapy notes
In the case of fundraising:
  • We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures

How do we typically use or share your health information? We typically use or share your health information in the following ways.

Treat you
  • We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization
  • We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan, so it will pay for your services.

Bill for your services
  • We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.


How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information: Visit HIPAA Article.

Help with public health and safety issues

Example: We use health information about you to manage your treatment and services.

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety
Do research
  • We can use or share your information for health research.
Comply with the law
  • We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
  • We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
  • We can share health information about you with organ procurement organizations.
Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
  • We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know 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 this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information: Visit Privacy Policy Article.
Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

This Notice of Privacy Practices applies to all the organizations on this site. Please see the appropriate page for contact information.

Elite Family Dental Care

1835 Cynthia Ln
Merrick, NY 11566
Read more about our dental services

Cosmetic Dentistry
Our experienced dentists help patients enhance their smiles by offering the latest in cosmetic treatments including Zoom! teeth whitening, Invisalign, and natural-looking dental implants.

Restorative Dentistry
Restorative treatments preserve your natural teeth wherever possible. Whether it be tooth-colored fillings, same-day crowns (made in our onsite dental lab), or natural-looking dental implants – our team will restore your smile to health and beauty by leveraging the recent advancements in dental technologies.

Dental Implants
As the premium option for replacing missing teeth, dental implants not only improve the appearance of your smile, they also improve your oral and overall health. Matching your natural teeth in color, size and shape, dental implants help restore your bite force, preserve your jawbone, and improve your confidence.

Invisalign
Invisalign offers discretion, comfort, and freedom to enjoy your favorite foods – all while getting a perfectly aligned smile. Our dentists have years of specialized experience in using these clear aligners to create beautiful, brilliant smiles.

Zoom! Teeth Whitening
Painless, professional-grade teeth whitening gives patients a megawatt smile – in just a single visit. Safer and more effective than store-bought whitening kits, Zoom! teeth whitening can bring out the best in your smile in just about an hour.

Periodontal Disease
Gum disease has the potential to lead to serious health problems. Early detection, diagnosis, and treatment for periodontal disease are essential to maintaining good oral health – and overall health.

CEREC Crowns
CEREC crowns – also known as same-day crowns – are available at Elite Family Dental Care. Using computer assisted design (CAD) and manufacturing (CAM), your permanent crown can be made while you wait, eliminating the need for multiple visits to restore a damaged tooth.

Oral Cancer Screenings
Oral cancer screenings are included in our preventative dental care. At your bi-annual checkup, you will be screened for any warning signs. Our digital imaging technologies also allow for the identification of symptoms beneath the surface of the mouth, cheeks, and gums.

Emergency Dentistry
Emergency dental services are available for patients who experience a loose crown, knocked-out tooth, or trauma to the teeth and jaws.

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