Saratoga Oral Surgery (Sodeifi DMD MD Inc.)
18805 Cox Avenue, Suite 130, Saratoga, CA 95070
Telephone: 408-222-3354
Effective Date: January 20, 2024
OUR PLEDGE TO PROTECT YOUR PRIVACY
Saratoga Oral Surgery is committed to protecting the privacy of your health information, which is referred to as Protected Health Information (PHI). We are required by law to maintain the privacy of your PHI, provide you with this notice of our legal duties and privacy practices with respect to your PHI, and notify you following a breach of unsecured PHI.
WHO WILL FOLLOW THIS NOTICE
This notice applies to all healthcare professionals, employees, volunteers, trainees, and other personnel under Saratoga Oral Surgery’s control.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
For Treatment: To provide, coordinate, or manage your healthcare and related services.
For Payment: To bill and receive payment for the treatment and services you receive.
For Healthcare Operations: To support the business activities of our practice.
Appointment Reminders and Health-Related Benefits or Services: To remind you of appointments and inform you of health-related benefits or services.
As Required By Law: When required to do so by federal, state, or local law.
SPECIAL CIRCUMSTANCES FOR USE AND DISCLOSURE
Respond to Lawsuits and Legal Actions: We may disclose PHI in response to a court or administrative order, subpoena, warrant, summons, or other lawful process.
Law Enforcement and Public Safety: For law enforcement purposes and to avert a serious threat to health or safety.
Health Oversight Activities: For audits, investigations, inspections, or licensing.
Workers’ Compensation: For workers’ compensation or similar programs.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU
Right to Inspect and Copy: You have the right to inspect and obtain a copy of your PHI.
Right to Amend: You can request to amend your health information.
Right to an Accounting of Disclosures: You can request a list of certain disclosures we have made of your PHI.
Right to Request Restrictions: You can request a restriction on the PHI we use or disclose
for treatment, payment, or healthcare operations.
Right to Request Confidential Communications: You can request that we communicate with you in a certain way or at a certain location.
Right to a Paper Copy of This Notice: You can ask for a paper copy of this notice at any time.
OUR RESPONSIBILITIES
- We are required to maintain the privacy and security of your PHI.
- We will notify you promptly if a breach occurs.
- We must follow the duties and privacy practices described in this notice.
- We will not use or share your information other than as described here unless you give us written permission.
CHANGES TO THIS NOTICE
We reserve the right to change this notice and the revised or changed notice will be effective for information we already have about you as well as any information we receive in the future.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services Office for Civil Rights.
CONTACT INFORMATION
For more information about our privacy practices or to exercise your rights, please contact us using the information at the top of this notice.