Notice of Privacy Practices
Effective Date: September 16, 2025
This Notice describes how medical and dental information about you may be used and disclosed, and how you can access this information. Please review it carefully.
Our Legal Duty
Lifetime Dental (“we,” “our,” or “us”) is required by law to maintain the privacy and security of your protected health information (“PHI”), provide you with this Notice describing our legal duties and privacy practices, and notify you following a breach of unsecured PHI.
We are required to follow the terms of this Notice that are currently in effect.
How We May Use and Disclose Health Information
We may use and disclose your PHI without your written authorization for the following purposes:
1. Treatment
We may use and share your PHI to provide, coordinate, or manage your dental and medical care. This may include sharing information with specialists, laboratories, or pharmacies involved in your treatment.
2. Payment
We may use and disclose your PHI to obtain payment for services provided, such as submitting claims to insurance companies or verifying coverage.
3. Health Care Operations
We may use and disclose PHI for administrative, quality assurance, training, auditing, accreditation, or business management activities.
4. Appointment Reminders and Communications
We may contact you by phone, voicemail, text message, mail, or email regarding appointments, billing, treatment follow-up, or related care.
5. Individuals Involved in Your Care
We may disclose PHI to family members, caregivers, or others involved in your care or payment for your care, unless you object or restrict such disclosures.
6. Public Health and Safety
We may disclose PHI to public health authorities or other agencies for purposes such as reporting disease, injury, abuse, neglect, or adverse events.
7. Health Oversight Activities
We may disclose PHI to government agencies for audits, inspections, investigations, or licensure activities as required by law.
8. Law Enforcement and Legal Requirements
We may disclose PHI when required by law, court order, subpoena, or administrative request, or for law enforcement purposes as permitted by law.
9. Coroners, Medical Examiners, and Funeral Directors
We may disclose PHI as necessary to allow these professionals to carry out their duties.
10. Research
We may use or disclose limited PHI for approved research purposes, subject to applicable privacy protections.
11. Workers’ Compensation
We may disclose PHI as authorized to comply with workers’ compensation or similar programs.
12. Required by Law
We will disclose PHI when required to do so by federal, state, or local law.
13. Other Uses and Disclosures With Your Authorization
Any other use or disclosure of your PHI not described in this Notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except where we have already relied on it.
Your Rights Regarding Your Health Information
You have the following rights with respect to your PHI:
1. Right to Access
You may request to inspect or obtain a copy of your health and billing records, with limited exceptions. Reasonable fees may apply.
2. Right to Request Amendment
You may request an amendment if you believe your information is incorrect or incomplete. We may deny requests in certain circumstances.
3. Right to an Accounting of Disclosures
You may request a list of certain disclosures made in the past six years, excluding disclosures for treatment, payment, or operations.
4. Right to Request Restrictions
You may request restrictions on certain uses or disclosures of your PHI. We are not required to agree to all requests.
5. Right to Request Confidential Communications
You may request to be contacted in a specific way or at a specific location. We will accommodate reasonable requests.
6. Right to a Paper Copy of This Notice
You may request a paper copy of this Notice at any time, even if you have received it electronically.
7. Right to Notification of a Breach
You have the right to be notified if your unsecured PHI is breached.
Our Responsibilities
We are required by law to maintain the privacy and security of your PHI, notify you promptly of any breach, and comply with the terms of this Notice.
We will not sell your PHI or use it for marketing purposes without your written authorization.
Changes to This Notice
We reserve the right to change this Notice at any time. Any revised Notice will apply to all PHI we maintain and will be available at our office and on our website.
Complaints
If you believe your privacy rights have been violated, you may file a complaint without fear of retaliation.
With Us:
Privacy Officer
Lifetime Dental
4151 Brockton Ave
Riverside, CA 92501
Phone: (951) 709-0504
With the U.S. Department of Health and Human Services:
Office for Civil Rights (OCR)
200 Independence Avenue SW
Washington, DC 20201
Phone: 1-877-696-6775
Acknowledgment of Receipt
You may be asked to sign a separate acknowledgment confirming that you received this Notice. Your signature does not indicate agreement—only receipt.
