HIPAA NOTICE OF PRIVACY PRACTICES
Effective Date: 7th January 2025
This notice explains how your medical information may be used and disclosed and how to access it. Please read it carefully. The terms of this Notice of Privacy Practices ("Notice") apply to Michigan Periodontics of Dr. Basam M Kinaiai, its affiliates, and its employees. Michigan Periodontics will share patients' protected health information as necessary for treatment, payment, and healthcare operations as the law permits. We are obligated by law to safeguard the privacy of our patient's protected health information. We also provide our patients with a Notice outlining our legal responsibilities and privacy practices concerning their protected health information. We must adhere to the conditions outlined in this notice for the duration of its validity. We retain the right to modify the terms of this notice as needed and to establish a new notice of privacy practices that will apply to all protected health information held by Michigan Periodontics. We are obligated to inform you if there is a breach involving your unsecured protected health information. Some state laws regarding the privacy of health information may be stricter than the federal HIPAA law. If you want a new copy of our Privacy Practices Notice or learn more about a specific state law, please write to the Privacy Officer at the address below.
USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION
Authorization and Consent
Except as outlined below, we will not use or disclose your protected health information for any purpose other than treatment, payment, or healthcare operations unless you have signed a form authorizing such use or disclosure. You have the right to revoke such authorization in writing, with such revocation being effective once we receive the writing; however, such revocation shall not be practical to the extent that we have taken any action in reliance on the authorization or if the authorization was obtained as a condition of obtaining insurance coverage, another law provides the insurer with the right to contest a claim under the policy or the policy itself.
Uses and Disclosures for Treatment
We will use and disclose your protected health information for your treatment. Doctors, nurses, and other professionals involved in your care will use information in your medical record and information you provide about your symptoms and reactions to your course of treatment, including procedures, medications, tests, medical history, etc.
Uses and Disclosures for Payment
We will utilize and disclose your protected health information as required for payment purposes. In the course of our routine business operations, we may transmit information regarding your medical procedures and treatments to your insurance company to facilitate the processing of payment for the services rendered to you. Furthermore, we may employ your information to generate a bill that will be sent to you or the individual responsible for your payment.
Uses and Disclosures for Health Care Operations
We will use and disclose your protected health information as necessary and as permitted by law for our healthcare operations, including clinical improvement, professional peer review, business management, accreditation, licensing, etc. For instance, we may use and disclose your protected health information to improve clinical treatment and patient care.
Contact Information for Further Assistance or Complaints
If you have inquiries, need further help, or would like to submit a request under this notice, you may contact the Michigan Periodontics Privacy Officer by phone at (586) 275-7667
Or at the following address:
Michigan Periodontics & Implants
3801 - Metropolitan Parkway
Sterling Heights, MI 48310
Your trust is important to us. Michigan Periodontics is committed to safeguarding your privacy and ensuring you feel confident in your care.
