Privacy Policy

Practice Covered by This Notice

This notice describes the privacy practices of Dentistry at East Piedmont. "We" and "our" refer to the dental practice; "you" and "your" refer to our patients.

Information Covered by This Notice

We create and maintain records about the dental care and services you receive. This notice applies to health information that identifies you and explains how we may use and disclose that information. It also outlines your rights regarding your health information.

We are required by law to:

• Maintain the privacy of health information that identifies you.
• Provide this notice of our legal duties and privacy practices.
• Abide by the terms of our privacy notice currently in effect.

Copies of this notice are available upon request and posted in the practice.

How We May Use and Disclose Your Protected Health Information

• Appointment Reminders. We may contact you for appointment reminders by mail, voicemail, email, or SMS.
• Payment. We may use and disclose health information to bill your insurance and collect payment for services rendered.
• Treatment. We may use health information to provide dental treatment and may share information with other healthcare providers involved in your care.
• Treatment Alternatives. We may use your information to inform you of treatment options or alternatives.
• Healthcare Operations. We may use health information for operations such as evaluating staff performance or improving services.

Disclosure to Family Members, Friends, and Other Third Parties

Federal and state law require that information about an adult patient (age 18 or older) only be shared with others when the patient has provided written authorization. This applies to a spouse and to adult dependents. If a parent asks about a claim for their 19-year-old child, for example, that information will not be released without the dependent's written consent. The same is true between spouses.

Parents of children under 18 have a right to that child's information without the child's consent.

To authorize disclosure to a specific family member, friend, or other third party, sign the Release of Information Authorization form in the office or ask the front desk for one. Once on file, the authorization allows us to share the items it covers, which can include benefits information, claim status and history, general claim information, dentist information, lab cases, and enrollment information. Authorization can be revoked at any time in writing.

In an emergency or after a death, we may notify family or others as appropriate.

Less Common Reasons for Disclosure

We may disclose health information for specific purposes including public health activities, victims of abuse, health oversight activities, lawsuits, law enforcement, organ donation, and to avert serious threats to health or safety.

A2P Messaging and SMS Communication

When you provide your phone number and opt in to receive SMS messages, you agree to the following terms for A2P messaging:

• Types of Messages. You may receive appointment reminders, treatment updates, promotional offers, and other marketing messages.
• Opt-In. By submitting your phone number via our website or forms, you consent to receive SMS messages from Dentistry at East Piedmont.
• Opt-Out. Reply "STOP" to any SMS to opt out. Reply "HELP" for help, or contact us directly.
• Message Frequency. Depends on your interactions with the practice.
• Message and Data Rates. Standard rates may apply based on your mobile carrier plan.

We do not sell or share your phone number with third parties for marketing purposes.

Other Uses of Health Information

We will only make additional uses or disclosures of your health information with your written authorization. You may revoke that authorization at any time in writing.

Your Rights

• Right of Access. You may request a copy of your health information in a preferred format.
• Right to Amend. You may request corrections to your health information if you believe it is incorrect or incomplete.
• Right to Request Restrictions. You may request restrictions on the use of your health information. We are not required to agree to every request.
• Right to Confidential Communications. You may request to receive communications through alternative means or locations; we accommodate reasonable requests.
• Accounting of Disclosures. You may request a list of certain disclosures we have made of your health information.
• Right to a Paper Copy. You may request a paper copy of this notice at any time.

Changes to This Notice

We reserve the right to change the terms of this notice and apply the revised terms to all information we maintain. Any change will be posted in the practice and on this page.

To Make a Privacy Complaint

If you believe your privacy rights have been violated, you may file a complaint by contacting us at the address or phone number below. You will not face retaliation for filing a complaint.

How to Contact Us

Dentistry at East Piedmont
3535 Roswell Road Suite 55
Marietta, GA 30062
Phone: (770) 321-5558
Email: Xray@SmilesInAtlanta.com