Notice of Privacy Practices

Pauly Dental LLC is committed to protecting the privacy of your personal health information. This Notice of Privacy Practices describes how we may use and disclose your personal health information to carry out treatment, payment, or healthcare operations and for other purposes permitted or required by law.It also describes your rights to access and control your personal health information.

This notice takes effect on 02/12/2026 and will remain in effect until replaced.

Uses and Disclosures of Personal Health Information

We may use and disclose your personal health information for the following purposes:

  • TreatmentWe may use and disclose your personal health information to provide, coordinate, or manage your health care and related services.This includes sharing information with other healthcare providers regarding your treatment and coordinating and managing your healthcare with others.
  • PaymentWe may use and disclose your personal health information to provide, coordinate, or manage your health care and related services.This includes sharing information with other healthcare providers regarding your treatment and coordinating and managing your healthcare with others.
  • Health Care OperationsWe may use and disclose your personal health information for our health care operations.These activities include, but are not limited to:
    • Quality assessment and improvement activities
    • Employee review activities
    • Training and education programs
    • Ensuring compliance with legal and regulatory requirements
  • AI-Assisted Front OfficeWe use AI-assisted technology to enhance efficiency and improve patient experience.This includes answering phone calls, scheduling, and patient communications.Any information gathered during these interactions is strictly confidential, for office use only, and HIPAA compliant.All data processed is encrypted during transmission and while stored.
  • Special Protections for Substance Use Disorder RecordsCertain health information we maintain, specifically records regarding substance use disorder (SUD) diagnosis, treatment, or referral, is protected by federal law under 42 CFR Part 2.These records receive a higher level of protection than other types of health information.We will not use or disclose these records without your written consent, except as specifically permitted by 42 CFR Part 2.
  • Restrictions on Legal ProceedingsYour SUD records, or testimony relaying the content of such records, shall not be used or disclosed in any civil, criminal, administrative, or legislative proceedings against you unless:
    You provide specific written consent for such use; or
    A court issues an order that meets the requirements of 42 CFR Part 2.

Notice of Redisclosure

Information disclosed with your consent may be subject to redisclosure by the recipient and may no longer be protected by federal privacy rules. However, for records protected by 42 CFR Part 2,the recipient is generally prohibited from making further disclosures of your SUD records without your express written consent or as otherwise permitted by law.

Single Consent for Treatment, Payment, and Operations (TPO)

If you provide a single written consent for the disclosure of your SUD records for treatment, payment, and health care operations, we may use and disclose those records for these purposes as permitted by HIPAA. This consent may be revoked at any time, except to the extent that we have already acted in reliance on it.

Other Permitted and Required Uses and Disclosures

We may also use and disclose your personal health information in the following instances:

  • As required by law
  • For public health activities
  • To report abuse, neglect, or domestic violence
  • For health oversight activities
  • In response to legal proceedings
  • To law enforcement officials
  • To coroners, medical examiners, and funeral directors
  • For research purposes
  • To prevent a serious threat to health or safety
  • For specialized government functions
  • For workers’ compensation

Your Rights

You have the following rights regarding your personal health information:

  • The right to inspect and copy your personal health information
  • The right to request a restriction on the use or disclosure of your personal health information
  • The right to request confidential communications
  • The right to request an amendment to your personal health information
  • The right to receive an accounting of certain disclosures
  • The right to obtain a paper copy of this notice

Changes to This Notice

We reserve the right to change the terms of this Notice of Privacy Practices and to make the new notice provisions effective for all personal health information that we maintain. If we make material changes to our privacy practices, we will make the revised Notice available upon request and post it in our facility and on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services.We will not retaliate against you for filing a complaint.

Contact Information

If you have any questions about this Notice of Privacy Practices, please contact our Privacy Officer at (316) 263-0889.