Notice of Privacy Practices
Effective Date: May 21, 2026
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Advanced Endodontics ("our practice," "we," "us") is required by law to maintain the privacy of your protected health information (PHI), to provide you with this Notice of our legal duties and privacy practices with respect to PHI, and to notify you following a breach of unsecured PHI.
We are required to abide by the terms of this Notice while it is in effect. We reserve the right to change the terms of this Notice and to make the new Notice effective for all PHI we maintain. If we revise this Notice, we will post the revised version in our office and on our website.
I. How We May Use and Disclose Your Health Information
The following describes the ways we may use and disclose health information that identifies you ("Health Information"). Except for the following purposes, we will use and disclose Health Information only with your written permission.
Treatment
We may use and disclose your Health Information to provide, coordinate, or manage your dental care and any related services. For example, we may disclose your Health Information to a referring dentist, specialist, or other healthcare provider involved in your care.
Payment
We may use and disclose your Health Information to obtain payment for services we provide to you. For example, we may send claims to your dental insurance company that include information about your diagnosis and treatment.
Healthcare Operations
We may use and disclose your Health Information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, conducting training programs, accreditation, certification, licensing, and credentialing activities.
Appointment Reminders
We may use and disclose your Health Information to contact you as a reminder that you have an appointment for treatment or medical care at our practice.
Treatment Alternatives
We may use and disclose your Health Information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health-Related Benefits and Services
We may use and disclose your Health Information to tell you about health-related benefits or services that may be of interest to you.
Release to Family / Friends
Our practice may release your Health Information to a friend or family member that is involved in your care, or who assists in taking care of you. For example, a parent or guardian may ask that we release your information to them.
Disclosures Required by Law
Our practice will use and disclose your Health Information when we are required to do so by federal, state, or local law.
II. Uses and Disclosures Requiring Your Authorization
Other uses and disclosures of your Health Information will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your Health Information as allowed by your authorization. We are unable to take back any disclosures we have already made with your authorization.
We will not use or disclose your Health Information for marketing purposes or sell your Health Information without your written authorization.
III. Special Disclosures
We may use or disclose your Health Information in the following special circumstances without your authorization:
- Public Health Activities: To prevent or control disease, injury, or disability; to report births and deaths; to report child abuse or neglect.
- Health Oversight Activities: To a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.
- Judicial and Administrative Proceedings: In response to a court or administrative order, subpoena, discovery request, or other lawful process.
- Law Enforcement: For law enforcement purposes as required by law or in response to a valid subpoena.
- Serious Threats to Health or Safety: To prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
- Workers' Compensation: As authorized by and to the extent necessary to comply with workers' compensation or other similar programs.
- Military and Veterans: If you are a member of the armed forces, as required by military command authorities.
- Coroners, Medical Examiners, and Funeral Directors: To a coroner or medical examiner for identification of a deceased person or to determine cause of death.
- Research: Under certain conditions for research purposes.
- National Security: To authorized federal officials for intelligence, counterintelligence, and other national security activities.
IV. Your Rights Regarding Your Health Information
You have the following rights regarding Health Information we maintain about you:
Right to Inspect and Copy
You have the right to inspect and copy Health Information that may be used to make decisions about your care. To inspect and copy your Health Information, you must submit your request in writing to our Privacy Officer. We may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.
Right to Amend
If you feel that Health Information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to our Privacy Officer. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request.
Right to an Accounting of Disclosures
You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of Health Information about you for purposes other than treatment, payment, and healthcare operations. To request this list, you must submit your request in writing to our Privacy Officer.
Right to Request Restrictions
You have the right to request a restriction or limitation on the Health Information we use or disclose about you for treatment, payment, or health care operations. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing to our Privacy Officer.
Special Rule: We must agree to your request to restrict disclosure of your PHI to a health plan if: (1) the disclosure is for payment or health care operations and is not otherwise required by law; and (2) the PHI pertains solely to a health care item or service for which you, or someone on your behalf (other than the health plan), has paid in full.
Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to our Privacy Officer. We will accommodate all reasonable requests.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy. You may obtain a copy of this Notice at our office or by contacting us at the information below.
Right to Be Notified of a Breach
You have the right to be notified in the event that we (or a Business Associate) discover a breach of unsecured Protected Health Information. Notice of any such breach will be made in accordance with federal requirements.
V. Our Duties
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this Notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
VI. Complaints
If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact our Privacy Officer in writing. All complaints must be submitted in writing.
You will not be penalized for filing a complaint.
To file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, send a letter to: 200 Independence Avenue, S.W., Washington, D.C. 20201, call 1-877-696-6775, or visit www.hhs.gov/ocr/privacy/hipaa/complaints/.
VII. Contact Our Privacy Officer
For questions about this Notice or to exercise any of your rights described above, please contact our Privacy Officer:
Privacy Officer — Advanced Endodontics
1400 Crescent Green, Suite 200, Cary, NC 27518
Phone: (919) 233-8830
Fax: (919) 233-7268
Email: [email protected]
This Notice is effective as of May 21, 2026. For website privacy information, please see our Privacy Policy.