Privacy Policy

NOTICE OF PRIVACY PRACTICES

Effective Date: February 16, 2026

This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully. The privacy of your health information is important to us. A current copy of this notice will always be available in our office and upon request.

OUR LEGAL DUTY Ross Family Dentistry is a Covered Entity under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). We are required by applicable federal and state law to maintain the privacy and security of your Protected Health Information (PHI). We are required to: maintain the privacy of your health information, provide you with this notice of our legal duties and privacy practices, follow the terms of this notice currently in effect, and notify you if a breach of your unsecured PHI occurs. We collect and maintain oral, written, and electronic health information to administer our business and provide dental services to our patients. We maintain physical, electronic, and procedural safeguards to protect your information against loss, misuse, or unauthorized access in accordance with federal and state privacy laws. We reserve the right to change our privacy practices and the terms of this notice at any time as permitted by law. Any changes will apply to all PHI we maintain, including information created or received before the changes were made.

USES AND DISCLOSURES OF YOUR HEALTH INFORMATION We may use and disclose your PHI without written authorization for the following purposes:

  • Treatment We may use or disclose your health information to provide, coordinate, or manage your dental care. This may include sharing information with: dental specialists, dental laboratories, pharmacies, & other healthcare providers involved in your treatment. For example, we may send your dental records or x-rays to an oral surgeon to determine whether surgical treatment is necessary.
  • Payment We may use and disclose your health information to obtain payment for services provided to you. This may include: submitting insurance claims, verifying insurance coverage, determining medical necessity, & billing and collection activities. 
  • Healthcare Operations We may use and disclose your health information for healthcare operations necessary to run our practice, including: quality assessment and improvement activities, reviewing provider performance and competence, training programs and credentialing activities, licensing and accreditation, fraud and abuse detection, and administrative and business operations. We may share PHI with business associates who perform services on our behalf. These associates are required by contract to protect the privacy and security of your information.
  • Appointment Reminders and Health Communications We may contact you using the information you provide for: appointment reminders, treatment alternatives, and health-related products or services. Communication methods may include: phone calls, voicemail, mail, email, & text messaging. Messages may be left on voicemail or answering machines associated with numbers you provide.
  • Individuals Involved in Your Care With your agreement, or if you do not object, we may disclose relevant health information to: family members, close friends, and others involved in your care or payment for care. In emergency situations, we may use professional judgment to determine whether disclosure is in your best interest.
  • Required by Law We may disclose your health information when required by federal, state, or local law. If laws conflict, we will comply with the more restrictive law.
  • Public Health and Safety We may disclose health information for public health activities such as: reporting disease or injury, reporting abuse, neglect, or domestic violence, & preventing serious threats to health or safety. 
  • Legal Proceedings and Law Enforcement We may disclose health information in response to: court orders, subpoenas, and other lawful legal processes. 
  • Coroners, Medical Examiners, and Funeral Directors We may disclose health information to identify a deceased person or determine cause of death.
  • Organ and Tissue Donation We may disclose health information to authorized organ procurement organizations.
  • Military and National Security We may disclose health information to authorized federal officials for lawful intelligence or national security activities.
  • Workers’ Compensation We may disclose health information as authorized by workers’ compensation laws.
  • Research We may disclose health information to approved researchers when appropriate privacy protections are in place.

USES AND DISCLOSURES REQUIRING WRITTEN AUTHORIZATION We will obtain your written authorization before: selling your PHI, using PHI for marketing purposes (with limited exceptions), posting patient information or images on social media, and disclosing psychotherapy notes (if applicable). You may revoke your authorization at any time in writing, except to the extent we have already acted upon it.

SPECIAL PROTECTIONS FOR CERTAIN HEALTH INFORMATION Certain types of health information receive additional protection under federal and state law, including: Substance Use Disorder (SUD) treatment records, HIV/AIDS information, mental health records, genetic testing information (GINA), sexually transmitted infections, reproductive health information, and child or adult abuse or neglect records. Substance Use Disorder treatment information cannot be used in legal proceedings without your written consent or court order.

YOUR RIGHTS You have the following rights regarding your health information:

  • Access You have the right to inspect or obtain a copy of your health records. Requests must be submitted in writing and reasonable fees may apply.
  • Amendment You have the right to request correction of inaccurate or incomplete health information. Requests must be submitted in writing.
  • Accounting of Disclosures You may request a list of certain disclosures of your health information made during the past six (6) years.
  • Request Restrictions You may request limits on certain uses or disclosures of your information. If you pay for services out-of-pocket in full, you may request that we not disclose that information to your health plan.
  • Confidential Communications You may request that we contact you through alternative methods or at alternative locations.
  • Receive a Copy of This Notice You may request a paper copy of this Notice at any time.
  • Breach Notification You have the right to receive notification if your unsecured PHI is breached.
  • File a Complaint If you believe your privacy rights have been violated, you may file a complaint without fear of retaliation. You may file a complaint with:

Ross Family Dentistry 170 Wamplers Lake Rd. Brooklyn, MI 49230 Phone: 517-592-3003

Or with: 

U.S. Department of Health and Human Services Office for Civil Rights
200 Independence Avenue SW
Room 509F, HHH Building
Washington, DC 20201

Phone: 1-800-368-1019
TDD: 1-800-537-7697

Complaint forms are available at:
https://www.hhs.gov/ocr/office/file/index.html

If you have questions about this notice or our privacy practices, please contact our office.

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Dr. Ross and his patient-centered team are excited that your family is considering making us your dental home. Book your appointment today to experience the Ross Family Dentistry difference. Request Appointment