HIPAA policy
Practice Name: Dental office of Irene Blaess Practice Phone Number: 210 691 1333
HIPAA NOTICE OF PRIVACY PRACTICES
Dental office of Irene Blaess effective Date: January 1, 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.
1. OUR COMMITMENT TO YOUR PRIVACY
We are committed to protecting the privacy of your Protected Health Information (PHI). Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and related federal confidentiality laws, we must safeguard your PHI in all forms—electronic, oral, and paper.
We are required to:
- Provide you with this Notice of our legal duties and privacy practices
- Follow the terms of this Notice
- Notify you in writing if we make any revisions
- Notify you within 10 business days if a breach of your unsecured PHI occurs
Misuse or unauthorized disclosure of PHI may result in penalties under HIPAA. You may request a current copy of this Notice at any time.
2. TYPES OF HEALTH INFORMATION WE COLLECT
PHI includes information related to:
- Your past, present, or future physical or mental health
- Healthcare services provided to you
- Past, present, or future payment for healthcare services
This may include medical history, dental records, diagnostic images, insurance information, and billing records.
3. PERMISSIBLE USES AND DISCLOSURES OF YOUR PHI
We may use or disclose your PHI without written authorization for:
Treatment
Coordinating or managing your care among healthcare providers.
Payment
Billing, insurance claims, eligibility verification, and reimbursement.
Healthcare Operations
Quality assessment, case management, audits, customer service, staff training, and
administrative activities.
Appointment Reminders & Treatment Alternatives
We may contact you about appointments, treatment options, or health-related services.
De-Identification
We may remove identifying information to create non-identifiable data.
4. SUBSTANCE USE DISORDER (SUD) RECORDS & LEGAL PROTECTIONS
If we receive or maintain records protected under 42 CFR Part 2, they receive additional confidentiality protections.
- SUD records may only be used or disclosed for treatment, payment, or healthcare operations as permitted by law.
- They may not be used in civil, criminal, administrative, or legislative proceedings without your written consent or a qualifying court order.
- You may opt out of any fundraising communications related to SUD-related care.
5. REDISCLOSURE NOTICE
PHI disclosed to individuals or organizations not covered by HIPAA may no longer be protected and may be subject to redisclosure. SUD records remain protected under federal law and cannot be redisclosed without your authorization.
6. OTHER USES & DISCLOSURES REQUIRING AUTHORIZATION
We must obtain your written authorization for:
- Use or disclosure of psychotherapy notes
- Use of PHI for marketing
- Sale of PHI
You may revoke authorization at any time in writing, except where we have already acted in reliance on it.
7. YOUR INDIVIDUAL RIGHTS
You have the right to:
Request Restrictions
We are not required to agree, but we will comply with approved restrictions.
Request Confidential Communications
You may request contact by specific methods or locations.
Inspect & Obtain Copies of Your PHI
Electronic copies are available when records are maintained electronically.
Request Amendments
If you believe your PHI is incorrect or incomplete.
Receive an Accounting of Disclosures
Covers certain disclosures made in the past six years.
Receive a Paper Copy of This Notice
Even if you received it electronically.
Restrict Disclosure to Health Plans
If you pay out-of-pocket in full for a service, we will not disclose related PHI to your health plan unless required by law.
8. COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with:
- Dental Office of Irene Blaess
- U.S. Department of Health & Human Services, office for Civil Rights
We will not retaliate against you for filing a complaint.
9. CONTACT INFORMATION
For questions about your privacy rights or PHI access, contact:
Practice Name: Dental office of Irene Blaess HIPAA Compliance officer: Karina Aponte
Practice Phone: (210)495-4800 Practice Email: Northwoodsdentalspa@gmail.com
10. NEW PATIENT RIGHTS UNDER HIPAA (2026 UPDATES)
You now have the right to:
- Access your PHI promptly and at a lower cost
- Direct your PHI to be sent to a third party (provider, caregiver, representative) in electronic format
11. ACCESS TO YOUR RECORDS
You may inspect your PHI in person, take notes, or capture images using your own device. Access will be provided within 15 calendar days of your request. One 15-day extension is permitted when necessary.
12. DISCLOSURES FOR CARE COORDINATION
We may disclose PHI to social service agencies, community-based organizations, or similar third parties for care coordination and case management, without requiring your authorization.
13. NO SIGNATURE REQUIRED
You are not required to sign any form acknowledging receipt of this Notice. This Notice will always be available upon request.
14. HOW TO FILE A COMPLAINT
If you believe your privacy rights have been violated, you have the right to file a complaint. You may file a complaint with our office or with the U.S. Department of Health & Human Services, Officefor Civil Rights (OCR). You will not be penalized or retaliated against for filing a complaint.
To file a complaint with our office:
Dental Officeof Irene Blaess Attn: HIPAA Compliance office– Karina Aponte
Phone: (210)935-3176 Email: karina.dental5999@gmail.com
To file a complaint with the U.S. Department of Health & Human Services:
office for Civil Rights (OCR) U.S. Department of Health & Human Services You may file online, by mail, or by phone. Instructions are available at:
https://www.hhs.gov/ocr/privacy/hipaa/complaints/ (hhs.gov in Bing)
Complaints must generally be filed within 180 days of when you knew that the violation occurred. Extensions may be granted for good cause.
Date 2-16-2026
