Notice of Privacy Practices
Draft for practice adoption and legal review — not yet the operative notice.
Before publication, the practice must confirm every described use and disclosure, the named privacy contact, how patients exercise these rights, paper-copy availability, and the actual effective date. Ask the front desk for the notice currently in effect.
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.
Canyon Lake Dental & Orthodontics keeps a record of the care we provide you. We are required by federal and Texas law to protect it, to give you this notice, and to follow the terms of the notice currently in effect. This page explains what we do with your information and what you can ask of us.
How we use and share your information without asking you first
To treat you
We use your records to provide your dental care and to coordinate it — the dentist, the hygienist, and the assistant working on your treatment all use the same chart. If we refer you to an oral surgeon, an endodontist, or your physician, we share what they need to treat you safely.
To get paid
We send your insurance carrier the information it needs to determine benefits and pay a claim — which teeth, which procedures, and the x-rays or photographs supporting them. If an account goes unpaid we may share the minimum necessary with a billing or collection service.
To run the practice
We use records for scheduling, for reviewing the quality of our own care, for training, and for our accountant and attorney when they need them. Anyone outside the practice who handles your information on our behalf is under a written agreement to protect it.
To remind you and follow up
We may contact you about appointments, recall visits, and treatment you have not yet scheduled, by phone, text, mail, or email. Tell us if you would rather we did not, or would rather we used a particular method — see confidential communications below.
Where the law requires or permits it
Some disclosures we must make, and some we are permitted to make, without your permission. These are limited to what the law allows, and include: public health reporting; reporting suspected abuse, neglect, or domestic violence; health oversight audits and inspections; subpoenas, court orders, and other legal process; certain law enforcement requests; coroners, medical examiners, and funeral directors; organ donation; workers' compensation claims; serious threats to health or safety; and specialized government functions such as military or national security. We may also share information about a decedent with the personal representative of their estate.
When we will ask your permission first
Anything not described above needs your written authorization. That always includes marketing that benefits someone else, and any sale of your information — which we do not do. You can cancel an authorization in writing at any time; that stops future sharing, though it cannot undo something already shared.
For some disclosures we will simply ask you in the moment — whether we may discuss your treatment with the family member who drove you, for example. You can say no.
Your rights
To see and get a copy of your records
Ask us, and we will give you a copy of your dental record, including x-rays. We may charge a reasonable, cost-based fee for copies. Ask if you want it sent somewhere else.
To ask us to correct something
If you believe something in your record is wrong or incomplete, ask us in writing to amend it. We may say no, and if we do we will tell you why in writing, and you can have your statement of disagreement added to the record.
To get a list of who we have shared it with
You can ask for an accounting of disclosures we have made, other than for treatment, payment, and running the practice. Your first request in a twelve-month period is free.
To ask us to limit what we share
You can ask us to restrict what we use or disclose. We do not have to agree, with one exception we must honor: if you pay for a visit in full yourself, you can tell us not to send that information to your health plan, and we will not.
To be contacted a particular way
You can ask us to reach you at a different number or address, or to leave no voicemail. We will accommodate any reasonable request, and we will not ask you why.
To a paper copy, and to know about a breach
You can have a paper copy of this notice at any time, even if you have read it here. If your information is ever involved in a breach, we will notify you.
Our duties, and changes to this notice
We must protect your information, give you the notice we have adopted, and abide by the version in effect. We may change that notice, and a change may apply to all the information we hold, including records created before it. Once this draft is adopted, the current version will be posted here and made available by the practice, with its effective date at the top.
Email, texts, and this website
Please do not send symptoms, diagnoses, or anything else clinical through the callback form or ordinary email. The form has no message box; call us so we can take those details through the practice's approved process. What this website itself collects is set out in our privacy and cookie policy.
Questions, or a complaint
Please start with us. Ask for Dr. Elizabeth Pohlmann, Owner and Privacy Officer, by phone or in writing at the practice.
You can also complain to the U.S. Department of Health and Human Services, Office for Civil Rights, online at hhs.gov/hipaa/filing-a-complaint. A complaint must normally be filed within 180 days. We will not retaliate against you for making one, here or there.