Patient Privacy Policy

Evergreen Oral and Maxillofacial Surgery is committed to protecting health Information about you. We create a record of the services you receive at our facility for use in your care and treatment. Typically, this record contains your health history, symptoms, examination and test results, diagnoses, treatment, and a plan for your future course of treatment.  Your health information and records will be maintained in a confidential manner, as required by law.   All of our staff and doctors strictly adhere to protecting your privacy. However, Evergreen Oral and Maxillofacial Surgery may use and disclose your health information to the extent necessary to provide you with quality health care.

Our Duties

We are required by law to:

  • Make sure that health information that identifies you is kept private;
  • Let you know promptly if a breach occurs that may have compromised the privacy or security of your information;
  • Provide notice of our legal duties and privacy practices with respect to your health information; and

What Are Treatment, Payment and Health Care Operations?

Treatment includes sharing information among health care providers involved in your care. For example, your physician may share information about your condition with the pharmacist to discuss appropriate medications, or with radiologists or other consultants in order to make a diagnosis. Evergreen Oral and Maxillofacial Surgery may use your health information as required by your insurer or managed care company to obtain payment for your treatment. We also may use and disclose your health information to improve the quality of care we render, e.g., for review and training purposes.

How Else Will Evergreen Oral and Maxillofacial Surgery Use My Health Information?

Unless you ask for restrictions on a specific use or disclosure, your health information may be used the following purposes:

  • To carry out health care treatment, payment, and operations functions.
  • For appointment reminders and to inform you of treatment alternatives or other benefits and services related to your health.
  • As required by law.
  • For health oversight activities, e.g., audits, inspections, investigations, and licensure notices.
  • During lawsuits and disputes.
  • To assist coroners, medical examiners, and funeral directors.
  • To prevent a serious threat to health or safety.
  • To address workers’ compensation, law enforcement, and other government requests.
  • We will also afford special privacy protections for drug and alcohol information.

Your Authorization Is Required for Other Disclosures.

Except as described above, we will not use or disclose your health information unless you authorize (permit) us in writing to disclose your health information. If you initially give permission, you may revoke that permission, which will be effective only after the date of your written revocation.

You Have Rights Regarding Your Health Information.

You have the following rights regarding your health information:

  • Right to request restriction. You may request limitations on the use or disclosures of your health information we use or disclose for health care treatment, payment, or operations.
  • Right to confidential communications. You may request that we communicate in a certain way or at a certain location, but you must specify how or where you wish to be contacted.
  • Right to inspect and copy. You have the right to inspect and copy your health information.
  • Right to request amendment. You may request an amendment or you may request to attach an additional statement to your records if you believe the health information we have about you in your record is incorrect or incomplete.
  • Right to accounting of disclosures. You may request a list of the disclosures of your Health Information that have been made to persons or entities other than for health care treatment, payment or operations in the past 6 years.

We Never Share Your Information Without an Authorization for Marketing Purposes

We do not share any information for marketing purposes unless specifically authorized for that purpose. You may revoke such an authorization, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written permission. We are unable, however, to retrieve any disclosures we have already made with your permission.

Special Privacy Protections for Alcohol and Drug Abuse Information

Alcohol and drug abuse Health Information enjoys special privacy protections. We will not disclose any information identifying an individual as being a patient, or provide any health information, relating to a patient’s substance abuse treatment unless: (i) the patient consents in writing; (ii) a court order requires disclosure of the information; (iii) health personnel need the information to meet a health emergency; (iv) qualified personnel use the health information for the purpose of conducting scientific research, management audits, financial audits, or program evaluation; or (v) it is necessary to report a crime or a threat to commit a crime, or to report abuse or neglect as required by law.