Deborah R Robbins, DDS PC
Notice of Privacy Practices
This notice describes how your health information may be used and disclosed, and how you can get access to this information. Please review it carefully.
We are required by law to protect the privacy of your protected health information (PHI), to provide individuals with notice of our legal duties and privacy practices with respect to PHI, and to notify affected individuals following a breach of unsecured PHI. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect February 16, 2026 and will remain in effect until we replace it.
We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law, and to make new Notice provisions effective for all PHI that we maintain. When we make a significant change in our privacy practices, we will change this Notice and post the new Notice clearly at our practice location, on our website, and we will provide you with a copy upon request. We collect and maintain oral, written, and electronic information to administer our business and to provide products, services, and information of importance to our patients. We maintain physical, electronic, and procedural safeguards in the handling and maintenance of our patients’ medical information, in accordance with applicable state and federal standards, to protect against risks such as loss, destruction, and misuse.
You may request a copy of our Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.
HOW WE MAY USE AND DISCLOSE PHI
We may use and disclose your PHI for different purposes, including treatment, payment, and health care operations. Some information, such as HIV-related information, genetic information, alcohol/substance abuse disorder treatment records, and mental health records, may be entitled to special confidentiality protections under applicable state/federal law. We will abide by these special protections as they pertain to applicable cases involving these types of records.
Treatment. We may use and disclose your PHI to another dentist or health care provider working in our facility or otherwise providing you treatment for the purpose of evaluation of your health, diagnosing medical conditions, and providing treatment. For example, your PHI may be disclosed to an oral surgeon to determine if surgical intervention is needed.
Payment. We provide dental services. Your PHI may be used to seek payment from your insurance plan. Payment activities include billing, collections, claims management, and determinations of eligibility and coverage to obtain payment from you, an insurance company, or another third party. For example, your insurance plan may request and receive information on the care you received from us.
Healthcare Operations. We may use and disclose your PHI in connection with our healthcare operations. For example, healthcare operations include quality assessment and improvement activities, conducting training programs, and licensing activities.
Your Authorization. You (or your legal personal representative) may give us written authorization to use your PHI or to disclose it to anyone for any purpose. Once you give us authorization to release your PHI, we cannot guarantee that the person to whom the information is provided will not disclose that information. You may take back your written authorization at any time, except if we have already acted based on your prior authorization. Your revocation will not affect any use or disclosure permitted by your authorization while it was in effect. Unless you give us written authorization, we will not use or disclose your PHI for any purpose other than those described in this Notice. We will obtain your authorization prior to using your PHI for marketing, fundraising, or for commercial use. You can opt out of these communications at anytime.
Individuals Involved In Your Care or Payment for Your Care. We may disclose your PHI to your family or friends, or any other individual identified by you when they participate in your care or in the payment for your care. Additionally, we may disclose your PHI to a patient representative. If a person has the authority by law to make healthcare decisions for you, we will treat that patient representative the same way we would treat you with respect to your PHI.
Reminders. We may use or disclose PHI to send you reminders about your dental care, such as appointment reminders, via US Mail, email, and telephone. By providing your email address to us, you agree that you may receive reminders and breach notifications via email. It is also understood that our office may leave a message on any voicemail or answering machine that may be attached to a telephone number that you provide.
Disaster Relief. We may use or disclose your PHI to assist in disaster relief efforts.
Required by Law. We may use or disclose your PHI when we are required to do so by law.
Public Health and Benefit Activities. We may use or disclose your PHI when required by law and when authorized by law for the following kinds of public health and public benefit activities: for public health, including to report disease and vital statistics, child or adult abuse, neglect or domestic violence; to avert a serious or imminent threat to health or safety; report reactions to medications or problems with products or devices; notify a person of a recall, repair, or replacement of products or devices; notify a person who may have been exposed to a disease or condition; for research; in response to court and administrative orders and other lawful process; to law enforcement officials with regard to crime victims and criminal activities; to coroners, medical examiners, funeral directors and organ procurement organizations; to the military, to federal officials for lawful intelligence, counterintelligence, and national security activities, and to correctional institutions and law enforcement regarding persons in lawful custody; and as authorized by state worker’s compensation laws.
Secretary of HHS. We will disclose PHI to the Secretary of the US Dept of Health and Human Services when required to investigate or determine compliance with HIPAA.
Health Oversight Activities. We may disclose PHI to an oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and credentialing, as necessary for licensure and for the government to monitor the healthcare system, government programs, and compliance with civil rights laws.
Special Protections for SUD records: Substance Use Disorder (SUD) Treatment records have enhanced protections. They cannot be used in legal proceedings without your consent or court order.
Business Associates. We may disclose PHI to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. Our business associates are required, under contract with us, to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.
Additional Restrictions on Use and Disclosure. Certain federal and state laws may require special privacy protections that restrict the use and disclosure of certain health information, including highly confidential information about you. “Highly Confidential Information” may include confidential information under federal laws governing reproductive rights, alcohol and drug abuse information, and genetic information as well as state laws that often protect the following types of information: HIV/AIDS, mental health, genetic tests, alcohol and drug abuse, STDs and reproductive health information, and child or adult abuse or neglect, including sexual assault.
OTHER USES AND DISCLOSURES OF PHI
Your authorization is required, with a few exceptions, for disclosure of psychotherapy notes, use or disclosure of PHI for marketing, and for the sale of PHI. We will also obtain your written authorization before using or disclosing your PHI for purposes other than those provided for in this Notice (or as otherwise permitted or required by law). You may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing your PHI, except to the extent that we have already acted in reliance on the authorization.
YOUR HEALTH INFORMATION RIGHTS
-You have a right to see and get a copy of your health records.
-You have a right to amend your health information.
-You have a right to ask to get an Accounting of Disclosures of when and why your health information may be used and shared.
- We do NOT sell or disclose your PHI to any outside firms (unless we are referring you to another dentist or specialist).
Alternative Communications. You have the right to request that we communicate with you about your PHI by alternative means or at alternative locations. You must make your request in writing. Your request must specify the alternative means or location, and also provide satisfactory explanation of how payments will be made under the alternative means or location you request. We will accommodate all reasonable requests. However, if we are unable to contact you using the ways or locations you have requested, we may contact you using the prior information we have.
Electronic Notice. You may receive a paper copy of this Notice upon request, even if you have agreed to receive this Notice electronically on our website or by email.
QUESTIONS AND COMPLAINTS
If you would like more information about our privacy practices, or have questions or concerns, please contact us.
If you are concerned that we may have violated your privacy rights, of if you disagree with a decision we made about access to your PHI or in response to a request you made to amend or restrict the use or disclosure of your PHI or to have us communicate with you by alternative means or at alternative locations, you may complain to us using the contact information listed at the end of this Notice. You may also submit a written complaint to the US Dept of Health and Human Services.
We support your right to the privacy of your PHI. We will not retaliate in any way if you choose to file a complaint with us or with the US Dept of Health and Human Services.
Deborah R Robbins, DDS, PC phone 615-855-1188
307 Bluebird Dr fax 615-855-1010
Goodlettsville, TN 37072 email info@drrobbins.net