The Health Insurance Portability and Accountability Act of 1996 (HIPPA) provides safeguard to protect
your privacy as a patient. These safeguards include restrictions on what you may see, have access to or
be notified regarding your Protected Health Information or PHI. These restrictions do not include the
normal interchange of information necessary to provide you and your family with treatment. HIPPA
provides certain rights and protections to you as a patient. We must balance these needs with our goals
of providing you with quality service and optimum care. Further information regarding HIPPA can be
found on our office “Notice of Privacy Practices for Protected Health Information” form or by contacting
the US Department of Health and Human Services at www.hhh.gov
For this reason, our Practice has adopted the following policies:
Patient information will be kept confidential except as is necessary to provide treatment or to
ensure that all administrative matters related to your care are handled appropriately. This
specifically includes the sharing of informations with other healthcare providers including your
referring dentist, outside laboratories, and/or insurance carriers, as is necessary and appropriate
for your care.
It is the policy of the office to remind patients of their appointments. This is done by calling
patients and when they are unable to answer their phone, messages will be left on their voice
mail of the number or numbers provide as their contact number. We ask that you specify to
receptionist if the number they have given them is not to receive any confirmation messages
regarding their upcoming appointment.
It is the policy of the office to check on surgical patients the day after their procedure. This is also
done by telephoning the patient and when we are unable to reach the patient, detailed post-
operative instructions may be left for the surgical patient and their care giver. At the time of
surgery, we request the best number to contact them for these post-operative calls and the
messages are left at the number given by the patient and/or care giver/driver that accompanied
them the day of surgery.
To maintain privacy and professionalism in our practice, no one is allowed in the back office
without a staff member.
In the normal course of providing care, patient records may be left in administrative areas, front
desk, nurses station, doctors desk and in/out boxes. Insurance forms, in-house coding forms, x-
rays, surgical notes, and other forms may be attached to charts while in these areas and may be
visible but not legible to patients passing by. Charts left in an area that may have prolonged
visibility will be covered or closed so not visible without further efforts.
Our practice utilizes a number of vendors in conducting business. Some of these vendors may
have access to PHI but agree to abide by the confidentiality rules of HIPPA.
We have all vendors agree to and sign a HIPPA Policy with our office.
As a patient, you agree to bring any suggestions, concerns or complaints regarding privacy to the
attention of Dr. Zech or the office staff so that they can be discussed and addressed in a timely
The practice agrees to provide the patient with access to their records in accordance with federal,
state and county laws.
The practice may modify any of these provision to better serve the needs of both the practice and