Signature Orthodontics Privacy Policy
Here at Signature Orthodontics, we are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect 9/23/2013 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 protected health information that we maintain. When we make a significant change in our privacy practices, we will change this Notice and post the new Notice clearly and prominently at our practice location, and we will provide copies of the new Notice upon request.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
We may use and disclose your health information for different purposes, including treatment, payment, and health care operations. For each of these categories, we have provided a description and an example. Some information, such as HIV-related information, genetic information, alcohol and/or substance abuse records, and mental health records may be entitled to special confidentiality protections under applicable state or 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 health information for your treatment. For example, we may disclose your health information to a specialist providing treatment to you.
Payment. We may use and disclose your health information to obtain reimbursement for the treatment and services you receive from us or another entity involved with your care. 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, we may send claims to your dental health plan containing certain health information.
Healthcare Operations. We may use and disclose your health information in connection with our healthcare operations. For example, healthcare operations include quality assessment and improvement activities, conducting training programs, and licensing activities.
Individuals Involved in Your Care or Payment for Your Care. We may disclose your health information to your family or friends or any other individual identified by you when they are involved in your care or in the payment for your care. Additionally, we may disclose information about you to a patient representative. If a person has the authority by law to make health care decisions for you, we will treat that patient representative the same way we would treat you with respect to your health information.
Public Health Activities. We may disclose your health information for public health activities, including disclosures to:
o Prevent or control disease, injury or disability;
o Report child abuse or neglect;
o Report reactions to medications or problems with products or devices;
o Notify a person of a recall, repair, or replacement of products or devices;
o Notify a person who may have been exposed to a disease or condition; or
o Notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.
National Security. We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institution or law enforcement official having lawful custody the protected health information of an inmate or patient.
Worker’s Compensation. We may disclose your PHI to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.
Law Enforcement. We may disclose your PHI for law enforcement purposes as permitted by HIPAA, as required by law, or in response to a subpoena or court order.
Health Oversight Activities. We may disclose your 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 health care system, government programs, and compliance with civil rights laws.
Judicial and Administrative Proceedings. If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process instituted by someone else involved in the dispute, but only if efforts have been made, either by the requesting party or us, to tell you about the request or to obtain an order protecting the information requested.
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 taken action in reliance on the authorization.
Your Health Information Rights
Access. You have the right to look at or get copies of your health information, with limited exceptions. You must make the request in writing. You may obtain a form to request access by using the contact information listed at the end of this Notice. You may also request access by sending us a letter to the address at the end of this Notice. If you request information that we maintain on paper, we may provide photocopies.
If you request information that we maintain electronically, you have the right to an electronic copy. We will use the form and format you request if readily producible. We will charge you a reasonable cost-based fee for the cost of supplies and labor of copying, and for postage if you want copies mailed to you. Contact us using the information listed at the end of this Notice for an explanation of our fee structure.
If you are denied a request for access, you have the right to have the denial reviewed in accordance with the requirements of applicable law.
Alternative Communication. You have the right to request that we communicate with you about your health information by alternative means or at alternative locations. You must make your request in writing. Your request must specify the alternative means or location, and provide satisfactory explanation of how payments will be handled 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 information we have.
Amendment. You have the right to request that we amend your health information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request under certain circumstances. If we agree to your request, we will amend your record(s) and notify you of such. If we deny your request for an amendment, we will provide you with a written explanation of why we denied it and explain your rights.
We will not share your opt-in to an SMS campaign with any third party for purposes unrelated to providing you with the services of that campaign. We may share your Personal Data, including your SMS opt-in or consent status, with third parties that help us provide our messaging services, including but not limited to platform providers, phone companies, and any other vendors who assist us in the delivery of text messages.
All of the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.
SMS/Text Messaging Terms & Conditions
By providing your mobile phone number to Signature Orthodontics & Pediatric Dentistry, including through our website forms, appointment forms, texting registration forms, or other communication channels, you consent to receive text messages from Signature Orthodontics & Pediatric Dentistry related to your care, appointments, inquiries, and practice communications.
Types of Text Messages You May Receive
Text messages from Signature Orthodontics & Pediatric Dentistry may include, but are not limited to:
- Appointment confirmations, reminders, rescheduling notices, and follow-up messages
- Responses to inquiries submitted through our website or office communication channels
- Treatment-related updates, care instructions, and general patient communication
- Office updates, location information, scheduling availability, and administrative notices
- Billing, insurance, or account-related reminders when applicable
- Promotional or informational messages about services, offers, or practice announcements, where permitted by law and with appropriate consent
Message Frequency
Message frequency may vary depending on your interaction with our office, appointment schedule, treatment status, and communication preferences. You may receive recurring messages as needed for appointment reminders, follow-ups, and patient communication.
Message and Data Rates
Message and data rates may apply depending on your mobile carrier and plan. Signature Orthodontics & Pediatric Dentistry is not responsible for any charges imposed by your wireless carrier.
Opt-Out Instructions
You may opt out of receiving text messages at any time by replying STOP to any text message you receive from us. After you send STOP, you may receive one final confirmation message confirming that you have been unsubscribed. After that, you will no longer receive text messages from us unless you opt in again.
Help Instructions
For help, reply HELP to any text message you receive from us, or contact our office directly.
You may also contact us using the information available on our website. Signature Orthodontics & Pediatric Dentistry lists office contact numbers and email addresses for Woodbridge, Manassas, and Falls Church locations on the website.
Consent Is Not a Condition of Treatment
Your consent to receive text messages is not required as a condition of receiving dental or orthodontic treatment from Signature Orthodontics & Pediatric Dentistry. You may choose to communicate with us by phone, email, or other available methods.
Privacy and Confidentiality
Text messaging may not be a fully secure method of communication. Please avoid sending sensitive medical, dental, financial, or personal information by text message unless specifically instructed by our office through a secure process.
We respect your privacy. Information collected through texting registration and communication is handled according to our Privacy Policy. Please review our Privacy Policy here:
Privacy Policy: https://signatureorthodontics-pd.com/privacy-policy/
Terms and Conditions
Use of our website and communication services is also subject to our general Terms and Conditions. Please review them here:
Terms and Conditions: https://signatureorthodontics-pd.com/terms-and-conditions/
Supported Carriers
Text messaging services may not be available on all mobile carriers or in all areas. Delivery of text messages is subject to effective transmission by your mobile carrier and is not guaranteed.
Changes to SMS/Text Messaging Terms
Signature Orthodontics & Pediatric Dentistry may update these SMS/Text Messaging Terms from time to time. Any updates will be posted on this page. Your continued use of our texting services after changes are posted means you accept the updated terms.
Questions
If you want more information about our privacy practices or have questions or concerns, please contact us.
How to contact us
Use the contact information below to reach our privacy team with any questions, concerns, complaints, requests, or to exercise your data rights.
Our Privacy Official: Dr. Ehab BenNasir
Telephone: 571-260-6100
Address: 2701 Neabsco Common Place Suite 134 Woodbridge VA 22191
E-mail: Hello@signatureorthodontics-pd.com