Health care providers must comply with the Health
Insurance Portability and Accountability Act of 1996. A few basics for
dentists might be:
BROC-PRIV1 Notice of Privacy Practices Brochure
A dental office needs to provide a copy of the privacy
policy to all staff and document that it has been distributed.
A dental office needs to select a privacy officer who will make many of the decisions involved in implementing
person) needs to be selected to receive complaints.
A dental office needs to establish procedures for
A dental office needs to provide patients with a Notice
of Privacy Practices (See brochure-item BROC-PRIV1)
A dental office needs to make a good faith effort to obtain
a signature on an Acknowledgement of Receipt of Notice of
Privacy Practices (see form C-HIPAA).
A dental office needs to obtain a patient
authorization to use or disclose Protected Health Information (only if
if the office intends to use the information for purposes not
described in the office Notice of Privacy Practices)
If a dental office intends to share Protected Health
Information other than a referral for normal treatment, a Business
Associate Contract should be given to the entity receiving the
information. The office should obtain a copy of the contract.
A Privacy Kit specific for dentists is available from
- Simple yet thorough, six panel, black and white brochure-suitable
for mailing with statements or alone.
C-HIPAA Acknowledgement of Receipt of Notice of Privacy Practices
- Single sheet, black and white form to keep in your patient's
||(1-3 packages of 100 - $15 per package)
( 4+ packages of 100 - $12 per package)
Notice of Privacy
CLICK HERE FOR FRONT
CLICK HERE FOR BACK
Acknowledgement of Receipt of Notice of Privacy Practices
Here to PREVIEW
If you are having