Home Notice of Privacy Practices (HIPAA)

Notice of Privacy Practices (HIPAA)

Effective Date: November 4th, 2025

Welcome to White Arch Dental. Your privacy and the protection of your health information are very important to us. This Notice explains how we may use and disclose your protected health information (PHI) and describes your rights regarding that information under the Health Insurance Portability and Accountability Act (HIPAA).

If you have any questions about this Notice, please contact us using the information at the bottom of this page.

Our Responsibilities

White Arch Dental is required by law to:

  • Maintain the privacy and security of your protected health information (PHI).
  • Provide you with this Notice describing our legal duties and privacy practices.
  • Notify you if a breach occurs that may have compromised your information.
  • Follow the terms of this Notice currently in effect.

How We Use and Share Your Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your dental care. For example, we may share your information with other healthcare providers, specialists, or dental labs involved in your care.

Payment

We may use and disclose your PHI to obtain payment for treatment and services provided. This may include sharing information with your insurance company or dental plan for billing, eligibility verification, and payment purposes.

Healthcare Operations

We may use your PHI to improve the quality of our services, conduct staff training, manage our business operations, and evaluate provider performance.

Other Permitted Uses and Disclosures

We may also disclose your PHI when required or permitted by law, including for:

  • Public health and safety activities (e.g., reporting disease or injury).
  • Health oversight (e.g., audits, inspections, or licensure).
  • Legal or administrative proceedings (e.g., court orders or subpoenas).
  • Law enforcement purposes.
  • Workers’ compensation claims.
  • Research (under approved safeguards).
  • Business associates who perform services for us under written agreements requiring them to protect your information.

Uses and Disclosures Requiring Your Authorization

We will not use or share your PHI for purposes other than those described in this Notice unless you authorize it in writing. This includes:

  • Marketing communications not related to your treatment;
  • The sale of your health information;
  • Most uses of psychotherapy notes (if applicable).

You may revoke your authorization at any time by submitting a written request.

Your Rights

You have important rights regarding your protected health information:

  • Access: You can request to view or receive a copy of your dental records.
  • Amendment: You may request corrections to your records if you believe they are inaccurate or incomplete.
  • Accounting of Disclosures: You can request a list of certain disclosures we’ve made of your PHI.
  • Restrictions: You can ask us to limit how we use or share your information. While we are not required to agree, we will consider your request.
  • Confidential Communications: You may request that we contact you through specific means (for example, only at work or by mail).
  • Copy of This Notice: You can request a paper copy of this Notice at any time, even if you’ve received it electronically.

To exercise any of these rights, please contact our Privacy Officer (contact information below).

Changes to This Notice

We may update this Notice at any time. Updates will apply to all health information we maintain and will be posted in our office and on our website. The effective date at the top of this page indicates the most recent revision.

Questions or Complaints

If you have any questions about this Notice or believe your privacy rights have been violated, please contact:

Privacy Officer
White Arch Dental 325 Ayer Road Suite B/110AHarvard, MA 01451
Phone: (978) 772-6658
Email: info@whitearchdental.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

Acknowledgment

Patients will be asked to sign an acknowledgment confirming receipt of this Notice at their first appointment.

White Arch Dental Committed to protecting your health information and providing high-quality care with integrity.