Last updated [February 16th, 2026]
NOTICE OF PRIVACY PRACTICES
This notice describes how medical and/or dental information about you may be used and disclosed,and how you can get access to this information. Please review it carefully.
This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) under federal law, including the Health Insurance Portability and Accountability Act (HIPAA), and applicable Tennessee confidentiality laws. It explains your rights, our responsibilities, and how federal and Tennessee law work together to protect your privacy.
We are required by law to maintain the privacy and security of your information, to provide you with this Notice, and to follow the terms of this Notice. We may change the terms of this Notice at any time. Anyrevised Notice will apply to all information we maintain and will be available upon request, in our office, or on our website.
A.Uses and Disclosures of Information
USES AND DISCLOSURES BASED ON YOUR IMPLIED CONSENT
When you receive care in our office, you imply consent for us to use and disclose your information for the following purposes. These uses are permitted by HIPAA and Tennessee law.
Treatment
We may use and disclose your information to provide, coordinate, or manage your dental or medical care. Examples include:
- Sharing records, X-rays, or chart notes with specialists
- Sending treatment specifications to laboratories
- Communicating with pharmacies regarding prescriptions
- Coordinating follow-up care with other providers
Payment
We may use and disclose your information to obtain payment for services, including:
- Submitting claims to health or dental plans
- Verifying coverage and eligibility
- Obtaining prior authorizations
- Responding to utilization review requests
Health Care Operations
We may use and disclose your information for practiceoperations, such as:
- Quality improvement activities
- Staff training and evaluation
- Licensing, accreditation, and compliance
- Use of sign-in sheets or calling your name in the waiting area
Example: Limited information may be disclosed to interns, students, or trainees involved in your care.
Business Associates
We may disclose your information to third-party “Business Associates” (billing services, IT support, transcription services, secure data storage providers). Business Associates arerequired by law to protect your information.
Appointment Reminders and Communication
We may contact you by phone, text, email, or mail regarding appointments, treatment, or health-related services. You may request alternativecommunication methods.
USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION
Certain uses and disclosures require your written authorization, including:
- Marketing communications not conducted face-to-face
- Sale of your information
- Most disclosures of psychotherapy notes
- Disclosures to employers or third parties not involved in your care
You may revoke an authorization any time in writing, except to the extent we have already relied on it.
USES AND DISCLOSURES WITH YOUR AUTHORIZATION OR OPPORTUNITY TO OBJECT
Family Members and Others Involved in Care
Unless you object, we may share information with a spouse, partner, family member, or friend involved in your care or payment.
Disaster Relief
We may disclose limited information to authorized organizations assisting withdisaster response. If you are unavailable, we may use our professional judgment to decide whatis in your best interest.
USES AND DISCLOSURES WITHOUT YOUR CONSENT, AUTHORIZATION, OR OPPORTUNITY TO OBJECT
We may use or disclose your information without consent in the following situations:
Required by Law
When federal or state law requires disclosure.
Abuse or Neglect
To report child, elder, or dependent adult abuse or neglect.
Health Oversight
For audits, investigations, or inspections by government agencies.
Legal Proceedings
In response to a court or administrative order, or in certain cases, a lawful subpoena.
Law Enforcement
For limited purposes such as locating a suspect, reporting a crime, or emergencies.
Coroners and Medical Examiners
For identification or cause of death.
Organ Donation
To organ procurement organizations when appropriate.
Workers’ Compensation
To comply with workers’ compensation or similar programs.
National Security and Military
For authorized national security, intelligence, or military purposes.
SPECIAL PROTECTIONS FOR REPRODUCTIVE HEALTH INFORMATION
Information related to reproductive health care may be subject to additional privacy protections underfederal law and our internal privacy practices.
- We may use and disclose reproductive health information for treatment, payment, and healthcare operations as permitted by law.
- We will not use or disclose reproductive health information for the purpose of investigating orimposing liability on an individual for seeking, obtaining, providing, or facilitating lawfulreproductive health care.
- Other uses and disclosures require your written authorization or must otherwise be permitted orrequired by law.
B. Your Rights
You have the following rights regarding your protected health information:
Inspect and Copy
Review or obtain a copy of your records, subject to legal limits
Request Restrictions
Request limits on uses or disclosures (not always required to be honored)
Confidential Communications
Request alternative communication methods or locations
Amendment
Request corrections to your records
Accounting of Disclosures
Request a list of certain disclosures made in the past six years
Paper Copy
Request a paper copy of this Notice at any time
Breach Notification
Be notified if a breach occurs
C. Our Responsibilities
We are required by law to:
- Maintain the privacy and security of your information
- Notify you if a breach occurs
- Use and disclose your information only as described in this Notice
- Follow the more protective rule when federal and Tennessee laws differ
D. Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Our Office
Contact our Privacy Officer in writing
U.S. Department of Health and Human Services, Office for Civil Rights (OCR).
We will not retaliate against you for filing a complaint.
CONTACT US
If you have questions or comments about this Privacy Policy, please contact us at:
Phone Number
615-331-9033
Email Address
office@nashvillesmileteam.com
Address
5437 Edmondson Pike, Nashville, TN 37211, United States