399 East 72nd Street Suite 1A
Between First and York Avenues
New York, NY 10021
(212) 988-8822
(212) 988-8858 Fax

   Simon W Rosenberg, DMD

Prosthodontics and Cosmetic Dentistry
The Center for High Tech Dentistry
"Improving Smiles One Patient at a Time
Using High Tech with a Gentle Touch
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Web Privacy Policy and Notice of Privacy Practices for Protected Health Information

Simon W. Rosenberg, D.M.D.
399 E 72nd Street #1A
New York, NY 10021
Voice 212 988-8822 Fax: 212 988-8858
Email: HIPAA@DrSimonRosenberg.com

Notice of Privacy Practices for Protected Health Information
This notice describes how health information about you may be used and disclosed and how you can get access to this information.

Please review it carefully!
The Privacy of your Health Information is important to us.

With your consent, the practice is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. Protected health information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and test results, diagnoses, treatment, and applying for future care or treatment. It also includes billing documents for those services.

Example of uses of your health information for treatment purposes:

A nurse obtains treatment information about you and records it in a health record. During the course of your treatment, the doctor determines a need to consult with another specialist in the area. The doctor will share the information with such specialist and obtain input.

Example of use of your health information for payment purposes:

We submit a request for payment to your health insurance company. The health insurance company requests information from us regarding health care given. We will provide information to them about you and the care given.

Example of Use of Your Information for Health Care Operations:

We obtain services from our insurers or other business associates such as quality assessment, quality improvement, outcome evaluation, protocol and clinical guidelines development, training programs, credentialing, health review, legal services, and insurance. We will share information about you with such insurers or other business associates as necessary to obtain these services.

Your Health Information Rights

The health record we maintain and billing records are the physical property of the practice. The information in it, however, belongs to you. You have a right to:

  • ·   Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office. We are not required to grant the request but we will comply with any request granted; 
  • ·   Request that you be allowed to inspect and copy your health record and billing record — you may exercise this right by delivering the request in writing to our office; 
  • ·   Appeal a denial of access to your protected health information except in certain circumstances; 
  • ·   Request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to our office; 
  • ·   File a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information; 
  • ·   Obtain an accounting of disclosures of your health information as required to be maintained by law by delivering a written request to our office. An accounting will not  include internal uses of information for treatment, payment, or operations, disclosures made to you or made at your request, or disclosures made to family members or friends in the course of providing care; 
  • ·   Request that communication of your health information be made by alternative means or at an alternative location by delivering the request in writing to our office; and, 
  • ·   Revoke authorizations that you made previously to use or disclose information except to the extent information or action has already been taken by delivering a written revocation to our office. 
  • If you want to exercise any of the above rights, please contact Elina Solomon (our hygienist) or Dr. Simon W. Rosenberg, D.M.D.,  in person or in writing, during normal hours.  S[he]  will provide you with assistance on the steps to take to exercise your rights. 

Our Responsibilities

The practice is required to:

  • ·   Maintain the privacy of your health information as required by law; 
  • ·   Provide you with a notice of our duties and privacy practices as to the information we collect and maintain about you; 
  • ·   Abide by the terms of this Notice; 
  • ·   Notify you if we cannot accommodate a requested restriction or request; and 
  • ·   Accommodate your reasonable requests regarding methods to communicate health information with you. 
  • We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the Notice by calling and requesting a copy of our "Notice" or by visiting our office and picking up a copy. 

To Request Information or File a Complaint

If you have questions, would like additional information, or want to report a problem regarding the handling of your information, you may contact  Elina Solomon (our hygienist) or Dr. Simon W. Rosenberg, D.M.D.

Additionally, if you believe your privacy rights have been violated, you may file a written complaint at our office by delivering the written complaint to  Elina Solomon (our hygienist)  or to Dr. Rosenberg.  You may also file a complaint by mailing it or e-mailing it to the Secretary of Health and Human Services whose street address and e-mail address will be provided on request.

  • ·   We cannot, and will not, require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment from the practice. 
  • ·   We cannot, and will not, retaliate against you for filing a complaint with the Secretary. 
  • Other Disclosures and Uses 

Notification

Unless you object, we may use or disclose your protected health information to notify, or assist in notifying, a family member, personal representative, or other person responsible for your care, about your location, and about your general condition, or your death.

Communication with Family

Using our best judgment, we may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person's involvement in your care or in payment for such care if you do not object or in an emergency.

Food and Drug Administration (FDA)

We may disclose to the FDA your protected health information relating to adverse events with respect to products and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacements.

Workers Compensation

If you are seeking compensation through Workers Compensation, we may disclose your protected health information to the extent necessary to comply with laws relating to Workers Compensation.

Public Health

As required by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Abuse & Neglect

We may disclose your protected health information to public authorities as allowed by law to report abuse or neglect.

Disaster Relief

We may use and disclose your protected health information to assist in disaster relief efforts.

Correctional Institutions

If you are an inmate of a correctional institution, we may disclose to the institution, or its agents, your protected health information necessary for your health and the health and safety of other individuals.

Law Enforcement

We may disclose your protected health information for law enforcement purposes as required by law, such as when required by a court order, or in cases involving felony prosecutions, or to the extent an individual is in the custody of law enforcement.

Health Oversight

Federal law allows us to release your protected health information to appropriate health oversight agencies or for health oversight activities.

Judicial/Administrative Proceedings

We may disclose your protected health information in the course of any judicial or administrative proceeding as allowed or required by law, with your consent, or as directed by a proper court order.

Other Uses

Other uses and disclosures besides those identified in this Notice will be made only as otherwise authorized by law or with your written authorization and you may revoke the authorization as previously provided.

Web site

If we maintain a website that provides information about our entity, this Notice will be on the website.

Effective Date: April 14, 2003

You will be given the opportunity when you come into the office to confirm that you have read this by signing the declaration that follows:

I, (Name inserted), hereby acknowledge that I have received a copy of this practice’s Notice of Privacy Practices. I have been given the opportunity to ask any questions I may have regarding this Notice.

Website Privacy Policy

 We have created this privacy statement in order to demonstrate our firm and continuing commitment to the privacy of personal information provided by those visiting and interacting with this web site. We hold the privacy of your personal information in the highest regard. The following discloses our information gathering and dissemination practices for this website. 

We recognize the importance of protecting your privacy and our policy is designed to assist you in understanding how we collect, use and safeguard the personal information you provide to us and to assist you in making informed decisions when using our site. This policy will be continuously assessed against new technologies, business practices and our customers' needs.

Sharing and Selling Information
We do not share, sell, lend or lease any of the information that uniquely identify a subscriber or patient (such as email addresses or personal details) with anyone except to the extent it is necessary to process transactions or provide services that you have requested.

What Information Do We Collect?
When you visit this web site you may provide us with two types of information: personal information you knowingly choose to disclose that is collected on an individual basis and Web site use information collected on an aggregate basis as you and others browse our Web site.

1. Personal Information You Choose to Provide

Registration Information
When you register for any of our products, services or newsletters you will provide us information about yourself.

Credit Card Information
If you choose to avail of our services, you may need to give personal information and authorization to obtain information from various credit services. For example, you may need to provide the following information:
-Name
-Mailing address
-Email address
-Credit card number

-Name on credit card

-Credit card billing address
-Business and home phone number

Email Information
If you choose to correspond with us through email, we may retain the content of your email messages together with your email address and our responses. We provide the same protections for these electronic communications that we employ in the maintenance of information received by mail and telephone.


2. Web Site Use Information
Similar to other commercial Web sites, our Web site utilizes a standard technology called "cookies" (see explanation below, "What Are Cookies?") and web server log files to collect information about how our Web site is used. Information gathered through cookies and Web server logs may include the date and time of visits, the pages viewed, time spent at our Web site, and the Web sites visited just before and just after our Web site.

How Do We Use the Information That You Provide to Us?

Broadly speaking, we use personal information for purposes of administering our business activities, providing the products and services you requested, to process your payment, ,  to monitor the use of the service,  our marketing and promotional efforts  and  improve our content and service offerings, and customize our site's content, layout, services and for other lawful purposes. These uses improve our site and better tailor it to meet your needs.

Furthermore, such information may be shared with others on an aggregate basis. Personally identifiable information or business information will not be shared with parties except as required by law.

Occasionally, we may also use the information we collect to notify you about important changes to our Website, new services, and special offers we think you will find valuable. You may notify us at any time if you do not wish to receive these offers by emailing us at the link provided on the newsletter.

What Are Cookies?
A cookie is a very small text document, which often includes an anonymous unique identifier. When you visit a Web site, that site's computer asks your computer for permission to store this file in a part of your hard drive specifically designated for cookies. Each Web site can send its own cookie to your browser if your browser's preferences allow it, but (to protect your privacy) your browser only permits a Web site to access the cookies it has already sent to you, not the cookies sent to you by other sites. Browsers are usually set to accept cookies. However, if you would prefer not to receive cookies, you may alter the configuration of your browser to refuse cookies. If you choose to have your browser refuse cookies, it is possible that some areas of our site will not function as effectively when viewed by the users.
A cookie cannot retrieve any other data from your hard drive or pass on computer viruses.

How Do We Use Information We Collect from Cookies?
As you visit and browse our Web site, the site uses cookies to differentiate you from other users. In some cases, we also use cookies to prevent you from having to log in more than is necessary for security. Cookies, in conjunction with our Web server's log files, allow us to calculate the aggregate number of people visiting our Web site and which parts of the site are most popular. This helps us gather feedback to constantly improve our Web site and better serve our clients. Cookies do not allow us to gather any personal information about you and we do not intentionally store any personal information that your browser provided to us in your cookies.

IP Addresses
IP addresses are used by your computer every time you are connected to the Internet. Your IP address is a number that is used by computers on the network to identify your computer. IP addresses are automatically collected by our web server as part of demographic and profile data known as traffic data so that data (such as the Web pages you request) can be sent to you.

Sharing and Selling Information
We do not share, sell, lend or lease any of the information that uniquely identify a subscriber (such as email addresses or personal details) with anyone except to the extent it is necessary to process transactions or provide services that you have requested.

How Can You Access and Correct Your Information?
You may request access to all your personally identifiable information that we collect online and maintain in our database by emailing us at the usual address.

What About Legally Compelled Disclosure of Information?
We may disclose information when legally compelled to do so, in other words, when we, in good faith, believe that the law requires it or for the protection of our legal rights. We may also disclose account information when we have reason to believe that disclosing this information is necessary to identify, contact or bring legal action against someone who may be violating our Terms of Service or to protect the safety of our users and the Public.

What About Other Web Sites Linked to Our Web Site?
We are not responsible for the practices employed by Web sites linked to or from our Web site or the information or content contained therein. Often links to other Web sites are provided solely as pointers to information on topics that may be useful to the users of our Web site.

Please remember that when you use a link to go from our Website to another web site, our Privacy Policy is no longer in effect. Your browsing and interaction on any other web site, including web sites, which have a link on our Website, is subject to that Web site's own rules and policies. Please read over those rules and policies before proceeding.

Your Consent
By using our Web site you consent to our collection and use of your personal information as described in this Privacy Policy. We reserve the right to amend this privacy policy at any time with or without notice.

Our Commitment To Data Security:

Please note that your information will be stored and processed on our computers in the United States. The laws on holding personal data in the United States may be less stringent than the laws of your Country of residence or citizenship. To prevent unauthorized access, maintain data accuracy, and ensure the correct use of information, we have put in place appropriate physical, electronic, and managerial procedures to safeguard and secure the information we collect online.

Choice/Opt-In/Opt-Out
This site allows visitors to unsubscribe so that they will not receive future messages. After unsubscribing we will discontinue sending the particular messages as soon as technically feasible.

Surveys & Contests

From time-to-time our site requests information from users via surveys or contests. Participation in these surveys or contests is completely voluntary and the user therefore has a choice whether or not to disclose this information. Information requested may include contact information (such as name and shipping address), and demographic information (such as zip code, age level). Contact information will be used to notify the winners and award prizes. Survey information will be used for purposes of monitoring or improving the use and satisfaction of this site.

A Special Note About Children

Children are not eligible to use our services unsupervised and we ask that children (under the age of 14) do not submit any personal information to us. If you are a minor, you can use this service only in conjunction with permission and guidance from your parents or guardians.

Acquisition or Changes in Ownership

In the event that the web site (or a substantial portion of its assets) is acquired, your information would be considered part of those assets, and may be part of those assets that are transferred.

Policy Modifications
We may change this Privacy Policy from time to time. If/when changes are made to this privacy policy, we will email users who have given us permission to do so. We will post any changes here, so be sure to check back periodically. However, please be assured that if the Privacy Policy changes in the future, we will not use the personal information you have submitted to us under this Privacy Policy in a manner that is materially inconsistent with this Privacy Policy, without your prior consent.

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Sat: Closed
Sun: Closed

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