Notice of Privacy Practices

Effective date: September 8, 2026

Who We Are

This notice applies to Austin Periodontal Associates, 7800 N Mopac Expy, Suite 310, Austin, TX 78759, and to every doctor, employee, and contractor who works here. We are required by federal law (the Health Insurance Portability and Accountability Act, HIPAA) and by Texas law to keep your health information private, to give you this notice of our legal duties and privacy practices, and to follow the notice currently in effect.

Your Health Information

“Protected health information” means information that identifies you and relates to your past, present, or future health, the care you receive, or payment for that care. It includes your chart, radiographs and photographs, treatment plans, billing records, and the conversations we have about your care.

How We May Use and Share Your Information Without Your Written Authorization

For treatment. We use your information to examine, diagnose, and treat you, and we share it with other providers involved in your care. Most commonly that means your referring general dentist, who receives a written report after each of your visits here, and any physician or specialist whose input is needed for your care, such as for medical clearance before sedation or surgery.

For payment. We use and share your information to bill and collect payment for your care: to verify your benefits, to file claims with your dental or medical insurer, to answer an insurer’s questions about the treatment, and to work with a financing company you have chosen to use.

For health care operations. We use your information to run the practice: quality review, training staff, business planning, credentialing, and audits. We may share it with the companies that provide services to us under written agreements that require them to protect it, such as our practice-management software vendor, patient-communication service, and secure record-exchange service.

Appointment reminders and care information. We may call, text, email, or mail you to remind you of appointments and to give you information about treatment options and post-operative care. Tell us if you would prefer a particular method or would rather not be contacted a certain way.

People involved in your care. With your agreement, or when you are unable to object and we judge it to be in your interest, we may share relevant information with a family member, close friend, or the person who is driving you home after sedation.

As required or permitted by law. We may share information when the law requires it, including to public health authorities; to report abuse, neglect, or domestic violence; to health oversight agencies for audits and licensing; in response to a court order, subpoena, or other lawful process; to law enforcement in limited circumstances; to a coroner, medical examiner, or funeral director; for organ donation; to avert a serious threat to health or safety; for workers’ compensation claims; and to the Department of Health and Human Services to show we are complying with privacy law.

Business associates. Companies that perform services for us and need your information to do so sign agreements that bind them to the same protections we follow.

Uses and Disclosures That Require Your Written Authorization

We will not do the following without your signed authorization: use your information for marketing; sell your information; share psychotherapy notes, if any exist; or publish your photographs, including before-and-after clinical photographs, on our website, social media, or in any other public setting. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

If we receive records protected under the federal substance-use-disorder confidentiality rules (42 CFR Part 2), we will not use or disclose them in any civil, criminal, administrative, or legislative proceeding against you without your written consent or a court order.

Reviews you post publicly on Google, Yelp, or similar sites are your own statements. We will not confirm or deny that you are a patient or discuss your care in a public reply. If we wish to quote your review on our own website, we do so only with your signed HIPAA authorization, which you may revoke at any time.

Notice Under Texas Health and Safety Code §181.154

Your health information may be disclosed electronically, for example in reports sent to your referring dentist, claims sent to your insurer, and records exchanged with other providers through a secure service. Except as permitted by law, we obtain your authorization before electronically disclosing your health information to anyone who is not another health care provider or covered entity involved in your care, payment, or operations.

Your Rights

To see and get a copy of your record. Ask in writing. We will provide it, usually within 15 business days under Texas law, in the form you request if we can reasonably do so, including electronically. We may charge a reasonable cost-based fee for copies. We can deny access in limited circumstances, and you may ask for that decision to be reviewed.

To ask us to correct your record. If you believe information is wrong or incomplete, ask in writing and tell us why. We may decline in certain cases and will explain in writing. You may then add a statement of disagreement to your record.

To ask for confidential communications. You may ask us to contact you a specific way, for example only at a certain phone number or only by mail. We will accommodate reasonable requests.

To ask us to limit what we share. You may ask us to restrict how we use or share your information for treatment, payment, or operations, or with people involved in your care. We are not required to agree, except that if you pay in full out of pocket for a service and ask us not to tell your insurer about it, we will honor that request unless the law requires the disclosure.

To get a list of disclosures. You may ask for an accounting of the disclosures we have made of your information in the six years before your request, other than for treatment, payment, and operations and certain other exceptions. The first list in a twelve-month period is free.

To be notified of a breach. We will tell you if a breach occurs that may have compromised the privacy or security of your information.

To a paper copy of this notice. Ask at any time, even if you agreed to receive it electronically. It is also posted in our office and on our website.

To choose someone to act for you. A person with medical power of attorney or a legal guardian can exercise your rights and make choices about your information. We will verify the person’s authority before acting.

Our Responsibilities

We are required by law to keep your information private and secure, to notify you promptly if a breach may have compromised your information, to follow the duties and privacy practices described in this notice and give you a copy of it, and not to use or share your information other than as described here unless you tell us in writing that we may. We reserve the right to change this notice. Changes apply to all information we hold. The current notice is always available in our office and at austinperiodontal.com.

Questions and Complaints

Privacy officer: Andrew Verrett, DDS, MS, Austin Periodontal Associates, 7800 N Mopac Expy, Suite 310, Austin, TX 78759. Phone (512) 346-6097. Email sarah@austinperiodontal.com.

If you believe your privacy rights have been violated, you may file a complaint with us using the contact above, or with the U.S. Department of Health and Human Services Office for Civil Rights by visiting hhs.gov/hipaa/filing-a-complaint, calling 1-800-368-1019, or writing to 200 Independence Avenue SW, Washington, DC 20201. We will not retaliate against you for filing a complaint.