Notice of Privacy Practices
HIPAA Compliance Notice
Effective Date: January 1, 2025
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Commitment to Your Privacy
Al Jinan Clinic is required by law to maintain the privacy of your Protected Health Information (PHI) and to provide you with this Notice of our legal duties and privacy practices with respect to your PHI.
We are required to abide by the terms of this Notice currently in effect. We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all PHI that we maintain.
How We May Use and Disclose Your Health Information
For Treatment
We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services.
Example: Your dentist may share your dental x-rays with a specialist for consultation on your treatment plan.
For Payment
We may use and disclose your PHI to obtain payment for services we provide to you.
Example: We may send your insurance company information about your treatment to obtain payment or verify coverage.
For Healthcare Operations
We may use and disclose your PHI for our healthcare operations, including quality assessment and improvement activities.
Example: We may use your information to evaluate the performance of our staff or to train dental students.
Other Uses and Disclosures
We may also use or disclose your PHI in the following situations:
Appointment Reminders
To remind you of upcoming appointments via phone, email, SMS, or WhatsApp
Treatment Alternatives
To inform you about treatment options or health-related benefits
As Required by Law
When required by federal, state, or local law
Public Health Activities
To prevent or control disease, injury, or disability
Health Oversight
To authorized health oversight agencies
Legal Proceedings
In response to court orders or lawful subpoenas
Your Rights Regarding Your Health Information
You have the following rights regarding your PHI:
Right to Inspect and Copy
You have the right to inspect and obtain a copy of your medical records and billing records.
Right to Amend
You have the right to request an amendment to your PHI if you believe it is incorrect or incomplete.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures we have made of your PHI.
Right to Request Restrictions
You have the right to request restrictions on certain uses and disclosures of your PHI.
Right to Request Confidential Communications
You have the right to request that we communicate with you about your PHI by alternative means or at alternative locations.
Right to a Paper Copy of This Notice
You have the right to obtain a paper copy of this Notice upon request.
How to Exercise Your Rights
To exercise any of your rights, please submit a written request to:
Privacy Officer
Al Jinan Clinic
[Clinic Address - Medical District]
Email: privacy@aljinanclinic.com
Phone: +966 50 123 4567
Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Our Privacy Officer
Contact information listed above
U.S. Department of Health and Human Services
Office for Civil Rights
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/
You will not be penalized or retaliated against for filing a complaint.
Changes to This Notice
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for PHI we already have about you as well as any information we receive in the future. We will post a copy of the current Notice in our clinic and on our website. The Notice will contain the effective date on the first page.
Acknowledgment of Receipt
By using our services, you acknowledge that you have received and reviewed this Notice of Privacy Practices. If you have any questions about this Notice, please contact our Privacy Officer.
This Notice is effective as of January 1, 2025, and will remain in effect until replaced or amended.