Alpers Family & Cosmetic Dentistry

This notice describes how dental and health information about you may be used and disclosed, and how you can access this information. Please review it carefully.

Alpers Family and Cosmetic Dentistry

7500 E. McDonald Drive, Suite 101B

Scottsdale, Arizona 85250

Phone: (480) 998-3355

Email: frontoffice@alpersdentistry.com

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Effective Date: June 9, 2026

THIS NOTICE DESCRIBES HOW MEDICAL AND DENTAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

OUR COMMITMENT TO YOUR PRIVACY

At Alpers Family and Cosmetic Dentistry, we are committed to protecting the privacy and security of your protected health information (“PHI”). We maintain records regarding your treatment, payment for services, and healthcare operations. Federal and state laws require us to safeguard this information and provide you with this Notice explaining our legal duties and privacy practices.

We are required by law to:

Maintain the privacy and security of your protected health information;

Provide you with this Notice of our legal duties and privacy practices;

Follow the terms of the Notice currently in effect;

Notify you promptly if a breach occurs that may have compromised the privacy or security of your information; and

Obtain your written authorization for uses and disclosures not otherwise permitted by law.

HOW WE MAY USE AND DISCLOSE YOUR INFORMATION

1. Treatment

We may use and disclose your health information to provide, coordinate, and manage your dental care.

Examples include:

·  Communicating with specialists, laboratories, pharmacies, physicians, or other healthcare providers;

·  Reviewing diagnostic images and treatment records;

·  Coordinating implant, periodontal, cosmetic, restorative, or emergency treatment;

·  Consulting with referring providers regarding your care.

2. Payment

We may use and disclose your information to obtain payment for services provided.

Examples include:

·  Billing insurance companies;

·  Verifying insurance eligibility and benefits;

·  Submitting claims and pre-authorizations;

·  Processing patient payments;

·  Utilizing third-party payment services and financing providers;

·  Managing outstanding account balances.

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3. Healthcare Operations

We may use and disclose information for activities necessary to operate our practice.

Examples include:

·  Quality assessment and improvement activities;

·  Staff training and education;

·  Licensing and accreditation;

·  Risk management and compliance activities;

·  Internal audits and business planning;

·  Administrative operations.

4. Appointment Reminders and Patient Communications

We may contact you regarding:

·  Appointment reminders;

·  Treatment recommendations;

·  Follow-up care;

·  Preventive services;

·  Practice-related announcements.

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Communications may occur through:

·  Telephone calls;

·  Voicemail messages;

·  Text messages;

·  Email;

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Secure electronic communication platforms.

You may request alternative communication methods or restrictions where reasonable.

5. Telehealth and Virtual Consultations

When appropriate, we may communicate with you through telehealth technologies, virtual consultations, or secure video conferencing platforms for treatment planning, consultations, follow-up care, or patient education.

6. Electronic Scheduling and Digital Services

We may utilize electronic scheduling systems, digital intake forms, electronic records systems, treatment planning software, and other healthcare technologies to support patient care and administrative functions.

7. Individuals Involved in Your Care

Unless you object, we may share relevant information with family members, caregivers, or others involved in your care or payment for your care when appropriate.

8. Business Associates

We may share information with trusted third-party service providers who perform services on our behalf.

Examples may include:

·  Practice management software providers;

·  Scheduling and communication vendors;

·  IT service providers;

·  Billing companies;

·  Payment processing companies;

·  Cloud storage providers;

·  Legal and accounting consultants.

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These organizations are legally and contractually required to protect your information.

9. Research

We may use or disclose information for research purposes when permitted by law and subject to appropriate privacy protections.

10. De-Identified Information

We may use information that has been de-identified in accordance with HIPAA standards. Such information cannot reasonably identify you and may be used to improve healthcare delivery, quality initiatives, educational programs, and operational effectiveness.

11. Health Information Exchange

We may participate in electronic information-sharing systems that facilitate treatment, payment, and healthcare operations among healthcare providers and health plans.

12. Public Health and Legal Requirements

We may disclose information when required or permitted by law, including:

·  Public health reporting;

·  Health oversight activities;

·  Court orders and legal proceedings;

·  Law enforcement requests;

·  Workers’ compensation claims;

·  Reporting abuse, neglect, or domestic violence;

·  Preventing serious threats to health or safety.

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ARTIFICIAL INTELLIGENCE AND ADVANCED TECHNOLOGY

As part of our commitment to providing high-quality care and operational excellence, we may utilize secure technologies, including artificial intelligence-assisted tools, to support healthcare operations.

Examples may include:

·  Diagnostic image analysis;

·  Clinical documentation assistance;

·  Treatment planning support;

·  Patient communication workflows;

·  Administrative efficiency tools.

These technologies are utilized under the supervision of licensed professionals and remain subject to HIPAA privacy and security requirements. Artificial intelligence tools are not permitted to independently diagnose, prescribe treatment, or replace professional clinical judgment.

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PHOTOGRAPHY, TESTIMONIALS, AND MARKETING

We may take clinical photographs, intraoral photographs, radiographs, scans, and other images as part of your treatment record.

Use of your information for marketing purposes generally requires your written authorization.

For cosmetic cases, before-and-after photographs, testimonials, social media content, website content, educational materials, or other promotional uses, we will obtain appropriate written authorization when required by law.

You may revoke an authorization in writing at any time, except to the extent action has already been taken in reliance upon that authorization.

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YOUR RIGHTS

You have the following rights regarding your health information:

1. Right to Access Records

You have the right to inspect and obtain a copy of your records in paper or electronic form, subject to limited exceptions permitted by law.

2. Right to Request Amendment

You may request correction or amendment of information you believe is inaccurate or incomplete.

3. Right to an Accounting of Disclosures

You may request a list of certain disclosures made outside of treatment, payment, and healthcare operations.

4. Right to Request Restrictions

You may request restrictions on certain uses or disclosures of your information.

While we are not required to agree to all requested restrictions, we will comply with a request not to disclose information to a health plan regarding services for which you have paid entirely out-of-pocket, as required by law.

5. Right to Confidential Communications

You may request that we communicate with you through alternative means or at alternative locations.

We will accommodate reasonable requests.

6. Right to Receive a Paper Copy

You may obtain a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

7. Right to Designate a Personal Representative

A person legally authorized to act on your behalf may exercise your rights under applicable law.

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COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with:

Privacy Officer

Alpers Family and Cosmetic Dentistry

7500 E. McDonald Drive, Suite 101B

Scottsdale, Arizona 85250

Email: frontoffice@alpersdentistry.com

Phone: (480) 998-3355

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.

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CHANGES TO THIS NOTICE

We reserve the right to modify this Notice at any time. Any revised Notice may apply to information we already maintain, as well as information received in the future.

The current version will be available in our office and on our website.

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QUESTIONS

If you have questions about this Notice or our privacy practices, please contact our Privacy Officer at:

frontoffice@alpersdentistry.com

(480) 998-3355

Alpers Family and Cosmetic Dentistry

Scottsdale, Arizona

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HIPAA Privacy Officer Contact Information

Privacy Officer
Alpers Family and Cosmetic Dentistry
7500 E. McDonald Drive, Suite 101B
Scottsdale, AZ 85250

Phone:(480) 998-3355

Email: frontoffice@alpersdentistry.com