THIS NOTICE DESCRIBES HOW MEDICAL AND DENTAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Last Updated: October, 2026
Our Commitment to Your Privacy
At Sky Dental, we are committed to protecting your Protected Health Information (PHI). PHI includes details about your dental history, treatments, billing, and health insurance. We are required by federal law (HIPAA) and New York State law to maintain the privacy of your PHI, provide you with this Notice of our legal duties and privacy practices, and notify you following a breach of unencrypted PHI.
1. How We May Use and Disclose Your Dental Information
We may use and share your health information for the following purposes without your explicit written authorization:
- For Treatment: We can use your PHI to provide, coordinate, or manage your dental care. For example, our dentists may share your X-rays and charts with a specialist (e.g., an endodontist or oral surgeon) to whom you are being referred.
- For Payment: We use and disclose your PHI to bill and collect payment from you, your insurance company, or third-party payers. For example, we submit your dental treatment codes to your insurance provider to process claims for your cleanings or fillings.
- For Healthcare Operations: We use your PHI to run our practice, improve patient care, and evaluate staff performance. For example, we may use your information to assess the quality of dental treatments provided in our clinic.
- Appointment Reminders & Service Options: We may use your information to contact you via phone, text, or email as a reminder for an upcoming cleaning or to inform you about treatment alternatives.
- Required by Law: We will disclose your PHI when mandated by federal, state, or local NYC laws (e.g., reporting public health risks or responding to a court order).
2. Uses and Disclosures That Require Your Written Authorization
We must obtain your explicit written authorization before using or sharing your PHI for any of the following:
- Marketing Purposes: We will never use your PHI for marketing campaigns, nor sell your data to third-party companies, without your clear written consent.
- Psychotherapy/Sensitive Notes: Any highly restricted clinical notes, if applicable, require explicit authorization.
- Other Uses: Any uses or disclosures not explicitly covered in this Notice will only be made with your written permission, which you can revoke at any time.
3. Your Individual Rights Regarding Your Dental Information
As a patient of a New York dental practice, you have specific, heightened rights under NYS Public Health Law § 18 and federal HIPAA regulations:
- Right to Inspect and Copy Your Records: You have the right to look at or get electronic/paper copies of your dental and billing records.
- New York Special Timeline: Under NY law, we must make your records available for inspection or provide copies within 10 calendar days of receiving your written request.
- Fees: We may charge a reasonable, cost-based fee for copies, which under NYS law cannot exceed $0.75 per page for paper copies, or the actual cost of duplication for digital media/X-rays.
- Right to Request Restrictions: You can ask us not to use or share certain PHI for treatment, payment, or operations. While we are not always required to agree, we must comply if you pay for a dental service entirely out-of-pocket and ask us not to share that data with your health insurance company.
- Right to Request Confidential Communications: You can ask us to contact you in a specific way (e.g., home phone only) or at a specific address. We will accommodate all reasonable requests.
- Right to Amend Your Records: If you feel your dental record is incorrect or incomplete, you can request a written amendment. We may deny this if the record was not created by us, but we will provide a written explanation.
- Right to an Accounting of Disclosures: You can request a list of times we shared your PHI for reasons other than treatment, payment, healthcare operations, or those you explicitly authorized.
- Right to a Paper Copy: Even if you are reading this on our website, you have the right to request a physical paper copy of this Notice at our front desk at any time.
4. Safeguards & New York SHIELD Act Compliance
In accordance with the HIPAA Security Rule and the New York State SHIELD Act, our practice utilizes strict administrative, physical, and technical safeguards. We encrypt digital patient portals, secure electronic transmissions, and require comprehensive Business Associate Agreements (BAAs) from any website hosts or IT providers handling your digital data.
5. Complaints and Contact Information
If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
To exercise any of your rights or file a complaint with our practice, please contact our Compliance Officer:
Mark Garrett at mark@skydentalnyc.com
Or via written correspondence at 111 Broadway, Suite 1304, New York, NY 10006
