Notice of Privacy Practices
MOUNTAIN VISTA DENTAL
NOTICE OF PRIVACY PRACTICES
Effective Date: March 1, 2026
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.
OUR COMMITMENT TO YOUR PRIVACY
Mountain Vista Dental is required by law to maintain the privacy and security of your Protected Health Information (PHI). We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this Notice and provide you with a copy upon request. WHAT IS PROTECTED HEALTH INFORMATION (PHI)?
Protected Health Information (PHI) is information that identifies you and relates to your past, present, or future physical or mental health condition, treatment, or payment for healthcare services.
Examples include dental records, clinical notes, x-rays, photographs, medical histories, insurance information, and billing records.
HOW WE MAY USE AND DISCLOSE YOUR INFORMATION
Treatment
To provide, coordinate, or manage your dental care. This may include sharing information with specialists, laboratories, hygienists, or other healthcare providers involved in your care.
Payment
To bill and collect payment from you, your insurance company, or a third party. This includes claims submission, benefit verification, pre-authorization, and sending billing statements to you.
Healthcare Operations
For practice operations such as quality improvement, staff training, licensing, accreditation, compliance activities, audits, and general business management.
As Required by Law
When required by federal, state, or local law.
Public Health and Safety
For public health activities, reporting abuse or neglect, preventing serious threats to health or safety, or complying with regulatory oversight agencies.
Legal and Governmental Activities
In response to court orders, subpoenas, workers’ compensation claims, law enforcement requests, military or national security activities, or other specialized government functions.
ELECTRONIC COMMUNICATIONS
We may communicate with you electronically regarding appointments, treatment, billing, and insurance matters. Electronic communication methods may include email, text message (SMS), or patient portal messaging. While we use reasonable safeguards, standard email and text messages may not always be encrypted and may carry some risk of unauthorized access.
By providing your email address or mobile number, you consent to receive electronic communications unless you notify us otherwise. You may request communication only through a secure portal, paper statements only, or no electronic communication by notifying us in writing.
SPECIAL PROTECTIONS FOR SUBSTANCE USE DISORDER RECORDS
Certain records relating to substance use disorder diagnosis, treatment, or referral may be protected under federal law (42 CFR Part 2). If applicable, these records generally may not be disclosed without your written consent, even for treatment, payment, or operations, unless permitted by law. They may not be used in legal proceedings without your written consent or a qualifying court order and are protected from unauthorized redisclosure.
YOUR RIGHTS
You have the right to inspect and obtain a copy of your PHI in paper or electronic format.
You may request an amendment to information you believe is incorrect or incomplete.
You may request restrictions on certain uses or disclosures. If you pay out-of-pocket in full for a service, you may request that we not share that information with your health insurer for payment or operations purposes, and we will comply unless required by law.
You may request confidential communications in a specific manner.
You may request an accounting of disclosures made in the past six years, excluding treatment, payment, and operations disclosures. One accounting per year is free; additional requests within 12 months may incur a reasonable fee. You may request a paper copy of this Notice at any time.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with:
Privacy Officer
Kathryn Carlson
Mountain Vista Dental
719-598-8886
Or with the U.S. Department of Health and Human Services, Office for Civil Rights at www.hhs.gov/ocr/privacy/hipaa. You will not be retaliated against for filing a complaint.
OTHER USES AND DISCLOSURES
We will not use or disclose your PHI for purposes not described in this Notice without your written authorization. You may revoke an authorization at any time in writing.
We do not sell your protected health information.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice. Any revised Notice will apply to all PHI we maintain. Updated versions will be available in our office, on our website (if applicable), and upon request.