Notice of Privacy Practices
YOUR RIGHTS
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
YOU HAVE THE RIGHT TO
Get an Electronic or Paper Copy of Your Dental Records
You can ask to see or get an electronic or paper copy of your dental records and other health information we have about you. Ask us how to do this.
We will provide a copy or a summary of your oral health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to Correct Your Dental Records
You can ask us to correct dental health information about you that you think is incorrect or incomplete. Ask us how to do this.
We may say “no” to your request, but we’ll explain to you why in writing within 60 days.
Request Confidential Communications
You can ask us to contact you in a specific way about your dental records information (for example, home or office phone) or to send your information to a different address.
We will say, “yes” to all reasonable requests.
Ask Us to Limit What We Use or Share
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
If you pay for a service or healthcare item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a List of Those With Whom We’ve Shared Information
You can ask for a list accounting of the times we’ve shared your health information, for up to six years prior to the date you ask, who we shared it with, and why.
We will include all the accounting disclosures except for those about treatment, payment, and healthcare operations, and certain other disclosures. We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a Copy of This Privacy Notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose Someone to Act For You
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
File a Complaint if You Feel Your Rights are Violated
You can file a complaint with us if you feel we have violated your rights by contacting the owner of Castle Hills Dental, Dr. Mathew Meyer. To file a complaint with our practice, please submit your request in writing attention: Dr. Mathew Meyer 4402 Vance Jackson Rd, Suite 236 San Antonio, TX 78230.
You can file a complaint with the U.S. Department of Health and Human Services’ Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, by calling 877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/
We will not retaliate against you for filing a complaint.
YOUR CHOICES
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, contact us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
- Include your information in a medical-based directory
- If you are not able to tell us your preference - for example, if you are unconscious, we may share your information if we believe it is in your best interest to do so. We may also share your information when needed to lessen a serious and imminent threat to your health or safety.
- In the following cases, we never share your information unless you give us written permission:
- Third-Party Marketing
- Sale of your protected health information
In the case of marketing:
We may contact you for our own marketing efforts, but you can tell us not to contact you again. We will honor your request to not contact you again.
OUR USES AND DISCLOSURES
We typically use or share your health information in the following ways:
Treatment: We can use your health information and share it with other professionals who are treating you. Example: A dental specialist treating you asks us about your overall dental health condition.
Run Our Dental Practice: We can use and share your dental health information to run our practice, improve your care, and contact you when necessary. Example: We use dental health information about you to manage your treatment and services at our practice.
Bill for Your Services: We can use and share your dental health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
Help With Public Health and Safety Issues
We can share dental health information about you for certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety
- Do Research
- We can use or share your information for health research
Comply With the Law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to Organ and Tissue Donation Requests
We can share health information about you with organ procurement organizations.
Work with a Medical Examiner or Funeral Director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address Workers’ Compensation, Law Enforcement, and Other Government Requests
We can use or share health information about you:
For workers’ compensation claims For law enforcement purposes or with a law enforcement official
With health oversight agencies for activities authorized by law For special government functions such as military, national security, and presidential protective services.
Respond to Lawsuits and Legal Actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Our Responsibilities
We are required by law to maintain the privacy and security of your protected health information.
We will let you know 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 give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
For More Information or to Report a Problem Contact the Owner/Dentist at (210) 342-0111.
Last Reviewed Date: August 1st, 2025
