Westside Pediatric Dental and Orthodontic Group respects the privacy and confidentiality of our patients’ protected health information. We are committed to following applicable federal and state privacy laws, including the Health Insurance Portability and Accountability Act of 1996, commonly known as HIPAA.
This statement is intended to provide general information about how we protect patient privacy. It is not a replacement for our official Notice of Privacy Practices.
Our Commitment to Patient Privacy
As a pediatric dental and orthodontic practice, we understand that health information is personal. We maintain policies and procedures designed to protect the privacy and security of patient information and to limit the use and disclosure of protected health information to what is permitted or required by law.
Protected health information may include information about a patient’s dental or orthodontic care, medical history, treatment, payment, insurance, appointments, and other information that can identify the patient.
How Health Information May Be Used
Westside Pediatric Dental and Orthodontic Group may use and disclose protected health information for purposes permitted by HIPAA and other applicable laws, including:
Treatment: To provide, coordinate, or manage dental and orthodontic care.
Payment: To bill for services, process insurance claims, and manage payment-related matters.
Healthcare Operations: To support practice operations such as quality improvement, staff training, scheduling, patient communication, and administrative functions.
We may also use or disclose information when required by law, for public health purposes, for health oversight activities, to respond to certain legal requests, or in other situations permitted by HIPAA.
Patient and Parent Rights
Patients, parents, and legal guardians may have certain rights under HIPAA and applicable state law, including the right to:
Request access to protected health information.
Request corrections to health information.
Request restrictions on certain uses or disclosures.
Request confidential communications.
Receive an accounting of certain disclosures.
Obtain a copy of the practice’s Notice of Privacy Practices.
File a complaint if they believe privacy rights have been violated.
Some rights may be subject to legal limitations, verification requirements, or specific procedures.
Notice of Privacy Practices
Our Notice of Privacy Practices explains in greater detail how protected health information may be used and disclosed, patient rights, and our legal duties regarding health information.
A copy of the Notice of Privacy Practices is available upon request at our office.
Website and Electronic Communications
Please do not submit sensitive medical, dental, orthodontic, or insurance information through general website forms or email unless the communication method has been specifically identified as secure. Standard email and general website contact forms may not be encrypted and may not be appropriate for sharing confidential health information.
For questions involving treatment, appointments, billing, insurance, or patient records, please contact our office directly.
Contact Information
For questions about this HIPAA Statement, our Notice of Privacy Practices, or privacy-related concerns, please contact:
Westside Pediatric Dental and Orthodontic Group
Privacy Contact: Dr. Bernard Gross
Phone: 310-362-9688
Email: westsidepdg@gmail.com
Address: 1304 15th Street
Suite 206
Santa Monica, CA 90404
Complaints
Patients, parents, and legal guardians may contact our office with privacy concerns. Filing a complaint will not affect the care provided by Westside Pediatric Dental and Orthodontic Group.
You may also have the right to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
