At the office of Thomas M. Anderson D.D.S. and Taylor L. Hewett D.M.D., we take the privacy of our patients very seriously. The following paragraphs outline the types of personal information that is collected and how it may be used. We recommend you review it carefully.

Our office realizes that the medical information about you and your health is personal and considered “Protected Health Information” or PHI and our office is committed to protecting this information. PHI includes individually identifiable information about your past, present, and/or future health or condition (s), the provision of care to you, or the payment for such health care.

Our office uses and discloses PHI about you for Treatment, Payment, and Health Care operations.

Our office may disclose PHI to your insurance provider, our dentist(s), and other dental care providers for treatment purposes. An example-we may wish to provide a dental service for you like a crown but first we might seek information from your insurance provider as to whether the service has been previously provided.

Our office also discloses your PHI in order to check insurance coverage, determine benefits, waiting periods, and secure payment for services provided to you. For Example-our office will use your PHI to request processing of your claims by your insurance provider.

Our office discloses your PHI as part our office operations such as quality of care or improvement. For example- We may use your PHI to evaluate the quality of dental services rendered.

Our office may disclose your PHI without your authorization for several other reasons. Subject to certain requirements, we may give your PHI without authorization for public health purposes, auditing purposes, research studies, and emergencies. We also provide PHI when required by law, such as for law enforcement in specific circumstances, or for judicial or administrative proceedings. In any situation, we will ask for your written authorization before disclosing your PHI. If you choose to sign an authorization to allow disclosure of your PHI, you can later revoke that authorization to stop any future uses and disclosures (other than for treatment, payment, and health care operations).

Our office may change our privacy policies at any time. Before we make a significant change in our policies, we will change our notice and post the new notice and make the new notice available to you. You can also request a copy of our notice at any time.

In most cases, you have a right to view or get a copy of your PHI. You also have the right to receive a list of instances where we have disclosed your PHI without your written authorization for reasons other than treatment, payment, or health care operations. If you believe that information in your record is incorrect or if important information is missing, you have the right to request that we correct the existing information or add the missing information. You may request in writing that we not use or disclose your PHI for treatment, payment, and health care operations except when specifically authorized by you, when required by law, or in emergency circumstances. We will consider your request but are not legally required to accept it. You also have the right to receive confidential communications of PHI by alternative means or at alternative locations if you clearly state that disclosure of all or part of your PHI could endanger you.

If you are concerned that we have violated your privacy rights, or you disagree with a decision we have made about access to your records, you may contact us at convenience. You may also send a written complaint to the U.S. Department of Health and Human Services. Customer Service can provide you with the appropriate address upon request.

Our office is required by law to protect the privacy of your information, provide this notice about our information practices, and follow the information practices that are described in this notice. If you wish to inspect your records, receive a listing of disclosures, or correct or add to the information in your record, or if you have any questions, complaints, or concerns, please contact our office.

When you enter or leave your full name, email address, and phone number, you are providing personal information that will be used by our office for the sole purpose of returning your request to be contacted by our office. We will only use this information to contact you in order to assist you in scheduling an appointment with our office and/or answer any questions you may have indicated in your comments or phone message. Our intention is to only use your personal information to return your request for contact regarding a dental appointment, and/or dental or insurance related questions.

Thomas M. Anderson DDS, PA

2245 Lewisville-Clemmons, Suite B
Clemmons,  North Carolina 27012