HIPAA Forms

What is this and why do we have it? The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. According to the Centers for Medicare and Medicaid Services (CMS):

Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs.

Title II of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic healthcare transactions and national identifiers for providers, health insurance plans, and employers. It helps people keep their information private.

The Administration Simplification provisions also address the security and privacy of health data. The standards are meant to improve the efficiency and effectiveness of the nation’s healthcare system by encouraging the widespread use of electronic data interchange in the U.S. health care system. So, here is our Playhouse Dental Privacy Notice and your Acknowledgement of Receipt of Statement of Privacy Practices.  After reading the first, please complete the second form and submit; we will have you review and sign it at the clinic.

In the Clinic

Our doctors and assistants will often address you in the waiting room. These conversations may include what is planned for your child, how your child is doing, or what is coming next.   We are always sensitive to the reality that the conversations may be overheard.  If you prefer to have any or all of these conversations in private, please let us know so that we may accommodate your request for, and right to, privacy.