Read and Accept DentalChat Hipaa Authorization:
We value your privacy. We try our best to get limited personal information. We at DentalChat are using standard online HIPAA standards. We will not be asking you for your social security number, etc. DentalChat offers various services – this includes helping you to find and learn about nearby dental healthcare providers, booking appointments with dental offices and dentists provider(s) of your choice (each, “Your Healthcare Provider”) and managing and forwarding your health history forms and other health-related information to share with Your Healthcare Providers (“DentalChat Services”). This is for Dental Chat, DentalChat, DentalChat Ios app, DentalChat Android App, any affiliate sites or DentalChat, inc. - mostly here referred to as DentalChat or DentalChat Services.
As part of this – by providing the DentalChat Services, We at DentalChat may collect, use, share, and exchange your health history forms and other health-related information with Your Healthcare Providers. Under a federal law called the Health Insurance Portability and Accountability Act (“HIPAA”), some of this health and health-related information may be considered “protected health information” or “PHI” if such information is received from or on behalf of Your Healthcare Providers.
Safeguards for PHI (Protected Health Information):
HIPAA protects the privacy and security of your PHI by limiting the uses and disclosures of PHI by most healthcare providers and by health plans (called “Covered Entities”) as well as companies, like DentalChat, that provide certain types of assistance to Covered Entities (called “Business Associates”). Under certain circumstances described in HIPAA, an individual needs to sign an Authorization form before a Covered Entity, like Your Healthcare Provider(s), can disclose protected health information to a third party.
Non-Protected Health Information
Your PHI Authorization
The purpose of this DentalChat Authorization (“Authorization”) is to request your written permission to allow DentalChat to use and disclose your PHI in the same way as we use and disclose your Non-PHI. If DentalChat is a Business Associate of Your Healthcare Providers, DentalChat needs your Authorization to be able to use and disclose your PHI in the same way it can currently use and disclose your Non-PHI when DentalChat is not working on behalf of Your Healthcare Providers, but is instead working on its own behalf. Therefore, when DentalChat relies on this Authorization, and uses and discloses PHI as described in this Authorization, it is not working as a Business Associate and the HIPAA requirements that apply to Business Associates will not apply to such uses and disclosures.
If you e-sign this Authorization, you give your permission to DentalChat to retain your PHI and to use and/or disclose your PHI in the same way that you have agreed that your Non-PHI can be used and disclosed.
Specifically, you agree that DentalChat can use your PHI to:
enable and customize your use of the DentalChat Services;
provide you alerts or other DentalChat Services regarding future appointments;
notify you regarding providers we think you may be interested in learning more about;
share information with you regarding services, products or resources about which we think you may be interested in learning more;
provide you with updates and information about the DentalChat Services;
market to you about DentalChat and third party products and services;
conduct analysis for DentalChat’s business purposes;
support development of the DentalChat Services; and
create de-identified information and then use and disclose this information in any way permitted by law, including to third parties in connection with their commercial and marketing efforts.
You also agree that DentalChat can disclose your PHI to:
third parties assisting DentalChat with any of the uses described above;
Your Healthcare Providers to enable them to refer you to, and make appointments with, other providers on your behalf, or to perform an analysis on potential health issues or treatments, provided that you choose to use the applicable DentalChat Service;
a third party as part of a potential merger, sale or acquisition of DentalChat;
our business partners who assist us by performing core services (such as hosting, billing, fulfillment, or data storage and security) related to the operation or provision of our services, even when DentalChat is no longer working on behalf of Your Healthcare Providers;
a provider of medical services, in the event of an emergency; and
organizations that collect, aggregate and organize your information so they can make it more easily accessible to your providers.
If DentalChat discloses your PHI, DentalChat will require that the person or entity receiving your PHI agrees to only use and disclose your PHI to carry out its specific business obligations to DentalChat or for the permitted purpose of the disclosure (as described above). DentalChat cannot, however, guarantee that any such person or entity to which DentalChat discloses your PHI or other information will not re-disclose it in ways that you or we did not intend or permit.
Expiration and Revocation of Authorization
Your Authorization remains in effect until you provide written notice of revocation to DentalChat.
YOU CAN CHANGE YOUR MIND AND REVOKE THIS AUTHORIZATION AT ANY TIME AND FOR ANY (OR NO) REASON.
Once DentalChat receives your Revocation of Authorization, DentalChat can only use and disclose your PHI as permitted in DentalChat’s agreements with Your Healthcare Provider(s). Your Revocation of Authorization does not affect DentalChat’s use of your Non-PHI.
We will make available to Your Healthcare Provider(s), current and past, your agreement to or revocation of this Authorization.
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