Notice of Privacy Practices
Carlos J. Rodríguez-Feo,
Effective Date:
February 16, 2026
Notice of Privacy
Practices
THIS NOTICE DESCRIBES
HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND
HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT
CAREFULLY.
We are required by law to maintain
the privacy of protected health information, to provide
individuals with notice of our legal duties and privacy
practices with respect to protected health information, and to
notify affected individuals following a breach of unsecured
protected health information. We must follow the privacy
practices that are described in this Notice while it is in
effect. This Notice takes effect February 16, 2026 and will
remain in effect until we replace it. We reserve the right to
change our privacy practices and the terms of this Notice at any
time, provided such changes are permitted by applicable law, and
to make new Notice provisions effective for all protected health
information that we maintain. When we make a significant change
in our privacy practices, we will change this Notice and post
the new Notice clearly and prominently at our practice location,
and we will provide copies of the new Notice upon request. You
may request a copy of our Notice at any time. For more
information about our privacy practices, or for additional
copies of this Notice, please contact us using the information
listed at the end of this Notice.
HOW WE MAY USE AND DISCLOSE HEALTH
INFORMATION ABOUT YOU We may use and disclose your health
information for different purposes, including treatment,
payment, and health care operations. For each of these
categories, we have provided a description and an example. Some
information, such as HIV-related information, genetic
information, alcohol and/or substance use disorder treatment
records, and mental health records may be entitled to special
confidentiality protections under applicable state or federal
law. We will abide by these special protections as they pertain
to applicable cases involving these types of records.
Treatment. We may use and disclose
your health information for your treatment. For example, we may
disclose your health information to a specialist providing
treatment to you.
Payment. We may use and disclose your
health information to obtain reimbursement for the treatment and
services you receive from us or another entity involved with
your care. Payment activities include billing, collections,
claims management, and determinations of eligibility and
coverage to obtain payment from you, an insurance company, or
another third party. For example, we may send claims to your
dental health plan containing certain health information.
Healthcare Operations. We may use and
disclose your health information in connection with our
healthcare operations. For example, healthcare operations
include quality assessment and improvement activities,
conducting training programs, and licensing activities.
Individuals Involved in Your Care or
Payment for Your Care. We may disclose your health information
to your family or friends or any other individual identified by
you when they participate in your care or in the payment for
your care. Additionally, we may disclose information about you
to a patient representative. If a person has the authority by
law to make health care decisions for you, we will treat that
patient representative the same way we would treat you with
respect to your health information.
Disaster Relief. We may use or
disclose your health information to assist in disaster relief
efforts. Required by Law. We may use or disclose your health
information when we are required to do so by law. Public Health
Activities. We may disclose your health information for public
health activities, including disclosures to: • Prevent or
control disease, injury or disability; • Report child abuse or
neglect; • Report reactions to medications or problems with
products or devices; • Notify a person of a recall, repair, or
replacement of products or devices; • Notify a person who may
have been exposed to a disease or condition; or • Notify the
appropriate government authority if we believe a patient has
been the victim of abuse, neglect, or domestic violence.
National Security. We may disclose to
military authorities the health information of Armed Forces
personnel under certain circumstances. We may disclose to
authorized federal officials health information required for
lawful intelligence, counterintelligence, and other national
security activities. We may disclose to correctional institution
or law enforcement official having lawful custody the protected
health information of an inmate or patient.
Secretary of HHS. We will disclose
your health information to the Secretary of the U.S. Department
of Health and Human Services when required to investigate or
determine compliance with HIPAA.
Worker’s Compensation. We may
disclose your PHI to the extent authorized by and to the extent
necessary to comply with laws relating to worker’s compensation
or other similar programs established by law.
Law Enforcement. We may disclose your
PHI for law enforcement purposes as permitted by HIPAA, as
required by law, or in response to a subpoena or court order.
Health Oversight Activities. We may
disclose your PHI to an oversight agency for activities
authorized by law. These oversight activities include audits,
investigations, inspections, and credentialing, as necessary for
licensure and for the government to monitor the health care
system, government programs, and compliance with civil rights
laws.
Judicial and Administrative
Proceedings. If you are involved in a lawsuit or a dispute, we
may disclose your PHI in response to a court or administrative
order. We may also disclose health information about you in
response to a subpoena, discovery request, or other lawful
process instituted by someone else involved in the dispute, but
only if efforts have been made, either by the requesting party
or us, to tell you about the request or to obtain an order
protecting the information requested.
Research. We may disclose your PHI to
researchers when their research has been approved by an
institutional review board or privacy board that has reviewed
the research proposal and established protocols to ensure the
privacy of your information.
Coroners, Medical Examiners, and
Funeral Directors. We may release your PHI to a coroner or
medical examiner. This may be necessary, for example, to
identify a deceased person or determine the cause of death. We
may also disclose PHI to funeral directors consistent with
applicable law to enable them to perform their duties.
Fundraising. We may contact you to
provide you with information about our sponsored activities,
including fundraising programs, as permitted by applicable law.
If you do not wish to receive such information from us, you may
opt out of receiving the communications.
SUD Treatment Information. If we
receive or maintain any information about you from a substance
use disorder treatment program that is covered by 42 CFR Part 2
(a “Part 2 Program”) through a general consent you provide to
the Part 2 Program to use and disclose the Part 2 Program record
for purposes of treatment, payment or health care operations, we
may use and disclose your Part 2 Program record for treatment,
payment and health care operations purposes as described in this
Notice. If we receive or maintain your Part 2 Program record
through specific consent you provide to us or another third
party, we will use and disclose your Part 2 Program record only
as expressly permitted by you in your consent as provided to us.
In no event will we use or disclose your Part 2 Program record,
or testimony that describes the information contained in your
Part 2 Program record, in any civil, criminal, administrative,
or legislative proceedings by any Federal, State, or local
authority, against you, unless authorized by your consent or the
order of a court after it provides you notice of the court
order.
OTHER USES AND DISCLOSURES OF PHI
Your authorization is required, with a few exceptions, for
disclosure of psychotherapy notes, use or disclosure of PHI for
marketing, and for the sale of PHI. We will also obtain your
written authorization before using or disclosing your PHI for
purposes other than those provided for in this Notice (or as
otherwise permitted or required by law). You may revoke an
authorization in writing at any time. Upon receipt of the
written revocation, we will stop using or disclosing your PHI,
except to the extent that we have already acted in reliance on
the authorization.
YOUR HEALTH INFORMATION RIGHTS
Access. You have the right to look at
or get copies of your health information, with limited
exceptions. You must make the request in writing. You may obtain
a form to request access by using the contact information listed
at the end of this Notice. You may also request access by
sending us a letter to the address at the end of this Notice. If
you request information that we maintain on paper, we may
provide photocopies. If you request information that we maintain
electronically, you have the right to an electronic copy. We
will use the form and format you request if readily producible.
We will charge you a reasonable cost-based fee for the cost of
supplies and labor of copying, and for postage if you want
copies mailed to you. Contact us using the information listed at
the end of this Notice for an explanation of our fee structure.
If you are denied a request for access, you have the right to
have the denial reviewed in accordance with the requirements of
applicable law.
Disclosure Accounting. With the
exception of certain disclosures, you have the right to receive
an accounting of disclosures of your health information in
accordance with applicable laws and regulations. To request an
accounting of disclosures of your health information, you must
submit your request in writing to the Privacy Official. If you
request this accounting more than once in a 12-month period, we
may charge you a reasonable, cost-based fee for responding to
the additional requests.
Right to Request a Restriction. You
have the right to request additional restrictions on our use or
disclosure of your PHI by submitting a written request to the
Privacy Official. Your written request must include (1) what
information you want to limit, (2) whether you want to limit our
use, disclosure or both, and (3) to whom you want the limits to
apply. We are not required to agree to your request except in
the case where the disclosure is to a health plan for purposes
of carrying out payment or health care operations, and the
information pertains solely to a health care item or service for
which you, or a person on your behalf (other than the health
plan), has paid our practice in full.
Alternative Communication. You have
the right to request that we communicate with you about your
health information by alternative means or at alternative
locations. You must make your request in writing. Your request
must specify the alternative means or location and provide
satisfactory explanation of how payments will be handled under
the alternative means or location you request. We will
accommodate all reasonable requests. However, if we are unable
to contact you using the ways or locations you have requested,
we may contact you using the information we have.
Amendment. You have the right to
request that we amend your health information. Your request must
be in writing, and it must explain why the information should be
amended. We may deny your request under certain circumstances.
If we agree to your request, we will amend your record(s) and
notify you of such. If we deny your request for an amendment, we
will provide you with a written explanation of why we denied it
and explain your rights.
Right to Notification of a Breach.
You will receive notifications of breaches of your unsecured
protected health information as required by law.
Electronic Notice. You may receive a
paper copy of this Notice upon request, even if you have agreed
to receive this Notice electronically on our Web site or by
electronic mail (e-mail).
QUESTIONS AND COMPLAINTS If you want
more information about our privacy practices or have questions
or concerns, please contact our Privacy Officer at (305)
665-3721. If you are concerned that we may have violated your
privacy rights, or if you disagree with a decision we made about
access to your health information or in response to a request
you made to amend or restrict the use or disclosure of your
health information or to have us communicate with you by
alternative means or at alternative locations, you may complain
to us using the contact information listed at the end of this
Notice. You also may submit a written complaint to the U.S.
Department of Health and Human Services. We will provide you
with the address to file your complaint with the U.S. Department
of Health and Human Services upon request. We support your right
to the privacy of your health information. We will not retaliate
in any way if you choose to file a complaint with us or with the
U.S. Department of Health and Human Services
Privacy Officer, Carlos J.
Rodríguez-Feo, DDS, PA, 6601 Southwest 80th Street,
Suite 125, Miami, Florida 33143, jawsurgery@bellsouth.net