Notice of Privacy Practices

1. Our Duty to Protect Your PHI

Rise Dental is required by law to maintain the privacy of your PHI and to provide you this notice of our legal duties and privacy practices. We must follow the terms of this Notice, though we reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by law. Any revised Notice will be effective for all PHI we maintain at that time and thereafter. You may obtain a revised Notice by contacting us (see Contact Information below) or by visiting this page.

2. How We Use and Disclose Your PHI

We may use or disclose your PHI for the following purposes:

• Treatment: To provide, coordinate, or manage your dental care and related services. For example, we may disclose PHI to specialists, laboratories, or other healthcare providers involved in your care.
• Payment: To obtain payment for services provided to you. This may include disclosures to insurance companies, billing services, or collection agencies.
• Healthcare Operations: For activities necessary to run our practice, improve quality, train staff, conduct audits, or business management and general administrative activities.
• Appointment Reminders/Health-Related Benefits: To contact you regarding appointment reminders or treatment alternatives or other health-related benefits and services that may be of interest to you.
• As Required by Law: When required by federal, state, or local law, court order, or other legal processes.
• Public Health Activities: To report disease, injuries, vital events, or conduct public health surveillance.
• Abuse or Neglect: To report child abuse or neglect, or domestic violence, as required or permitted by law.
• Health Oversight Activities: For audits, investigations, inspections, or licensure related to the dental practice.
• Law Enforcement: For law enforcement purposes as required by law or in response to a valid subpoena or court order.
• Research: Under certain circumstances, with your written authorization or if an institutional review board approves a waiver.
• Threat to Health or Safety: To prevent or lessen a serious threat to health or safety of a person or the public.
• Business Associates: To our vendors or service providers (e.g., Dental Intelligence) who perform services on our behalf and agree via Business Associate Agreements (BAAs) to safeguard PHI.

3. Uses and Disclosures Requiring Your Authorization

We must obtain your written authorization before using or disclosing your PHI for purposes other than those described above, except in specific circumstances permitted by law. If you authorize a use or disclosure, you may revoke that authorization in writing at any time, and we will stop such use or disclosure except to the extent we have already taken action based on your original authorization.

4. Your Rights Regarding PHI

You have the following rights regarding the PHI we maintain about you. To exercise any of these rights, please submit a request in writing to our Privacy Officer (contact details below). We will verify your identity before fulfilling requests.

• Right to Inspect and Copy: You may request a copy of your PHI in our designated record sets (e.g., billing records, clinical records). We may charge a reasonable fee for copying and mailing.
• Right to Amend: If you believe that the PHI we have is incorrect or incomplete, you may request an amendment. We may deny the request in certain cases (e.g., if the information was not created by us).
• Right to an Accounting of Disclosures: You may request a list of certain disclosures of your PHI made by us over the past six years (or shorter period if state law requires). This excludes disclosures for treatment, payment, or healthcare operations.
• Right to Request Restrictions: You may request restrictions on certain uses or disclosures of your PHI (e.g., to a health plan if you paid out-of-pocket in full for a service). We are not required to agree to all requests but will comply if required by law or if we agree in writing.
• Right to Confidential Communications: You may request that we contact you in a specific way or location (e.g., call only at work). We will accommodate reasonable requests.
• Right to a Paper Copy of This Notice: You may request a paper copy of this Notice even if you have agreed to receive it electronically.
• Right to Receive Notification of a Breach: If there is a breach of your unsecured PHI, we will notify you as required by law.
• Right to Opt Out of Marketing Communications: You have the right to opt out of marketing communications. See our Privacy Policy for details on opting out of emails, SMS/text messages, and other campaigns.

5. Complaints

If you believe your privacy rights have been violated, you may file a complaint with Rise Dental or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

To file with us: Contact our Privacy Officer:
Email: privacy@risesmiles.com
Phone: (512) 325-9889
Address: 1651 S. Bell Blvd. Suite #301, Cedar Park, TX 78613

To file with HHS OCR:
Visit HHS OCR Complaint Portal.

6. Effective Date

This Notice is effective as of June 23, 2025.

7. Contact Information

For questions about this Notice or our privacy practices, contact:
Rise Dental Privacy Officer
Email: privacy@risesmiles.com
Phone: (512) 325-9889
Office: 1651 S. Bell Blvd. Suite #301, Cedar Park, TX 78613