Privacy Policy
DETROIT MERCY DENTAL NOTICE OF PRIVACY PRACTICES
Effective Date: January 1, 2026
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.
IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT THE HIPAA PRIVACY OFFICER IDENTIFIED BELOW.
OUR LEGAL DUTY
The privacy of your health information is important to us. We are committed to protecting your health information. We create a record of the care and services you receive. We need this record to provide you with quality care and to comply with certain legal requirements.
This Notice applies to all of the records of your care created by University of Detroit Mercy School of Dentistry (UDM) and its providers and staff. This Notice will tell you about the ways in which we may use and disclose your health information. This Notice will also describe your rights and obligations we have regarding the use and disclosure of your health information.
UDM is required by law to make sure that health information that identifies you is kept private. We are also required to give you this Notice of our legal duties and privacy practices with respect to health information about you. We are also required to follow the terms of the Notice that is currently in effect. You may request a copy of this Notice at any time.
We reserve the right to revise this Notice. Any revisions to this Notice will be effective for health information we already have about you as well as any information we receive in the future. We will post a copy of any revised Notice in our center.
USES AND DISCLOSURES OF HEALTH INFORMATION
The following describes the different ways that your health information may be used or disclosed by this center. For clarification, we have included some examples. Not every possible use or disclosure is specifically mentioned. However, all of the ways we are permitted to use and disclose your health information will fit within one of these general categories:
Treatment: We may use or disclose health information about you to provide you with treatment and services. We may use or disclose your health information to a physician or other healthcare provider providing treatment to you. We may also disclose your health information to a pharmacy who needs it to dispense a prescription to you or to a dental laboratory as needed to provide for your care.
Payment: We may use and disclose health information about you so that the treatment and services you receive at this center may be billed to and payment may be collected from you, an insurance company or a third party. For example,
we may need to give your health information about treatment you received at the center so your health plan will reimburse you for the treatment.
Healthcare Operations: We may use and disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.
Because you are receiving care in the School of Dentistry, your information will be used specifically for the training of dentists, dental hygienists and dental specialists, including the release of information as necessary for the American Dental Association Commission on Dental Accreditation.
We will also use or disclose your health information for the following purposes:
- To remind you of an appointment through the method you choose, such as voicemail messages, text messages, email messages, postcards, or letters. You have the right at any time to inform us you do not want appointment reminder messages via any specific method.
- To inform you of health-related services that may interest you.
- To inform you of new treatment alternatives that may be of interest to you.
- To inform you of the opportunity to participate in special programs sponsored by the School of Dentistry.
For Research Purposes: We may use or disclose your protected health information for research when the use or disclosure for research has been approved by an institutional review board that has reviewed the research proposal and research protocols.
Required by Law: We may use or disclose your health information when we are required to do so by law.
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 any health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institutions or law enforcement officials having lawful custody of protected health information of an inmate or a patient under certain circumstances.
Abuse or Neglect: We may, consistent with applicable law, disclose your health information to appropriate authorities if
we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence.
To Avert a Serious Threat to Health or Safety: We may, consistent with applicable law and ethical standards of conduct, use and disclose your health information, when such use or disclosure is necessary to prevent or lessen a serious or imminent threat to your health or safety or to the health and safety of the public. Any disclosure, however, would only be to someone able to help prevent the threat.
Health Oversight Activities: We may disclose health information to a governmental or other oversight agency for activities authorized by law. For example, we may disclose your health information in connection with investigations, inspections, etc.
Law Enforcement: We may release health information about you if required by law when asked to do so by a law enforcement official.
Coroners and Medical Examiners: We may release health information to a coroner or medical examiner to identify a deceased individual or determine the cause of death.
Potential for Redisclosure: It is possible that health information disclosed pursuant to this Notice and applicable law may be subject to redisclosure by the recipient and no longer protected by patient privacy laws.
Your Authorization: Other uses and disclosures of your health information not covered by this Notice of Privacy Practices will be made only with your written authorization. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect.
To Your Family and Friends: With your consent, we may disclose your health information to a family member, friend or other person to the extent necessary to help with your healthcare or with payment for your healthcare.
Persons Involved in Care: We may use or disclose health information to notify, or assist in the notification of identifying or locating a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death. Under emergency circumstances, we may use this information in an attempt to notify family members. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination using our professional judgment disclosing only health information that is directly relevant to the person’s involvement in your healthcare. We will also use our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays, or other similar forms of health information.
Marketing Health-Related Services: We will not transmit your health information to a third party for marketing
communications without your written authorization.
Sale of PHI: Under no circumstances will we sell our patient lists or your health information to a third party without your written authorization. Such authorization must state that the disclosure will result in remuneration to the covered entity.
Substance Use Disorder Treatment Records: We may not use or disclose substance use disorder treatment records received or maintaining from substance use disorder treatment programs that are subject to 42 CFR Part 2, or testimony
relaying the content of such records, in any civil, criminal, administrative, or legislative proceedings against you, unless: (1) you provide written consent; or (2) a court issues an order after notice and an opportunity to be heard are provided to you or the holder of the record, as required under 42 CFR Part 2. Any court order authorizing use or disclosure must be accompanied by a subpoena or other legal requirement compelling disclosure before the requested record is used or disclosed.
PATIENT RIGHTS
Access: You have the right to inspect and copy your health information for as long as we maintain such information. You must make a request in writing to obtain access to your health information. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing or other supplies associated with your request. If your health information is maintained in an electronic health record, you also have the right to request that an electronic copy of your record be sent to you or another individual or entity. We may charge you a reasonable cost-based fee associated with transmitting the electronic health record. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to your health information, you may request that the denial be reviewed. For information regarding such a review, contact the HIPAA Privacy Officer.
Disclosure Accounting: You have the right to receive a list of disclosures this center has made of your health information.
We are not required to list certain disclosures, including disclosure made for or incidental to treatment, payment, healthcare operations and certain other activities. To request this accounting of disclosures, you must submit your request in writing to the HIPAA Privacy Officer. Your request must state a time period which may not be longer than six years or dates before April 14, 2003. If disclosures were made through an electronic health record, you have the right to request an accounting of such closures that were made during the previous 3 years.
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 these additional requests.
Restrictions: You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement, except in an emergency. Your request must be made in writing.
Your Right to Request Certain Methods of Communication: You have the right to request that we communicate with you only in a certain manner. For example, you can ask that we only contact you at work or by email. To make a request, you must submit your request in writing to the HIPAA Privacy Officer. We will accommodate all reasonable requests.
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. All
requests must be mailed in writing to the attention of the Privacy Officer.
Electronic Notice: You have the right to a paper copy of this Notice. Even if you receive this Notice on our website or by
e-mail, you are entitled to receive a paper copy of this Notice. To obtain a paper copy of this Notice, visit our website or
contact the HIPAA Privacy Officer.
COMPLAINTS
If you are concerned that we may have violated your privacy rights, you may file a complaint with our center or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with our center, contact the HIPAA Privacy Officer listed below. All complaints must be submitted in writing.
HIPAA Privacy Officer:
Ashish Patel, D.D.S.
Assistant Dean for Clinic Operations
University of Detroit Mercy School of Dentistry
2700 Martin Luther King Jr. Blvd.
Detroit, MI 48208