Paul Y. Lin, D.D.S. 82 Townsend Street San Francisco Ca 94107
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Privacy Policy

Notice Of Privacy Practices For Protected Health Information

This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please take a moment to review the details below carefully and feel free to contact the office with any questions or concerns.

The Health Insurance Portability & Accountability Act of 1996 (“HIPPA”) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential. This Act gives you, the patient, significant rights to understand and control how your health information is used. “HIPPA” provides penalties for covered entities that misuse personal health information.

As required by “HIPPA”, we have prepared this explanation of how we are required to maintain the privacy of your health information, and how we may use and disclose your health information.

We may use and disclose your medical records for each of the following purposes;

TREATMENT means providing, coordinating, or managing health care and related services by one or more health care providers. An example of this would include a physical examination.

PAYMENT means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment.

HEALTH CARE OPERATIONS includes the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost management analysis, and customer service. An example would be an internal quality assessment review.

REQUIRED BY LAW means we will provide all such information we are required to make available by statutory regulatory authorities or when we are required to do so by law.

ABUSE OR NEGLECT we may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence, or the possible victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety, or the health or safety of others.

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, counter intelligence, and other national security activities. We may disclose to correctional institutions or law enforcement officials having lawful custody of a protected health information inmate or patient under certain circumstances.

MARKETING HEALTH RELATED SERVICES we may also create and distribute de-identified health information by removing all references to individually identifiable information.

APPOINTMENT REMINDERS we may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken action relying on your authorization.

You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the Privacy Officer:

  • The right to request restrictions on certain uses and disclosures of protected health information, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we to agree to a restriction, we must abide by it unless you agree in writing to remove it.
  • The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations.
  • The right to inspect and copy your protected health information.
  • The right to amend you protected health information.
  • The right to receive an accounting of disclosures of protected health information.
  • The right to obtain a paper copy of this notice from up upon request.

We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information.

This notice is effective as of January 1, 2005 and we are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain. We will post, and you may request a written copy of a revised Notice of Privacy Practices from this office.

Please feel free to contact us if you have any questions regarding this policy, or any concerns regarding your protected health information. > contact us

You have recourse if you fell that your privacy protections have been violated. You have the right to file a written complaint with our office, or with the Department of Health & Human Services, Office of Civil Rights, about violations of the provisions of this notice, or the policies and procedures of our office. We will not retaliate against you for filing a complaint.

Please feel free to contact us if you have any questions regarding this policy, or any concerns regarding your protected health information.

For more information about “HIPPA” or to file a complaint, you may contact :

The U.S. Department of Health & Human Services
Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-877-696-6775

General Information Privacy Policy

You have certain rights under state and federal law with respect to the privacy of information we obtain about you when you join or support our organization. You will receive a notice on an annual basis from us in electronic or written form advising your of our collection, use, and dissemination policy with regard to the information we have relating to you, your family, or any other information we may have on file. Your local state may provide you with protections not specifically noted in this notice, however we will meet or exceed these protections to the best or our ability at all times, or will adjust our policies when to do so.

Your protected health information is not affected by this general policy and is fully protected under our Notice Of Privacy Policies For Protected Health Information.


Much of the personal information we collect comes from you, when you join our practice. This information is collected through medical and personal information forms or through e-mail contact with you.


We use information collected about our patients to perform normal operational functions such as providing treatment and care, undertaking quality assessment and improvement activities, advising you of new treatment options or benefits within our practice, sending you well wishes on your birthday, and for other purposes intrinsically related to our normal operations and as permitted by state and federal law.

All information collected in this manner is considered CONFIDENTIAL and is not shared with other non-affiliated parties, third parties, or with non-necessary individuals. We do however, as part of our normal operations provide this information, as permitted by law, and without your prior authorization to:

  1. Staff members who need this information to perform normal business and operation functions for us
  2. Persons conducting oversight, audit, or research studies on OUR behalf only
  3. Medical professionals in the case of an emergency where care must be provided without the ability of the student or a third party to immediately consent
  4. Law enforcement or other regulatory governmental authority
    5. Insurance and financial companies in order to facilitate billing and collection activities
  5. Persons that perform marketing services on OUR behalf only, as permitted by law

Information obtained is kept in the strictest confidence and all staff members provided access to this information are required to sign a confidentiality agreement not to disclose such information.


We retain information about you in electronic form within a number of databases and spreadsheets, and in other forms as may be suitable to the normal business and operations of our office from time to time. You have the right to know the contents of any recorded personal information about you that is in our records. You also have the right to request that we correct, amend, or delete any of the information that you find is in error.

To exercise this right, you must make a written request to our Privacy Officer. If the requested changes are in order, we will make the appropriate corrections, amendments, or deletions in our records. If we cannot make the change, you then have the option of filing a statement of the reasons why you disagree with our decision, which will be included in your record so anyone reviewing your records will have access to the disputed information.

You may request a copy of your personal information at any time, for which you will be charged a nominal photocopying and mailing fee, by submitting a written request to our Privacy Officer. Please allow fourteen days for collation and preparation of such information for your review.


As required by law, we will notify you of our personal information practices regularly. We reserve the right to modify our practices at any time when permitted by law, and will post or make available written copies of the changed information practices policy upon request.

If after reading this you have any further questions, please feel free to contact our office.