SCHEDULE CONSULTATION
ICÓNICA

HIPAA Notice

NOTICE OF PRIVACY PRACTICES (HIPAA)

Effective Date: December 13, 2025

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

1. OUR LEGAL DUTY ICÓNICA DENTAL GROUP

Is required by the Health Insurance Portability and Accountability Act (HIPAA), the Florida Information Protection Act (FIPA), and the Florida Dental Practice Act to maintain the privacy of your Protected Health Information (“PHI”). We are also required to provide you with this Notice of our legal duties and privacy practices.

2. SPECIAL FLORIDA & FEDERAL PROTECTIONS

Certain “highly confidential” information receives extra protection. We will not disclose the following without your specific written authorization, unless strictly required by law:

  • Reproductive Health (2024 Rule):We are prohibited from using/disclosing PHI to investigate or impose liability for lawful reproductive health care.
  • HIV/AIDS:Test results or status (Fla. Stat. § 381.004).
  • Genetics:Genetic testing results (Fla. Stat. § 760.40).
  • Substance Abuse:Records related to substance use disorder (42 CFR Part 2).
  • Psychotherapy Notes:Separate notes maintained by a mental health professional.

3. HOW WE MAY USE AND DISCLOSE YOUR PHI (ROUTINE)

  • Treatment:To provide dental treatment (e.g., sending X-rays to a specialist, lab, or pharmacy).
  • Payment:To obtain payment (e.g., sending diagnosis codes to Delta Dental, CareCredit, or collections agencies).
  • Healthcare Operations:To improve our practice (e.g., internal quality audits, licensing, staff training, business planning).
  • Appointment & Refill Reminders:To remind you of appointments or treatment needs via voicemail, text (SMS), or email. Warning: Standard email/text is unencrypted; you accept the risk of interception.
  • Incidental Disclosures:You may be called by name in the waiting room. We take precautions, but incidental overhearing may occur.
  • AI & Automated Tools:We may use AI tools to assist in diagnostics (X-ray analysis) or administration. These support, but do not replace, provider judgment.
  • Business Associates:To third-party vendors (IT, billing) who have signed a strict confidentiality contract (BAA).

4. DISCLOSURES TO FAMILY & OTHERS

  • Individuals Involved in Care:Unless you object, we may disclose relevant PHI to a family member or friend involved in your care/payment (e.g., spouse picking up aligners).
  • Inability to Agree (The “Coma” Clause):If you are incapacitated or in an emergency, we may disclose PHI to your family/friends if we determine it is in your best interest based on professional judgment.
  • Post-Mortem Care:To family members involved in your care prior to death, unless inconsistent with your prior preferences.
  • School/Work Proof:We may disclose proof of immunization or “proof of appointment” to a school/employer with your verbal agreement.

5. SPECIAL DISCLOSURES (LEGAL, SAFETY & ADMINISTRATIVE)

We may disclose PHI without your authorization in the following situations:

  • Serious Threat to Health or Safety:To prevent a serious and imminent threat to the health or safety of a person or the public.
  • Business Transfer:If ICÓNICA DENTAL GROUP is sold or merged, your records will be transferred to the new owner to ensure continuity of care.
  • Secretary of HHS:To the U.S. Dept. of Health and Human Services to investigate compliance.
  • Abuse or Neglect:To DCF as required by Florida law for suspected abuse of children or vulnerable adults.
  • Law Enforcement:To assist police (e.g., locating a suspect), subject to “Reproductive Health” restrictions.
  • Legal Proceedings:In response to a court order or valid subpoena.
  • Workers’ Compensation:To comply with Florida laws for work-related conditions.
  • Public Health:To report disease, defective products (FDA), or adverse drug reactions.
  • Health Oversight:For audits, investigations, or licensure (Florida Board of Dentistry).
  • Coroners, Medical Examiners & Funeral Directors:To identify a deceased person or determine cause of death.
  • Organ Donation:To organ procurement organizations if applicable.
  • Research:To researchers, provided an Institutional Review Board (IRB) has approved the study protocol.
  • Military, Veterans & National Security:As required by command authorities or for intelligence activities.
  • Inmates:To correctional institutions for health/safety.
  • Whistleblowers:If a workforce member believes in good faith we acted unlawfully, they may report to oversight agencies.

6. SPECIFIC PROHIBITIONS (WHAT WE WILL NEVER DO)

  • Genetic Underwriting:Prohibited by GINA.
  • Sale of Data:We will never sell your PHI without written authorization.
  • Marketing:We will never use PHI for paid marketing without written authorization.

7. YOUR RIGHTS REGARDING YOUR PHI

  • Right to Access (Electronic Format):To inspect/copy records. Electronic copies available if records are digital. Cost-based fees apply.
  • Right to Amend:To request correction of incorrect records (we may deny if accurate).
  • Right to an Accounting:A list of non-routine disclosures over the past 6 years.
  • Right to Restrict:To ask us to limit sharing. Federally Mandated: If you pay in full out-of-pocket, you can demand we not share that service info with your insurance.
  • Right to Breach Notification:To be notified of a breach. Florida Rule: We will notify you within 30 days (stricter than federal 60-day rule).
  • Right to Good Faith Estimate:If uninsured/self-pay, to receive a cost estimate before care.
  • Right to a Paper Copy:You may request a paper copy of this Notice at any time.

8. CHANGES TO THIS NOTICE

We reserve the right to change this Notice. New terms apply to all PHI we maintain. Updated Notices will be posted on our website and in-office.

  1. COMPLAINTS & CONTACTIf you believe your privacy rights have been violated, you may file a complaint with us or theU.S. Dept. of Health and Human Services (OCR). We will not retaliate.
  • Contact Our Privacy Officer:305-426-6422 | office@iconica.dental