Legal
Notice of Privacy Practices
Your rights under HIPAA and how we use and protect your protected health information.
Effective date: 2026
Our commitment to your privacy
Persell & Brockman Orthodontics understands that your health information is personal and private. This Notice explains how we may use and disclose your protected health information (PHI) and your rights under the Health Insurance Portability and Accountability Act (HIPAA).
How we may use and disclose your PHI
We may use and disclose your PHI for treatment, payment, and health care operations, such as scheduling, coordinating care with your dentist, billing insurance, and quality improvement. We may also disclose PHI when required by law or to public health authorities.
Your rights
- Request restrictions on certain uses and disclosures of your PHI.
- Receive confidential communications about your health information.
- Inspect and obtain a copy of your health records.
- Request amendments to your health records.
- Receive an accounting of certain disclosures of your PHI.
- File a complaint if you believe your privacy rights have been violated.
Our responsibilities
We are required by law to maintain the privacy of your PHI, provide you with this Notice, follow the terms of the Notice currently in effect, and notify you following a breach of your unsecured PHI.
Questions and complaints
If you have questions about this Notice or want to exercise your privacy rights, please contact us at (402) 420-2400. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
Changes to this Notice
We reserve the right to change this Notice. Any revised Notice will apply to all of your PHI already on file as well as any information created or received after the change is effective.
Template notice: This is a standard HIPAA Notice of Privacy Practices template. Persell & Brockman Orthodontics must have this reviewed by qualified legal counsel or a HIPAA compliance professional and customized to match the practice's actual policies, procedures, and state law requirements before using it as the official office Notice.