Smiles While You Sleep

HIPAA Privacy Addendum

Applies to: Smiles While You Sleep/dba Jones Anesthesia
Last Updated: February 12, 2025

This HIPAA Privacy Addendum (“Addendum”) supplements the Smiles While You Sleep Privacy Policy and applies to all Protected Health Information (“PHI”) collected, created, received, maintained, or transmitted by Smiles While You Sleep in connection with the provision of dental or anesthesia‑related services. This Addendum is intended to comply with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), the Health Information Technology for Economic and Clinical Health Act (“HITECH”), and all applicable federal and state privacy laws.

1. Protected Health Information (PHI)

PHI includes individually identifiable health information that relates to your past, present, or future physical or mental health condition, the provision of healthcare to you, or payment for such care. PHI may include, but is not limited to:

• Medical history and treatment information
• Dental records
• Diagnostic information
• Appointment details
• Insurance and billing information
• Any other information classified as PHI under HIPAA

PHI is distinct from general personal information collected through our Website.

2. How We Use and Disclose PHI

We may use or disclose your PHI only as permitted or required by HIPAA, including:

a. Treatment

To provide, coordinate, or manage your dental or anesthesia care, including communication with your referring dentist, specialists, or other healthcare providers involved in your treatment.

b. Payment

To obtain payment for services rendered, including billing, claims processing, insurance verification, and eligibility checks.

c. Healthcare Operations

For internal administrative, quality assurance, training, auditing, accreditation, and compliance activities.

d. As Required by Law

We may disclose PHI when required by federal, state, or local law, including public health reporting, abuse or neglect reporting, or law enforcement requests.

e. Other Permitted Uses

As allowed under HIPAA, including but not limited to:

• Appointment reminders
• Treatment alternatives
• Health‑related benefits or services

Any other use or disclosure of PHI requires your explicit written authorization, which you may revoke at any time in writing.

3. Patient Rights Under HIPAA

You have the following rights regarding your PHI:

• Right to Access: You may request copies of your health records.
• Right to Amend: You may request corrections to your PHI.
• Right to an Accounting of Disclosures: You may request a list of certain disclosures of your PHI.
• Right to Request Restrictions: You may request limits on how your PHI is used or disclosed.
• Right to Confidential Communications: You may request communications via alternative means or locations.
• Right to a Paper Copy: You may request a paper copy of this Addendum at any time.

Requests must be submitted in writing to our office.

4. Safeguards and Security Measures

Smiles While You Sleep employs administrative, technical, and physical safeguards designed to protect PHI from unauthorized access, disclosure, alteration, or destruction. These safeguards include:

• Secure electronic systems and encrypted data transmission
• Access controls and authentication procedures
• Staff training on HIPAA compliance
• Policies governing the handling, storage, and disposal of PHI

Despite these measures, no system can guarantee absolute security.

5. Business Associates

We may engage third‑party service providers (“Business Associates”) who require access to PHI to perform services on our behalf, such as billing, analytics, or IT support. All Business Associates are required to sign a Business Associate Agreement (BAA) obligating them to safeguard PHI in accordance with HIPAA.

6. Breach Notification

In the event of a breach involving unsecured PHI, we will provide notifications as required by HIPAA and applicable state law. This may include notifying affected individuals, the U.S. Department of Health and Human Services (HHS), and, when required, the media.

7. Changes to This Addendum

We reserve the right to amend this HIPAA Privacy Addendum at any time. Updates will be posted on our Website, and the “Last Updated” date will be revised accordingly.

8. Contact Information

For questions about your PHI or your HIPAA rights, please contact:

Smiles While You Sleep
Email: mjones@swysleep.com
Phone: 502-262-1080
Address: 9720 Park Plaza Avenue, Unit 206, Louisville, KY  40245