NOTICE OF PRIVACY PRACTICES
Effective Date: October 20, 2026
THIS NOTICE DESCRIBES HOW MEDICAL AND DENTAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
WHO WE ARE
This Notice applies to Total Care Dental & Orthodontics and TCD Specialty Group, including our dental offices, dentists, specialists, employees, staff members, and other workforce members who are permitted to use or disclose protected health information as part of your care or our healthcare operations.
For purposes of this Notice, “we,” “our,” and “us” refer to Total Care Dental & Orthodontics and TCD Specialty Group.
YOUR RIGHTS
When it comes to your health information, you have certain rights.
Get a Copy of Your Medical or Dental Record
You may ask to see or obtain an electronic or paper copy of your dental, medical, billing, and other health information that we maintain about you.
We will provide a copy or summary of your health information, usually within the time required by applicable law.
We may charge a reasonable, cost-based fee where permitted by law.
Ask Us to Correct Your Record
You may ask us to correct health information about you that you believe is incorrect or incomplete.
We may deny your request in certain circumstances, but we will explain the reason for the denial in writing when required by law.
Request Confidential Communications
You may ask us to contact you in a specific way, such as at a particular telephone number, or to send correspondence to a different address.
We will accommodate reasonable requests as required by law.
Ask Us to Limit What We Use or Share
You may ask us not to use or disclose certain health information for treatment, payment, or healthcare operations.
We are generally not required to agree to your request.
If you pay for a healthcare service or item out of pocket in full, you may ask us not to disclose information about that service or item to your health insurer for purposes of payment or healthcare operations. We will honor that request unless a law requires us to disclose the information.
Get a List of Certain Disclosures
You may request an accounting of certain disclosures of your health information made during the six years before the date of your request.
The accounting will not include certain disclosures, including many disclosures made for treatment, payment, or healthcare operations and disclosures you specifically authorized.
We will provide one accounting during a 12-month period without charge. We may charge a reasonable, cost-based fee for additional requests where permitted by law.
Get a Copy of This Notice
You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
Choose Someone to Act for You
If you have given someone medical power of attorney or another person is legally authorized to act as your personal representative, that person may exercise your rights and make choices regarding your health information as permitted by law.
We may verify that person’s authority before taking action.
File a Complaint
You may complain if you believe your privacy rights have been violated.
You may contact our Privacy Officer using the information at the end of this Notice.
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
We will not retaliate against you for filing a complaint.
YOUR CHOICES
For certain health information, you may tell us your preferences regarding what we share.
Where applicable, you may tell us your preferences regarding:
• Sharing information with family members, friends, or others involved in your care
• Sharing information in connection with disaster relief
• Certain communications about services or treatment alternatives
If you are unable to tell us your preference, such as during an emergency or because you are incapacitated, we may disclose information when we believe it is in your best interest and when permitted by law.
We may also disclose information when necessary to lessen a serious and imminent threat to health or safety.
USES REQUIRING YOUR WRITTEN AUTHORIZATION
We will obtain your written authorization before using or disclosing your health information when authorization is required by law.
Examples may include certain:
• Marketing activities
• Sales of protected health information
• Uses and disclosures not otherwise permitted by law
If you provide written authorization, you may revoke it in writing at any time, except to the extent we have already acted in reliance on it.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
Treat You
We may use your health information and share it with dentists, physicians, specialists, laboratories, pharmacies, and other healthcare professionals involved in your treatment.
Example: We may share dental records or radiographs with a specialist participating in your care.
Run Our Organization
We may use and disclose your health information to operate our practice, improve care, train staff, perform quality assessment activities, conduct credentialing, and manage our business.
Example: We may use health information to review the quality of care provided by our clinicians.
Bill for Services
We may use and disclose your health information to bill and obtain payment from dental plans, health plans, government programs, or other responsible parties.
Example: We may provide information to your dental benefit plan so that it can determine eligibility or pay for treatment.
Business Associates
We may share protected health information with companies or individuals that perform services on our behalf and need the information to perform those services.
These organizations are known as business associates when applicable under HIPAA.
We require business associates to appropriately safeguard protected health information as required by law.
Appointment Reminders and Care-Related Communications
We may use your health information to contact you regarding appointments, treatment, follow-up care, treatment alternatives, or health-related services that may be of interest to you.
OTHER USES AND DISCLOSURES PERMITTED OR REQUIRED BY LAW
We may use or disclose health information without your written authorization when permitted or required by law, including for certain purposes involving:
• Public health and safety activities
• Reporting suspected abuse, neglect, or domestic violence
• Health oversight activities
• Judicial and administrative proceedings
• Law enforcement
• Coroners and medical examiners
• Organ and tissue donation
• Workers’ compensation
• Certain government functions
• National security activities
• Correctional institutions
• Preventing or reducing a serious threat to health or safety
Any such disclosure will be made only in accordance with applicable legal requirements.
SUBSTANCE USE DISORDER RECORDS
Certain records relating to substance use disorder treatment may be subject to additional federal confidentiality protections under 42 CFR Part 2.
Where such protections apply, we will use and disclose those records only as permitted by applicable law.
Certain information obtained from or maintained in connection with a federally assisted substance use disorder treatment program may require your consent before it can be used or disclosed, except where otherwise permitted by law.
We will comply with applicable restrictions governing redisclosure and use of such information.
STATE LAW
California law and other applicable laws may provide additional privacy protections for certain types of health information.
When another applicable law provides greater privacy protection than HIPAA, we will follow the more protective requirement.
OUR RESPONSIBILITIES
We are required by law to maintain the privacy and security of your protected health information.
We will notify you as required by law if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in the Notice currently in effect.
We will not use or disclose your information other than as described in this Notice unless you authorize us in writing or another use or disclosure is permitted or required by law.
You may revoke an authorization in writing at any time, subject to applicable legal limitations.
CHANGES TO THIS NOTICE
We may change the terms of this Notice.
Changes may apply to all health information we maintain, including information created or received before the change.
If we materially revise this Notice, the revised Notice will be available upon request, at our offices, and on our Website.
QUESTIONS OR COMPLAINTS
For questions regarding this Notice, requests regarding your privacy rights, or complaints concerning our privacy practices, contact:
Total Care Dental & Orthodontics
TCD Specialty Group
Attn: Privacy Officer
5703 S. Vermont Ave.
Los Angeles, CA 90037
Phone: (323) 751-5600
Fax: (888) 699-6623
Email: [email protected]
Website: tcdspecialtygroup.com
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
You may also file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
You may also obtain information about filing a complaint through the U.S. Department of Health and Human Services Office for Civil Rights website.
We will not retaliate against you for filing a complaint.