HIPAA

Your health information is important, and Pine Glen Dental Group is committed to protecting it. This page explains how we collect, use, and safeguard your protected health information (PHI) in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable Illinois state privacy laws. Please read this notice carefully. A complete Notice of Privacy Practices is available at our office and provided to all new patients at their first visit.

What Is Protected Health Information?

Protected health information (PHI) refers to any individually identifiable health information we create, receive, or maintain in connection with your dental care. This includes information about your health history, treatment, and payment.

How We Use and Share Your Information

We use and disclose your health information as permitted by HIPAA. The most common reasons include the following:

Treatment: We may share your information with other healthcare providers involved in your care, such as specialists, oral surgeons, or labs, to coordinate and deliver appropriate dental treatment.

Payment: We may use your information to bill for services, process insurance claims on your behalf, or verify coverage. Because we are a fee-for-service practice, we work with patients to submit out-of-network claims when applicable.

Healthcare operations: We may use your information for internal purposes such as quality reviews, staff training, and practice management activities that support the care we provide.

We may also use or disclose your information when required by law, in response to a court order, or for public health and safety purposes as outlined under HIPAA.

How We Protect Your Information

We implement physical, administrative, and technical safeguards to protect your health information from unauthorized access, use, or disclosure. Our team is trained on privacy practices and patient confidentiality.

Your Rights Under HIPAA

You have rights regarding your health information. Here is a summary of what you are entitled to:

You have the right to request a copy of your health records and ask that we correct any information you believe is inaccurate. You may request that we limit how we use or share your information in certain situations, though we are not always required to agree to those requests. You may ask us to communicate with you in a specific way or at a specific location, and we will accommodate reasonable requests. You also have the right to receive an accounting of certain disclosures we have made of your health information and to receive a paper copy of this notice upon request.

Authorizations

For uses and disclosures not described in this notice, including most uses for marketing purposes, we will ask for your written authorization. You may revoke a previously granted authorization at any time by submitting a written request to our office.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

Changes to This Notice

We reserve the right to update this notice and to make the revised version effective for health information we already hold, as well as any information we receive in the future. The current version is always available at our office and upon request.

Contact Pine Glen Dental Group

If you have questions about this notice or your privacy rights, please do not hesitate to reach out. Our team is available to help you schedule an appointment or address any concerns you may have about your health information. You may also stop by our office at 838 W Glen Ave, Peoria, IL 61614, or ask a member of our front desk team for a printed copy of our full Notice of Privacy Practices.

Effective Date: May 8, 2026