Dental One Associates of Fayetteville
410 N Jeff Davis Drive, Fayetteville, GA 30214

Privacy Policy

NOTICE OF PRIVACY PRACTICES

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.

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) requires all health care records and other individually identifiable health information (protected health information) used or disclosed to us in any form, whether electronically, on paper, or orally, be kept confidential. This federal law gives you, the patient, significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information. As required by HIPAA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information.

Without specific written authorization, we are permitted to use and disclose your health care records for the purposes of treatment, payment and health care operations.

  • Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. Examples of treatment would include crowns, fillings, teeth cleaning services, etc.
  • Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be billing your dental plan for your dental services.
  • Health Care Operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. An example would include a periodic assessment of our documentation protocols, etc.

In addition, your confidential information may be used to remind you of an appointment (by phone or mail) or provide you with information about treatment options or other health-related services including release of information to friends and family members that are directly involved in your care or who assist in taking care of you. We will use and disclose your protected when we are required to do so by federal, state or local law. We may disclose your PROTECTED HEALTH INFORMATION to public health authorities that are authorized by law to collect information, to a health oversight agency for activities authorized by law included but not limited to: response to a court or administrative order, if you are involved in a lawsuit or similar proceeding, response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested. We will release your PROTECTED HEALTH INFORMATION if requested by a law enforcement official for any circumstance required by law. We may release your PROTECTED HEALTH INFORMATION to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necessary, we also may release information in order for funeral directors to perform their jobs. We may release PROTECTED HEALTH INFORMATION to organizations that handle organ, eye or tissue procurement or transplantation, including organ donation banks, as necessary to facilitate organ or tissue donation and transplantation if you are an organ donor. We may use and disclose your PROTECTED HEALTH INFORMATION when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat. We may disclose your PROTECTED HEALTH INFORMATION if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate authorities. We may disclose your PROTECTED HEALTH INFORMATION to federal officials for intelligence and national security activities authorized by law. We may disclose PROTECTED HEALTH INFORMATION to federal officials in order to protect the President, other officials or foreign heads of state, or to conduct investigations. We may disclose your PROTECTED HEALTH INFORMATION to correctional institutions or law enforcement HIPAA/@Notice of Privacy Practices.doc officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: (a) for the institution to provide health care services to you, (b) for the safety and security of the institution, and/or (c) to protect your health and safety or the health and safety of other individuals or the public. We may release your PROTECTED HEALTH INFORMATION for workers’ compensation and similar programs.

Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

You have certain rights in regards to your PROTECTED HEALTH INFORMATION, which you can exercise by presenting a written request to our Privacy Officer at the practice address listed below:

  • The right to request restrictions on certain uses and disclosures of PROTECTED HEALTH INFORMATION, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.
  • The right to request to receive confidential communications of PROTECTED HEALTH INFORMATION from us by alternative means or at alternative locations.
  • The right to access, inspect and copy your PROTECTED HEALTH INFORMATION.
  • The right to request an amendment to your PROTECTED HEALTH INFORMATION.
  • The right to receive an accounting of disclosures of PROTECTED HEALTH INFORMATION outside of treatment, payment and health care operations.
  • The right to obtain a paper copy of this notice from us upon request.

We are required by law to maintain the privacy of your PROTECTED HEALTH INFORMATION and to provide you with notice of our legal duties and privacy practices with respect to PROTECTED HEALTH INFORMATION.

We are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all PROTECTED HEALTH INFORMATION that we maintain. Revisions to our Notice of Privacy Practices will be posted on the effective date and you may request a written copy of the Revised Notice from this office.

You have the right to file a formal, written complaint with us at the address below, or with the Department of Health & Human Services, Office of Civil Rights, in the event you feel your privacy rights have been violated. We will not retaliate against you for filing a complaint.

For more information about our Privacy Practices, please contact:
Dental Care Alliance
6240 Lake Osprey Dr.
Sarasota, FL 34240
Ph #: 941-955-3150

For more information about HIPAA or to file a complaint:
The U.S. Department of Health & Human Services
Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
877-696-6775 (toll-free)

Read What Our Patients Say
Patient Reviews
Very good care
Susan O.
I absolutely loved loved loved the service and the workers were excellent, extremely polite and patient ! Thank you Dental One !!!!!
Imani D.
Young professionals and very knowledgeable of patients care and concerns. I was very satisfied with Dr. B!! I highly recommend her..
Patrick S.
Great service and excellent staff.
Tommy B.
The visit before last, my experience with the billing/check-out staff was unpleasant. I would not refer a friend out of fear they might have an encounter similar to mine.
Shani R.
Toni is the best
Donald N.
Efficient service with a smile
Jon P.
I have always been afraid of dentist.. Hence the reason I always put stuff off until the pain hit. However, o came across Dental ONE and from the receptionist, like Phyllis, to the doctors, they were […]
Virginia N.
Appointments are typically honored with no wait time; staff is courteous, professional, and they keep your anxieties at a minimum.
Dianne C.
Very nice facility staff. Good services. Efficient. No hard sell for products. I changed from another dentist since hubby raved about them. Not disappointed nor sorry I did.
Tammy S.
Dr Joe is the the best . Did a very difficult crown removal and replacement for me. His experience was to the benefit of me. Trust him with all my dental work.
KATE F.
Courteous and efficient
Richard F.
It is above average.
Jeanette A.
This place is just AWESOME! The energy is always positive. Ms. Toni does my cleaning and she is the sweetest! Always quick, thorough and painless! Dr. Jo follows up and he has the warmest eyes and […]
J L.
Your staff was efficient but somewhat overbooked. Waited 25 min. past booked time for appointment.
Shirley W.
Everyone did a great job from start to finish.
Brandalyn O.
I would give a nine. I feel the service was good.
Patricia C.
Denise is fabulous! Always helpful and informative. Dr Shatz was very personable and made me comfortable of his procedure
Peyton S.
I had my crown re-cemented this afternoon, and I was in complete awe when the procedure was done less than 30mins and that I dont feel any single thing! Not only that but the standards of hygiene and […]
Shenna
Excellent Service. Caring staff.
Sharita N.
Office Hours
Mon. – 8:00 AM - 7:00 PM
Tue. – 8:00 AM - 5:00 PM
Wed. – 7:00 AM - 4:00 PM
Thu. – 8:00 AM - 5:00 PM
Fri. – 7:00 AM - 4:00 PM
Sat. – Closed
Sun. – Closed
Phone: (678) 228-8348
Fax: (770) 460-7249
Healthcare Financing with
CareCredit
We Accept Most Insurance Plans!
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We accept most insurance plans and will be happy to help you understand the coverage that you have. We will do our best to see that you receive your maximum insurance benefits for all covered services.

No Insurance? No Worries! See our discounts and offers here

For appointments, call us at: (678) 228-8348 or
Request an Appointment
For appointments, call: (678) 228-8348
Office Hours
  • Monday 8:00 AM - 7:00 PM
  • Tuesday 8:00 AM - 5:00 PM
  • Wednesday 7:00 AM - 4:00 PM
  • Thursday 8:00 AM - 5:00 PM
  • Friday 7:00 AM - 4:00 PM
  • Saturday Closed
  • Sunday Closed
Get in touch:
  • Phone: (678) 228-8348
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