Debemos aceptar su solicitud para restringir la divulgacin de su PHI que se relacione exclusivamente con un artculo o servicio de atencin en salud por el cual Usted, u otra persona en su nombre, pag en su totalidad de su bolsillo, si tal divulgacin es para un plan de salud por el propsito de llevar a cabo el pago u operaciones de atencin en salud. The costs for dental school services is generally 30 to 60 percent lower than private practice fees. Can file Medicaid if patient is covered for dental - patient should call case worker to check. Campus Box #1150, Lincoln, NE 68583-0740. We have to take x-rays and do a clinical exam to determine if we can extract a wisdom tooth. I am a Bridge To Care (BTC) patient and I need a medication refill, what should I do? The following required pre-dental courses must be completed (preferably from a four-year institution) prior to admission and be no more than five years old: Two lecture courses with a minimum of four semester hours each. Phone: (313) 494-6700. Planning for our organizations future operations, and fundraising for the benefit of our organization. Phone: (919) 537-3660. Your information will not be disclosed without your written permission, except as permitted by law and stated in the Carolina Dentistry Notice of Privacy Practices. The contact form is the best method for reaching us. For any other use and/or disclosure of PHI about you not otherwise described in this Notice of Privacy Practices, we will seek your authorization. Dial 702-774-2400 to schedule a screening appointment. Podremos compartir con una agencia pblica o privada (por ejemplo, la Cruz Roja) su PHI para fines de socorro en un desastre. The Adams School of Dentistry will accept a maximum of 64 credit hours from an accredited two-year community college or from an accredited online college or university accepted by the Office of Undergraduate Admissions at UNC-Chapel Hill. Por ejemplo, podremos usar o divulgar la PHI para que uno de nuestros residentes en odontologa pueda certificarse por la experiencia en un campo especfico de la odontologa, como la ortodoncia, o para organizaciones que acrediten nuestros programas especiales como la American Dental Association Commission on Dental Education. If you would like to object to our use or disclosure of PHI about you in the above circumstances, please call our contact person listed on the cover page of this Notice. You may request alternative communications by contacting the HIPAA Privacy Liaison at 919-537-3588. We may use and/or disclose PHI about you, including disclosure to a foundation, to contact you to raise money for the School and its operations. We encourage you to visit the ADAs Dental Admission Test website to stay up to date on important announcements. We must explain how we protect PHI about you. Review your appointment reminder information before your appointment so you know where to go when you arrive. Podremos usar y / o divulgar la PHI para gestionar o coordinar su atencin en salud. 2023 The University of North Carolina at Chapel Hill. Treatment costs in this clinic are similar to a private practice, and most insurances are accepted. De acuerdo con esta misin y con las leyes federales aplicables la School of Dentistry no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo en sus programas y actividades de salud. Tambin podremos divulgar informacin a las siguientes personas: (i) un proveedor de atencin en salud que le est brindando a Usted servicios mdicos de emergencia y (ii) a otras instalaciones o profesionales en salud mental, discapacidades del desarrollo o abuso de sustancias cuando sea necesario coordinar su atencin o tratamiento. PAUNAWA: Kung ikaw ay nagsasalita ng Tagalog, maaari kang gumamit ng libreng serbisyo ng tulong sa wika. Bajo estas circunstancias, le responderemos por escrito, declarando el por qu no podemos aceptar su solicitud y describiendo algunos de los derechos que usted pudiese tener para solicitar una revisin sobre nuestra negacin. How to Become a Patient Click here to learn more about being a patient of Carolina Dentistry. Privacy Liaison at 919-537-3588. To speak with someone in the alumni offices, call (919) 537-3257. If you have been referred for a specialty service, please contact the division directly. Please note: completing a screening appointment does not guarantee that you will be accepted as a patient. You may request an amendment of PHI about you by contacting the HIPAA Adems, la ley de Carolina del Norte protege, no slo sus derechos de privacidad, sino tambin su relacin con su mdico y, si aplica, su proveedor en salud mental. 919-537-3588. If you have questions about admissions, please emailDDSAdmissions@unc.edu. 301 Lloyd St Podremos rechazar su solicitud si: Le informaremos por escrito las razones de la negacin y le describiremos sus derechos para presentar una declaracin por escrito en la que exponga su desacuerdo con la negacin. Las circunstancias en las cuales Usted no tiene que dar su consentimiento, autorizar o tener la oportunidad de aceptar u objetar, incluyen: A menos de que usted lo objete, podremos divulgar su PHI en las siguientes circunstancias (con sujecin a las restricciones especiales que se tratan en la sub seccin B.5 que se presenta a continuacin): Si usted desea objetar nuestro uso o divulgacin de su PHI en las circunstancias anteriores, por favor, llame a la persona de contacto que se presenta en la portada de este aviso. You will be given a recommendation on a provider level based on your treatment needs and personal preferences, but you are free to choose any provider level youd like. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F, HHH Building, Washington D.C. 21201; 1-800-368-1019; 800-537-7697 (TDD). We may share with a family member, relative, friend or other person identified by you, PHI directly related to that persons involvement in your care or payment for your care. object. If you cancel your authorization in writing, we will not disclose PHI about you after we receive your cancellation, except for disclosures which were being processed before we received your cancellation. If your patient account number is eight digits (XXXX-XXXX), please use the form below to submit your payment. Podremos compartir con un familiar, representante autorizado u otra persona responsable de su atencin la PHI necesaria para comunicarle a estas personas sobre su ubicacin, condicin general o muerte. Revisar actividades y usar o divulgar la PHI en el caso de que vendamos nuestro negocio, propiedad o demos control de nuestro negocio o propiedad a alguien ms. Seguir las instrucciones dadas sobre el tratamiento de seguimiento. Then, they will conduct a series of tests which may include measuring your range of motion and muscle strength, as well as palpating the area. 4) you would not have the right to see and copy the record as described in paragraph 3 above. Thank you for your patience as we answer many patient questions. We encourage applicants to apply early and will review applications even if DAT scores are pending. We will tell you in writing the reasons for the denial and describe your rights to give us a written statement disagreeing with the denial. Estas situaciones incluyen tratamiento de emergencia, divulgaciones a la Secretara del Departamento de Salud y Servicios Sociales, y usos y divulgaciones descritos en la sub seccin B.2 de la seccin anterior de este comunicado. Compartir informacin honesta y completa sobre su historial mdico y dental, enfermedades previas, hospitalizaciones, exposicin a enfermedades contagiosas, alergias, medicamentos y cuidado mdico actual. El tratamiento de la persona: Carolina Dentistry reconoce y respeta la dignidad de cada paciente. More details about our interview process will be included in our interview invitations. Does GYN Wellness Clinic provide contraception? We are tentatively planning on conducting in-person interviews for the 2022-2023 admissions cycle, but that is subject to change based on COVID-19 infection rates and University standards. Puede encontrar la informacin de contacto en la pgina web de la Oficina de Derechos Civiles, www.hhs.gov/ocr. Tambin divulgaremos su informacin si la ley nos obliga a hacerlo, por ejemplo, cuando se presenta una orden de la corte, cuando sospechamos que hay abuso o abandono de un menor de edad o adulto discapacitado, y cuando uno de nuestros proveedores o estudiantes crean que un cliente tiene una enfermedad contagiosa o est infectado con el VIH y no sigue las medidas de seguridad. Su solicitud debe ser por escrito y debe explicar sus razones para la modificacin. You may be informed about what can and cannot be provided, and your providers will make referrals for treatment when necessary. Even if you object, we may still share the PHI about you, if necessary for the emergency circumstances. Ser considerado y respetuoso con los estudiantes, el profesorado, el personal y otros pacientes. If you need help filing a grievance, the individual listed above is available to help you. The contact form is the best method for reaching us. 2. No estamos obligados a estar de acuerdo con su solicitud de restricciones en la mayora de circunstancias. La School of Dentistry no excluye a las personas ni las trata de manera diferente debido a su raza, color, nacionalidad, edad, discapacidad o sexo. When the use and/or disclosure is necessary for public health activities. If you request a list of disclosures more than once in 12 months, we can charge you a reasonable fee. hay algunos servicios que brindamos a travs de personas o compaas externas, incluidos vendedores, contratistas proveedores de atencin en salud, instalaciones de almacenamiento externas y compaas de seguros de responsabilidad civil. Some North Carolina laws provide you with more protection for specific types of information than federal laws protecting the privacy of medical information about you, and where applicable, we will follow the requirements of those state laws. Informar a su proveedor cuando haya cambios en su estado de salud general o si sufren alguna complicacin y molestias imprevistas despus del tratamiento. When the use and/or disclosure is required by law. You should expect to be treated with consideration and respect regardless of your age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, veteran status, or source of payment. In connection with its supervision of our services, the North Carolina Department of Health and Human Services may make inspections of our operations and may review health information of our patients. For example, we may disclose PHI about you in response to an order of a court or administrative tribunal. No walkins accepted. 1) the information was not created by us (unless you prove the creator of the information is no longer available to amend the record); Emergency After Hours (for current patients only): 402-559-0642. The first step to becoming a patient at UNLV School of Dental Medicine is to schedule a screening appointment, which will help determine if your needs are a suitable match for our student doctors.