Privacy Policies
Online Privacy Policy
Protecting your private information is our priority. This Statement of Privacy applies to www.amazoncreekdental.com, and Mariya Melnik Costa DMD PC and governs data collection and usage. For the purposes of this Privacy Policy, unless otherwise noted, all references to Mariya Melnik Costa DMD PC include www.amazoncreekdental.com and Amazon Creek Dental. The Amazon Creek Dental website is a Dental News, Information, Local Dental Services, and Ecommerce site. By using the Amazon Creek Dental website, you consent to the data practices described in this statement.
Privacy Compliance Certification
Amazon Creek Dental has HIPPA certification.
Collection of your Personal Information
In order to better provide you with products and services offered, Amazon Creek Dental may collect personally identifiable information, such as your:
- First and Last Name
- Mailing Address
- E-mail Address
If you purchase Amazon Creek Dental's products and services, we collect billing and credit card information. This information is used to complete the purchase transaction.
Amazon Creek Dental may also collect anonymous demographic information, which is not unique to you, such as your:
- Age
- Gender
- Household Income
We do not collect any personal information about you unless you voluntarily provide it to us. However, you may be required to provide certain personal information to us when you elect to use certain products or services. These may include: (a) registering for an account; (b) entering a sweepstakes or contest sponsored by us or one of our partners; (c) signing up for special offers from selected third parties; (d) sending us an email message; (e) submitting your credit card or other payment information when ordering and purchasing products and services. To wit, we will use your information for, but not limited to, communicating with you in relation to services and/or products you have requested from us. We also may gather additional personal or non-personal information in the future.
Use of your Personal Information
Amazon Creek Dental collects and uses your personal information to operate and deliver the services you have requested.
Amazon Creek Dental may also use your personally identifiable information to inform you of other products or services available from Amazon Creek Dental and its affiliates.
Sharing Information with Third Parties
Amazon Creek Dental does not sell, rent or lease its customer lists to third parties.
Amazon Creek Dental may, from time to time, contact you on behalf of external business partners about a particular offering that may be of interest to you. In those cases, your unique personally identifiable information (e-mail, name, address, telephone number) is not transferred to the third party. Amazon Creek Dental may share data with trusted partners to help perform statistical analysis, send you email or postal mail, provide customer support, or arrange for deliveries. All such third parties are prohibited from using your personal information except to provide these services to Amazon Creek Dental, and they are required to maintain the confidentiality of your information.
Amazon Creek Dental may disclose your personal information, without notice, if required to do so by law or in the good faith belief that such action is necessary to: (a) conform to the edicts of the law or comply with legal process served on Amazon Creek Dental or the site; (b) protect and defend the rights or property of Amazon Creek Dental; and/or (c) act under exigent circumstances to protect the personal safety of users of Amazon Creek Dental, or the public.
Tracking User Behavior
Amazon Creek Dental may keep track of the websites and pages our users visit within Amazon Creek Dental, in order to determine what Amazon Creek Dental services are the most popular. This data is used to deliver customized content and advertising within Amazon Creek Dental to customers whose behavior indicates that they are interested in a particular subject area.
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Automatically Collected Information
Information about your computer hardware and software may be automatically collected by Amazon Creek Dental. This information can include: your IP address, browser type, domain names, access times and referring website addresses. This information is used for the operation of the service, to maintain quality of the service, and to provide general statistics regarding use of the Amazon Creek Dental website.
Links
This website contains links to other sites. Please be aware that we are not responsible for the content or privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of any other site that collects personally identifiable information.
Security of your Personal Information
Amazon Creek Dental secures your personal information from unauthorized access, use, or disclosure. Amazon Creek Dental uses the following methods for this purpose:
- SSL Protocol
When personal information (such as a credit card number) is transmitted to other websites, it is protected through the use of encryption, such as the Secure Sockets Layer (SSL) protocol.
We strive to take appropriate security measures to protect against unauthorized access to or alteration of your personal information. Unfortunately, no data transmission over the Internet or any wireless network can be guaranteed to be 100% secure. As a result, while we strive to protect your personal information, you acknowledge that: (a) there are security and privacy limitations inherent to the Internet which are beyond our control; and (b) security, integrity, and privacy of any and all information and data exchanged between you and us through this Site cannot be guaranteed.
Right to Deletion
Subject to certain exceptions set out below, on receipt of a verifiable request from you, we will:
• Delete your personal information from our records; and
• Direct any service providers to delete your personal information from their records.
Please note that we may not be able to comply with requests to delete your personal information if it is necessary to:
• Complete the transaction for which the personal information was collected, fulfill the terms of a written warranty or product recall conducted in accordance with federal law, provide a good or service requested by you, or reasonably anticipated within the context of our ongoing business relationship with you, or otherwise perform a contract between you and us;
• Detect security incidents, protect against malicious, deceptive, fraudulent, or illegal activity; or prosecute those responsible for that activity;
• Debug to identify and repair errors that impair existing intended functionality;
• Exercise free speech, ensure the right of another consumer to exercise his or her right of free speech, or exercise another right provided for by law;
• Comply with the California Electronic Communications Privacy Act;
• Engage in public or peer-reviewed scientific, historical, or statistical research in the public interest that adheres to all other applicable ethics and privacy laws, when our deletion of the information is likely to render impossible or seriously impair the achievement of such research, provided we have obtained your informed consent;
• Enable solely internal uses that are reasonably aligned with your expectations based on your relationship with us;
• Comply with an existing legal obligation; or
• Otherwise use your personal information, internally, in a lawful manner that is compatible with the context in which you provided the information.
Children Under Thirteen
Amazon Creek Dental does not knowingly collect, either online or offline, personal information from persons under the age of thirteen. If you are under 18, you may use www.amazoncreekdental.com only with the permission of a parent or guardian.
E-mail Communications
From time to time, Amazon Creek Dental may contact you via email for the purpose of providing announcements, promotional offers, alerts, confirmations, surveys, and/or other general communication. In order to improve our Services, we may receive a notification when you open an email from Amazon Creek Dental or click on a link therein.
If you would like to stop receiving marketing or promotional communications via email from Amazon Creek Dental, you may opt out of such communications by clicking on the UNSUBSCRIBE button.. or email back saying UNSUBSCRIBE
Changes to this Statement
Amazon Creek Dental reserves the right to change this Privacy Policy from time to time. We will notify you about significant changes in the way we treat personal information by sending a notice to the primary email address specified in your account, by placing a prominent notice on our website, and/or by updating any privacy information. Your continued use of the website and/or Services available after such modifications will constitute your: (a) acknowledgment of the modified Privacy Policy; and (b) agreement to abide and be bound by that Policy.
Contact Information
Amazon Creek Dental welcomes your questions or comments regarding this Statement of Privacy.
If you believe that Amazon Creek Dental has not adhered to this Statement, please contact Amazon Creek Dental at:
Mariya Melnik Costa DMD PC - DBA: Amazon Creek Dental
2233 Willamette Street, Suite B 1st Floor, Eugene, Oregon 97405
Email Address: office@amazoncreekdental.com
Telephone number: (541)485-6644
Effective as of June 26, 2023
PATIENT RIGHTS AND HIPAA AUTHORIZATIONS
Amazon Creek Dental takes our responsibility to safeguard your protected health information very seriously. We value your trust as an important part of our ability to provide you with the best possible dental care. We are dedicated to defending your right to a confidential relationship with your dentist.
This notice is intended to inform you of how we protect, use, and disclose your information, as well as to explain your right to control these disclosures.
Tell a staff member of Amazon Creek Dental if you do not understand this authorization, and we will explain it to you.
Your Health Information
We may use and disclose health information about you without your permission for the following purposes:
We may disclose your information for treatment purposes and to coordinate your medical care.
We may disclose your information to ensure that you receive insurance benefits.
We may disclose your information internally to enhance the operation of our practice. This includes our commitment to reviewing the quality of care we provide.
We may disclose your information to comply with a limited number of legal requirements, as outlined in this notice.
Additional information regarding each of these disclosures is provided in this notice. In any case, we will only disclose the minimum amount of information necessary for the purpose it was requested.
Our Duties
We are required by law to keep your information private. We must also provide you with this Notice and abide by its terms. We may need to revise our privacy practices from time to time. We expressly reserve the right to change the terms of our Notice of Privacy Practices and to make the new terms effective for all information covered by our Notice. If such changes occur, we will let you know about the new terms by providing a copy of the changes.
The following specifies your rights regarding this authorization under the Health Insurance Portability and Accountability Act of 1996, as amended from time to time (“HIPAA”).
Your Privacy Rights
Please note that you are entitled to very specific rights regarding the use and disclosure of your information. We have listed your rights below
Right to Inspect and Copy
You have the right to inspect and copy your health information, such as medical and billing records, that we use to make decisions about your care. You do not have the right of access to the following protected dental information: psychotherapy notes, information compiled for legal proceedings, laboratory results to which the Clinical Laboratory Improvement Act (“CLIA”) prohibits access or information held by certain research laboratories. We may deny your request to inspect and/or copy information in certain limited circumstances. If you are denied access to your health information, you can ask that the denial be reviewed. If the law requires such a review, we will select a licensed healthcare professional to review your request and our denial. The person conducting the review will not be the person who denied your request, and we will comply with the outcome of the review. In addition, Amazon Creek Dental may deny access if we reasonably believe access could cause harm to you or another individual. If access is denied, you may request to have another licensed healthcare professional for a second opinion at your expense. You must submit a written request to our designated contact in order to inspect and/or copy your information. If you request a copy of your information, we may charge a fee for the costs of copying, mailing, or other associated supplies. You may also choose to receive a copy of your health information in electronic form.
Right to Amend
If you believe our records contain errors, you may make a written request that they be amended. We reserve the right to review your request and can decline to amend the record. We are required to place a copy of your proposed amendment in the record, even when we do not agree to amend the record itself.
We may deny your request for an amendment if we did not create the information unless the person or entity that created the information is no longer available to make the amendment.
Right to Request Restrictions
You have the right to request restrictions on the use and disclosure of your information. We are not required to agree to your request. If we do agree, we will comply to the best of our ability unless the information is needed to provide you with emergency treatment. To request restrictions, you may complete and submit the Request for Restriction on Use/Disclosure of Medical Information to our designated Privacy Officer/Contact. If your restriction invalidates your insurance coverage, we may require you to execute a waiver of insurance benefits and a payment agreement.
Right to revoke or cancel this authorization
You have the right to revoke or cancel this authorization at any time, except: (a) to the extent information has already been shared based on this authorization; or (b) this authorization was obtained as a condition of obtaining insurance coverage. To revoke or cancel this authorization, you must submit your request in writing to Amazon Creek Dental at the following address 2233 Willamette St, Suite B 1st Floor, Eugene, OR 97405
Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you may complete and submit the form Request for Restriction on Use/Disclosure of Medical Information to our designated Privacy Officer/Contact. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive it electronically, you are still entitled to a paper copy. To obtain such a copy, contact 541-485-6644 or office@amazoncreekdental.com
Right to an Accounting of Disclosures
You have the right to request an “accounting of disclosures” for your protected dental information by Amazon Creek Dental or its business associates. The maximum disclosure accounting period is the six years immediately preceding the accounting request. Amazon Creek Dental is not required to provide an accounting for disclosures: (a) for treatment, payment, or dental care operations; (b) to you or your personal representative; (c) for notification of or to persons involved in an individual’s dental care or payment for dental care, for disaster relief, or for facility directories; (d) pursuant to an authorization; (e) of a limited data set; (f) for national security or intelligence purposes; (g) to correctional institutions or law enforcement officials for certain purposes regarding inmates or individuals in lawful custody; or (h) incident to otherwise permitted or required uses or disclosures. Accounting for disclosures to dental oversight agencies and law enforcement officials must be temporarily suspended on their written representation that an accounting would likely impede their activities. This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment, and healthcare operations. To obtain this list, you must submit your request in writing to our designated Privacy Officer/Contact. It must state a time period, which may not be longer than six years and may not include dates before December 13, 2022. Your request should indicate in what format you want the list (for example, on paper or electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to be notified following a breach of your PHI
You have the right to be notified following a breach of your PHI by our practice.
Complaints and Investigations
We have developed procedures for investigating any complaints or concerns you may have regarding our use and disclosure of your information or any other complaint you may have regarding our services. The law allows you to contact the Secretary of the Department of Health and Human Services with complaints about our use and disclosure of information.
If you believe your privacy rights have been violated. You may also contact our on-site Privacy Officer/Contact, who is dedicated to investigating complaints regarding the use and disclosure of information in our care. We will not, and legally cannot, retaliate against you for any complaint.
Types of Use and Disclosure of Your Protected Health Information We may disclose your information for the following purposes without your consent:
For Treatment Purposes
We may disclose information needed for the provision, coordination, or management of health care and related services, including the coordination between our office and a third party, such as a consultation between medical providers or a referral from our office to another provider. Personnel in our office may share information about you and disclose information to people who do not work in our office in order to coordinate your care, such as phoning prescriptions to your pharmacy, scheduling lab work, and ordering X-rays. Family members and other healthcare providers may be part of your medical care outside this office and may require information about you that we have.
For Payment
To obtain reimbursement from your insurer, we may be required to disclose your information. This may be necessary for determining your eligibility for coverage and adjudication of claims, billing, claims management, and collections activities. We may also be required to disclose your information to your insurer for review of the medical necessity, coverage, appropriateness, or justification of our charges.
For example, we may need to give your health plan information about a service you received here so your health plan will pay us or reimburse you for the service. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment. You have the right to restrict disclosures of your PHI to a health plan if you have paid out-of-pocket in full for the treatment.
For Health Care Operations
We may use and disclose health information about you in order to run the office and make sure that you and our other patients receive quality care. Healthcare operations may include: Quality assessment and improvement activities. Reviewing the competence or qualifications of healthcare professionals or evaluating practitioner and provider performance, Conducting training programs, accreditation, certification, licensing, or credentialing activities. Arranging for or conducting medical reviews, legal services or auditing functions, including fraud and abuse detection and compliance programs. Managing and operating our practice, including activities such as customer service and complaint resolution
Appointment Reminders
We may contact you (via texting, emails, voicemail messages, postcards, or letters) as a reminder that you have an appointment for your treatment or medical care at our office.
Treatment Alternatives
We may tell you about or recommend possible treatment options or alternatives that may be of interest to you. We also may tell you about health-related products or services that may be of interest to you.
Marketing Health-Related Services
We will not use your health information for marketing communications without your written, prior authorization. We will not sell your PHI to another organization for marketing or any other purposes.
You may refuse to sign this authorization.
Your refusal to sign will not affect your ability to obtain treatment, payment, enrollment, or your eligibility for benefits. However, you may be required to complete this authorization form before receiving treatment if you have authorized Amazon Creek Dental to disclose information about you to a third party. If you refuse to sign this authorization, and you have authorized Amazon Creek Dental to disclose information about you to a third party, Amazon Creek Dental has the right to decide not to treat you or accept you as a patient in our practice. Once the information about you leaves this office according to the terms of this authorization, this office has no control over how it will be used by the recipient. You need to be aware that at that point, your information may no longer be protected by HIPAA. If the person or entity receiving this information is not a health care provider or health plan covered by federal privacy regulations, the information described above may be disclosed to other individuals or institutions and would no longer be protected by these regulations.
Special Instructions for completing this authorization for the use and disclosure of Psychotherapy Notes.
HIPAA provides special protections to certain medical records known as “Psychotherapy Notes.” All Psychotherapy Notes recorded on any medium by a mental health professional (such as a psychologist or psychiatrist) must be kept by the author and filed separately from the rest of the client’s medical records to maintain a higher standard of protection. “Psychotherapy Notes” are defined under HIPAA as notes recorded by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint or family counseling session and that are separate from the rest of the individual’s medical records. Excluded from the “Psychotherapy Notes” definition are the following: (a) medication prescription and monitoring, (b) counseling session start and stop times, (c) the modalities and frequencies of treatment furnished, (d) the results of clinical tests, and (e) any summary of diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date. Except for limited circumstances set forth in HIPAA, in order for a medical provider to release “Psychotherapy Notes” to a third party, the client who is the subject of the Psychotherapy Notes must sign this authorization to specifically allow for the release of Psychotherapy Notes. Such authorization must be separate from an authorization to release other dental records.
Special Situations
We may use or disclose health information about you without your permission for the following purposes, subject to all applicable legal requirements and limitations:
To Avert a Serious Threat to Health or Safety. We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Required By Law. We will disclose health information about you when required to do so by federal, state, or local law.
Research. We may use and disclose health information about you for research projects that are subject to a special approval process. We will ask you for your permission if the researcher will have access to your name, address, or other information that reveals who you are or will be involved in your care at the office.
Organ and Tissue Donation. If you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate such donation and transplantation.
Military, Veterans, National Security, and Intelligence. If you are or were a member of the armed forces or part of the national security or intelligence communities, we may be required by military command or other government authorities to release health information about you. We may also release information about foreign military personnel to the appropriate foreign military authority.
Workers’ Compensation. We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
Public Health Risks. We may disclose health information about you for public health reasons in order to prevent or control disease, injury, or disability; or report births, deaths, suspected abuse or neglect, non-accidental physical injuries, reactions to medications, and problems with products.
Health Oversight Activities. We may disclose health information to a health oversight agency for audits, investigations, inspections, or licensing purposes. These disclosures may be necessary for certain state and federal agencies to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. Subject to all applicable legal requirements, we may also disclose health information about you in response to a subpoena.
Law Enforcement. We may release health information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons, or similar process, subject to all applicable legal requirements.
Coroners, Medical Examiners, and Funeral Directors. We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or to determine the cause of death.
Information Not Personally Identifiable. We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.
Family and Friends. We may disclose health information about you to your family members or friends if we obtain your verbal agreement to do so or if we give you an opportunity to object to such a disclosure and you do not raise an objection. We may also disclose health information to your family or friends if we can infer from the circumstances, based on our professional judgment, that you would not object. For example, we may assume you agree to our disclosure of your personal health information to your spouse when you bring your spouse with you into the exam room during treatment or while treatment is discussed. In situations where you are not capable of giving consent (because you are not present or due to your incapacity or medical emergency), we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest. In that situation, we will disclose only health information relevant to the person’s involvement in your care.
Deceased Person’s PHI may be disclosed by our practice to family or others involved in the person’s care or payment for care unless our practice knows the deceased preferred that certain people not receive the PHI. Disclosures are limited to the PHI directly relevant to the person’s involvement.
Other Uses and Disclosures of Health Information
We will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific, written Authorization. We must obtain your Authorization separate from any Consent we may have obtained from you.
If you give us Authorization to use or disclose health information about you, you may revoke that Authorization, in writing to 2233 Willamette St, Suite B 1st Floor, Eugene, OR 97405 , at any time. If you revoke your Authorization, we will no longer use or disclose information about you for the reasons covered by your written Authorization. However, we cannot take back any uses or disclosures already made with your permission.