Effective date: October 4, 2026. 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. Monempour Endodontics & Associates, 433 N Camden Dr, Suite 1100, Beverly Hills, CA 90210, 310-278-5993, is required by law to maintain the privacy of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.
Treatment. We use your health information to provide endodontic care and share it with other providers involved in your care, such as your referring dentist, who receives a report after your visit.
Payment. We may use and disclose your information to obtain payment for services, for example to a financing company you choose or, at your request, to provide documentation you can submit to a dental plan. Health care operations. We may use your information to run the practice, including quality review, staff training, and appointment reminders by phone, text or email.
Other uses permitted or required by law. These include disclosures required by law; for public health activities; to report abuse or neglect; for health oversight; in response to a court order or lawful subpoena; to avert a serious threat to health or safety; to coroners, medical examiners or funeral directors; for workers' compensation; and to business associates who perform services for us under written agreements that require them to protect your information. We may contact you about treatment alternatives or health-related services we offer. Any other use or disclosure, including most uses for marketing and any sale of your information, will be made only with your written authorization, which you may revoke in writing at any time.
You have the right to inspect and obtain a copy of your health and billing records, usually within 30 days of a written request, and to receive an electronic copy if we keep the record electronically. You may request a correction to your records; we may deny the request in certain cases and will tell you why in writing. You may request an accounting of certain disclosures made in the six years before your request. You may request restrictions on how we use or disclose your information; we are not required to agree, except that we must honor a request not to disclose information to a health plan when you have paid in full out of pocket for that item or service. You may ask us to communicate with you in a specific way or at a specific location, and we will accommodate reasonable requests. You may obtain a paper copy of this notice at any time, even if you agreed to receive it electronically. You may choose someone to act for you under a medical power of attorney or as a legal guardian; we will confirm their authority before acting.
We will notify you promptly, as required by law, if a breach occurs that may have compromised the privacy or security of your information.
Our website forms are for appointment requests and general questions; please do not include detailed health information in them. Information collected on the website is described in our Privacy Policy. If you give us a mobile number, we may send appointment-related texts; reply STOP to opt out.
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at the address or phone number above, or with the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue SW, Washington, DC 20201, 1-877-696-6775, or www.hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you for filing a complaint.
We reserve the right to change this notice and to make the new notice apply to health information we already hold. The current notice is posted in our office and on this website, and a copy is available at the front desk on request.
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