Mary Jean A. Oropesa, DDS,PLLC

Your First Appointment

Your first visit will take approximately an hour and a half. We will gather pertinent medical information including your medical/dental history, take necessary X-rays, photographs and study models. We will do a comprehensive examination including a cancer and periodontal screening. Ideally you will not have your teeth cleaned at your first visit nor will we begin treatment until you understand what your needs are and what treatment will involve. We want your visits to our office to be pleasant. We have headphones in every operatory with a variety of music to choose from. We also have movie glasses for long appointments. We invite you to bring your favorite CDs and DVDs.


Fees and Insurance

Our mission is to deliver the finest care possible. Payment is due at the time of service. If this is not convenient for you, we have partnered with Care Credit, which allows you to schedule your procedures today and spread payments over time. If you have insurance, we will be more than happy to assist with the billing.


Comprehensive Approach

Our goal is to give our patients a complete and comprehensive oral examination, focusing on your total oral health which includes oral cancer screening, examination of the teeth and supporting tissues. We will mutually go over all the findings and present our recommendations, providing you with the "state of the art" treatment methods available for optimal oral health.


Your Time Is Valuable...

We respect the value of your time. We work hard to stay on time and ask that you help us by keeping your scheduled appointments. We request that our patients respect the mutual value of time by giving 48 hours notice if it is necessary to reschedule appointment times.


To Protect Your Health

You can feel assured that everything is being done to meet and exceed all government guidelines for protecting you and your family members in this office. We will be happy to explain all procedures and safeguards used to ensure your continued health and prevent the spread of diseases and infections. We use the latest proven sterilization methods and are proud to share all control measures with you.


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 office of Dr. Mary Jean A. Oropesa, DDS respects your privacy.  We understand your personal health information is very sensitive.  We will not disclose your information to others unless you tell us to do so, or unless the law authorizes us to do so.

The law protects the privacy of the health information we create and obtain in providing our care and service to you.  For example, your protected health information includes your symptoms, test results, diagnoses, treatment, health information from other providers, and billing and payment information relating to these services.  Federal and state law allows us to use and disclose your protected health information for purposes of treatment and health care operations.  Sate law requires us to get your authorization to disclose this information for payment purposes.

Examples of Use and Disclosures of Protected Health Information for Treatment, Payment, and Health Operations

For treatment:

  • Information obtained by a nurse, physician, or other member of our health care team will be recorded in your medical record and used to help decide what care may be right for you.
  • We may also provide information to others providing your care.  This will help them stay informed about your care.

For Payment:

  • We request payment from your health insurance plan.  Health plans need information from us about medical/dental care.  Information provided to health plans may include your diagnoses, procedures performed, or recommended care.

For health care operations:

  • We use your medical records to assess quality and improve services.
  • We may use and disclose medical records to review the qualifications and performance of our health care providers and to train our staff.
  • We may contact you to remind you about appointments and give you information about treatment alternatives or other health-related benefits and services.
  • We may contact your to raise funds.
  • We may use or disclose your information to conduct or arrange for services, including:
    • Medical quality review by your health plan;
    • Accounting, legal, risk management, and insurance services;
    • Audit functions, including fraud and abuse detection and compliance programs.

Your Health Information Rights

The health and billing records we create and store are the property of the practice of Dr. Mary Jean A. Oropesa, DDS.  The protected health information in it, however, generally belongs to you.  You have a right to:

  • Receive, read, and ask questions about this Notice.
  • Ask us to restrict certain uses and disclosures.  You must deliver this request in writing to us. We are not required to grant the request.  But we will comply with any request granted.
  • Request and receive from us a paper copy of the most current Notice of Privacy Practices for Protected Health Information ("Notice").
  • Request that you be allowed to see and get a copy of your protected health information.  You may make this request in writing.  We have a form available for this type of request.
  • Have us review a denial of access to your health information -- except in certain circumstances.
  • Ask us to change your health information.  You may give us this request in writing.  You may write a statement of disagreement if your request is denied.  It will be stored in your medical record, and included with any release of your records.
  • When you request, we will give you a list of disclosures of your health information.  The list will not include disclosures  to third party payors.  You may receive this information without charge once every 12 months.  We will notify you of the cost involved if you request this information more than once in twelve months.
  • Ask that your health information be given to you by another means or at another location.  Please sign, date and give us your request in writing.
  • Cancel prior authorizations to use or disclose health information by giving us a written revocation.  Your revocation does not affect information that has already been released.  It also does not affect any actions taken before we have it.  Sometimes, you cannot cancel an authorization if its purpose is to obtain insurance.

For help with these rights during normal business hours, please contact:

Dr. Mary Jean A. Oropesa

425-822-8248
11416 Slater Ave. N.E. Suite 101
Kirkland, WA 98033

Our Responsibilities

We are required to:

  • Keep your protected health information private;
  • Give you  this notice;
  • Follow the terms of this notice.

We have the right to change our practices regarding the protected health information we maintain.  If we make changes, we will update this Notice.  You may receive the most recent copy of this Notice by calling and asking for it or by visiting our office to pick one up.

To Ask for Help or Complain

If you have any questions, want more information, or want to report a problem about the handling of your protected health information, you may contact:

Dr. Mary Jean A. Oropesa, DDS
425-822-8248
11416 Slater Ave. N.E. Suite 101
Kirkland, WA 98033

If you believe your privacy rights have been violated, you may discuss your concerns with any staff member.  You may also deliver a written complaint to Dr. Mary Jean A. Oropesa at 11416 Slater Ave. Suite 101, Kirkland, WA 98033.  You may also file a complaint with the U.S. Secretary of Health and Human Services.

We respect your right to file a complaint with us or with the U.S. Secretary of Health and Human Services.  If you complain we will not retaliate against you.

Other Disclosures and Uses of Protected Health Information

Notification of Family and others

  • Unless you object, we may release health information about you to a friend or family member who is involved in your medical/dental care.  We may also give information to someone who helps pay for your care.  We may tell your family or friends your condition and that you are in a hospital.  In addition, we may disclose health information about you to assist in disaster relief efforts.
  • (Hospitals) Information may be provided to people who ask for you by name.  We may use and disclose the following information in a hospital directory:
    • your name
    • location
    • general condition, and
    • Religion (only to clergy).

You have the right to object to this use or disclosure of your information.  If you object we will not use or disclose it.

We may use and disclose your protected health information without your authorization as follows.

  • With Medical Researchers -- If the research has been approved and has policies to protect the privacy of your health information.  We may also share information with medical researchers preparing to conduct a research project.
  • To Funeral Directors/Coroners consistent with applicable law to allow them to carry out their duties.
  • To Organ Procurement Organizations (tissue donation and transplant) or persons who obtain, store, or transplant organs.
  • To Food and Drug Administration (FDA) relating to problems with food, supplements, and products.
  • To Comply with Workers' Compensation Laws -- if you make a workers' compensation claim.
  • For Public Health and Safety Purposes as Allowed or Required by Law:
    • To prevent or reduce a serious, immediate threat to the health or safety of a person or the public.
    • To public health or legal authorities
      • to protect public health and safety
      • to prevent or control disease, injury, or disability
      • to report vital statistics such as births or deaths.
  • To Report Suspected Abuse or Neglect to public authorities.
  • To Correctional Institutions if you are in jail or prison, as necessary for your health and the health and safety of others.
  • For Law Enforcement Purposes such as when we receive a subpoena, court order, or other legal process, or you are a victim of crime.
  • For Health and Safety Oversight Activities.  For example, we may share health information with the Department of Health.
  • For Disaster Relief Purposes.  For example, we may share health information with disaster relief agencies to assist in notification of your condition to family or others.
  • For Work-Related Conditions That Could Affect Employee Health.  For example, an employer may ask us to assess health risks on a job site.
  • To Military Authorities of U.S. and Foreign Military Personnel.  For example, the law may require us to provide information necessary to a military mission.
  • In the Course of Judicial/Administrative Proceedings at your request, or as directed by a subpoena or court order.
  • For Specialized Government Functions. For example, we may share information for national security purposes.

Other Uses and Disclosures of Protected Health Information

  • Uses and disclosures not in this Notice will be made only as allowed or required by law or with your written authorization.
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