Rome McClellan Dental Group home
Effective date: September 18, 2026
THIS NOTICE DESCRIBES HOW MEDICAL AND DENTAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Your information. Your rights. Our responsibilities.
This notice describes the privacy practices of PV Dental, LLC, doing business as Rome McClellan Dental Group and operating under Dynamic Dental Services Group, LLC, concerning protected health information, or PHI. PHI includes identifiable information about your health, care, or payment for care that is protected by HIPAA. This notice applies to the practice identified below; it does not establish a joint notice covering other DDS Group practices or independent providers.
You may request a copy of this notice and discuss it with our privacy contact:
Privacy Officer / Privacy Contact — PV Dental, LLC, doing business as Rome McClellan Dental Group
7501 Mission Rd, Suite 102
Prairie Village, KS 66208
Phone: (913) 786-4404
Email: info@rmdentalgroup.com
Website: https://www.rmdentalgroup.com/
Please call for instructions before sending sensitive information by ordinary email.
Your rights
Inspect or obtain a copy of your records
You may ask to inspect or receive an electronic or paper copy of your dental record and other health information we maintain about you in a designated record set. Ask our privacy contact how to submit a request. We generally act on an access request within 30 days. If an extension is permitted and necessary, we will provide the required written explanation and completion date. We may charge a reasonable, cost-based fee for copies as permitted by law. A summary may be provided if you agree to it. Certain limited exceptions apply; if access is denied, we will explain the reason and any available review rights.
Request a correction
You may ask us to amend information you believe is incorrect or incomplete. We generally act within 60 days, subject to a permitted extension with written notice. We may deny a request in circumstances allowed by law, but will explain the reason in writing and how you may submit a statement of disagreement. An amendment does not necessarily erase the original record.
Request confidential communications
You may ask us to contact you in a particular way or at a different address or telephone number. We will accommodate reasonable requests. Tell us how you want us to communicate with you.
Request limits on uses or disclosures
You may ask us to restrict certain uses or disclosures for treatment, payment, or health care operations. We are not required to agree to every request. If we agree, we will follow the restriction except as permitted by law, including when information is needed for emergency treatment.
If you pay for a service or item in full out of pocket, you may request that we not disclose information about that service or item to your health plan for payment or health care operations. We will honor that restriction unless disclosure is required by law. Tell us about the request before the information is sent to the plan.
Receive an accounting of certain disclosures
You may request a list of certain disclosures made during the six years before your request. The accounting generally excludes disclosures for treatment, payment, or health care operations and other categories excluded by law, including certain disclosures you authorized. We will provide one accounting in a 12-month period without charge. If a permitted fee applies to an additional request, we will tell you in advance so you may withdraw or modify it.
Obtain this notice
You may request a paper copy at any time, even if you previously agreed to receive it electronically. We will provide a paper copy promptly.
Have an authorized representative act for you
A person legally authorized to act as your personal representative, such as an authorized health care agent or legal guardian, may exercise applicable rights on your behalf. We will verify the person’s authority and follow applicable limits and exceptions, including rules concerning minors and safety.
File a complaint without retaliation
If you believe your privacy rights have been violated, you may complain to the practice’s privacy contact using the information above. You may also complain to the U.S. Department of Health and Human Services Office for Civil Rights:
- Website: https://www.hhs.gov/hipaa/filing-a-complaint/index.html
- Telephone: 1-877-696-6775
- Mail: 200 Independence Avenue, S.W., Washington, D.C. 20201
We will not retaliate against you for filing a complaint.
Your choices and written authorizations
Family, friends, and others involved in care
Where permitted by law, you may agree or object to sharing relevant information with family, friends, or others involved in your care or payment for care, or for disaster-relief purposes. If you cannot express a preference, we may use professional judgment to share information in your best interest as permitted by law. Information may also be disclosed when legally permitted to lessen a serious and imminent threat to health or safety.
Uses requiring authorization
We will obtain your written authorization for uses or disclosures requiring authorization, including marketing and sale of PHI where required by law and most uses or disclosures of psychotherapy notes. Uses and disclosures not otherwise described in this notice will be made only with your written authorization unless permitted or required by law.
You may revoke an authorization in writing at any time. A revocation does not undo actions already taken in reliance on the authorization or other exceptions recognized by law.
Fundraising choices
If we contact you for fundraising, you may opt out of future fundraising communications. If we hold substance use disorder patient records subject to 42 CFR Part 2, we will provide clear, conspicuous advance notice and an opportunity to choose not to receive fundraising communications using that information, as required by law. This paragraph explains your rights if such communications occur; it does not state that this dental practice operates a fundraising program.
How we typically use and disclose information
Treatment
We may use and share information to provide and coordinate care. For example, we may share relevant dental records or X-rays with a specialist treating you, communicate with a pharmacy about a prescription, or provide information needed by a dental laboratory.
Payment
We may use and disclose information to bill and obtain payment from you, health plans, or other responsible parties. For example, we may send information needed for a dental-benefit claim, subject to any applicable restriction on disclosure to your health plan.
Health care operations
We may use and share information to operate the practice, improve quality, assess services, train personnel, manage treatment, and perform appropriate administrative activities. Service providers performing functions for us may receive PHI under legally required safeguards and agreements.
Care-related communications
As permitted by law, we may contact you about appointments, treatment alternatives, and health-related benefits or services. You may request reasonable confidential communication arrangements. Communications that require authorization remain subject to that requirement.
Other uses and disclosures permitted or required by law
We may use or disclose information for the following purposes only when applicable legal conditions are met:
- Public health and safety: disease prevention, product recalls, adverse-event reporting, reporting abuse or neglect, and preventing or reducing a serious threat to health or safety.
- Health oversight: audits, investigations, inspections, and other authorized oversight activities.
- Research: research satisfying applicable authorization, waiver, or other legal requirements.
- Legal obligations: disclosures required by federal, state, or local law, including to HHS for HIPAA compliance review.
- Donation and death-related functions: appropriate disclosures to organ-procurement organizations, coroners, medical examiners, or funeral directors.
- Workers’ compensation and government functions: disclosures permitted for workers’ compensation, law enforcement, military, national-security, and other authorized government functions.
- Judicial and administrative proceedings: disclosures in response to a valid court or administrative order, or a subpoena or other lawful process when required safeguards and legal conditions have been met.
A request, subpoena, or investigation does not automatically authorize every disclosure. Additional protections described below or imposed by law continue to apply.
Additional protections for certain information
If we hold substance use disorder patient records protected by 42 CFR Part 2, we will not use or disclose those records, or testimony describing their contents, in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a qualifying court order and subpoena or other legally required compulsion. Any consent for those proceedings must satisfy the applicable separate-consent requirements. These protections apply only to records subject to Part 2; this notice does not characterize all dental records as Part 2 records or represent that RM operates a Part 2 treatment program.
Other federal or applicable state laws may impose additional restrictions on particular information or disclosures. Where a more protective law applies, we follow that law. An authorization, consent, or court order must meet any applicable additional requirements.
Our responsibilities
- We are required by law to maintain the privacy and security of PHI and to provide this notice of our legal duties and privacy practices.
- We will notify affected individuals following a breach of unsecured PHI as required by law, without unreasonable delay and within applicable legal time limits.
- We must follow the privacy practices in the notice currently in effect.
- We will not use or disclose information outside the circumstances described here without authorization unless another use or disclosure is permitted or required by law.
Changes to this notice
We reserve the right to change this notice and make a revised notice apply to information we already maintain as well as information received in the future, as permitted by law. A revised notice will show its effective date and be available upon request, in the office, and on our website.
Questions or requests
Contact the practice’s Privacy Officer / Privacy Contact at (913) 786-4404, info@rmdentalgroup.com, or the Prairie Village address above. Ask how to submit a privacy request or complaint securely.