After-hours care T. 770-446-0929 / Fax 770-446-6977

cosmo dental-logo

After-hours care T. 770-446-0929 / Fax 770-446-6977

cosmo dental-logo

After-hours care T. 770-446-0929 /
Fax 770-446-6977

Notice of Privacy Practices

Notice of Privacy Practices

Contact Us

6185 Buford Hwy. Building A-1
Norcross, GA 30071

T. 770-674-7980
After Hours: 770-446-0929

Monday - Friday: 9 AM to 6 PM
Saturday: 9 AM to 1 PM
Sunday closed 

What is the HIPAA notice I receive from my doctor and health plan?

Your health care provider and health plan must give you a notice that tells you how they may use and share your health information. It must also include your health privacy rights. In most cases, you should receive the notice on your first visit to a provider or in the mail from your health plan. You can also ask for a copy at any time.

Why do I have to sign a form?

The law requires your doctor, hospital, or other health care provider to ask you to state in writing that you received the notice.

The law does not require you to sign the “acknowledgement of receipt of the notice.”
Signing does not mean that you have agreed to any special uses or disclosures (sharing) of your health records.
Refusing to sign the acknowledgement does not prevent a provider or plan from using or disclosing health information as HIPAA permits.
If you refuse to sign the acknowledgement, the provider must keep a record of this fact.

What is in the Notice?

The notice must describe:

How the Privacy Rule allows provider to use and disclose protected health
information. It must also explain that your permission (authorization) is necessary before your health records are shared for any other reason
The organization’s duties to protect health information privacy
Your privacy rights, including the right to complain to HHS and to the organization if you believe your privacy rights have been violated
How to contact the organization for more information and to make a complaint.

When and how can I receive a Notice of Privacy Practices?

You’ll usually receive notice at your first appointment. In an emergency, you should receive notice as soon as possible after the emergency.
The notice must also be posted in a clear and easy to find location where patients are able to see it, and a copy must be provided to anyone who asks for one.
If an organization has a website, it must post the notice there.
A health plan must give its notice to you at enrollment. It must also send a reminder at least once every three years that you can ask for the notice at any time.
A health plan can give the notice to the “named insured” (subscriber for coverage). It does not also have to give separate notices to spouses and dependents.

NOTICE TO PATIENTS (FTCA Information) Center for Pan Asian Community Services, Inc. at 3510 Shallowford Road and its health centers the COSMO Primary and COSMO Dental at 6185 Buford Hwy Building G and Building A are Health Center Program grantees under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n). For the purposes of malpractice insurance, the organization and its employees are deemed federal employees with resultant coverage under the Federal Tort Claims Act (FTCA) for actions within the scope of deemed employment, pursuant to 42 U.S.C. 233(g)-(n). Accordingly, claims or notice of medical malpractice claims should be submitted by a claimant to the Office of General Counsel at the address below. U.S. Department of Health and Human Services Office of the General Counsel General Law Division Claims and Employment Law Branch, 330 C Street, SW, Attention: CLAIMS Switzer Building, Suite 2600, Washington, DC 20201 / Fax No.: 202-619-2922 /