HIPAA Non-Discrimination Notice
for Medicaid & Medicare Use

©All Rights Reserved HIPAA made EASY™

Patient Empowered Dentistry complies with applicable Federal Civil Rights Laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Patient Empowered Dentistry does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. We provide free aids and services to people with disabilities to communicate effectively with us, such as: HIPAA interpretation in written format, written information in large print, audio-accessible formats via www.HHS.gov 800#, electronic formats & hard copies.

We also comply with HIPAA Law to provide free HIPAA Translation to people whose primary language is not English. For language translation, in the top 15 common languages we will have you call: 800-752-0093. Or please contact our HIPAA Officer for additional guidance on these translation links or other fore mentioned communication aids at the phone number listed below.

If you believe that Patient Empowered Dentistry has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:

HIPAA Officer: Dr. Chris Dyki
Office Name: Patient Empowered Dentistry
Office Address: 24840 Gratiot Ave, Eastpointe, Michigan 48021
Office Phone: 586-771-6340
Office Fax: 586-771-6383

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf , or by U.S. mail or telephone:

U.S. Department of Health and Human Services
200 Independence Avenue, SW Room 509F
HHH Building Washington, D.C. 20201
Phone: 800-368-1019 Fax: 800-537-7697
Language Translation Phone: 800-752-0093

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html

Language Assistance Services for Individuals with Limited English Proficiency

Section 1557 Of The Affordable Care Act

We will take reasonable steps, in accordance with current HIPAA requirements, to provide free language assistance services to people who speak common languages that we are likely to hear within our practice and who don’t speak English well enough to talk to us about the healthcare service we provide.

Translation of the above statement in:

Spanish: Tomaremos medidas razonables, de acuerdo con los requisitos actuales de HIPAA, para proporcionar servicios de asistencia lingüística gratuitos a las personas que hablan idiomas comunes que probablemente escuchemos en nuestra práctica y que no hablen el inglés lo suficientemente bien como para hablarnos sobre la atención médica. Servicio que brindamos.

French: Nous prendrons des mesures raisonnables, conformément aux exigences actuelles de la loi HIPAA, pour fournir des services d’assistance linguistique gratuits aux personnes qui parlent des langues communes que nous sommes susceptibles d’entendre dans notre cabinet et qui ne parlent pas suffisamment l’anglais pour nous parler des soins de santé. service que nous fournissons.

Italian: Adotteremo misure ragionevoli, in conformità con gli attuali requisiti HIPAA, per fornire servizi di assistenza linguistica gratuiti a persone che parlano lingue comuni che probabilmente sentiremo all’interno della nostra pratica e che non parlano inglese abbastanza bene da parlarci della sanità servizio che forniamo.

French Creole (Haitian Creole): Nou pral pran mezi rezonab pou bay sèvis asistans lang gratis pou moun ki pale lang nou pagen ide deyo ak ki pa pale angle byen ase pou pale ak nou sou swen nou ap bay.

German: In Übereinstimmung mit den aktuellen HIPAA-Anforderungen werden wir angemessene Schritte unternehmen, um Menschen, die gängige Sprachen sprechen und die wir wahrscheinlich in unserer Praxis hören werden, kostenlose Sprachassistenzdienste anzubieten, die nicht gut genug Englisch sprechen, um mit uns über die Gesundheitsversorgung zu sprechen Service, den wir anbieten.

Portegues: Tomaremos medidas razoáveis, de acordo com os requisitos atuais da HIPAA, para fornecer serviços gratuitos de assistência em idiomas para pessoas que falam idiomas comuns que provavelmente escutaremos em nossa prática e que não falam inglês o suficiente para conversar conosco sobre os cuidados de saúde. serviço que prestamos.

Croatian: Poduzimat ćemo razumne korake, u skladu s trenutnim zahtjevima HIPAA-e, pružiti besplatne usluge jezične pomoći osobama koje govore zajedničke jezike koje ćemo vjerojatno čuti u našoj praksi i koji ne govore dovoljno dobro engleski jezik da razgovaraju s nama o zdravstvenoj zaštiti usluge koje pružamo.

Greek: Θα λάβουμε εύλογα μέτρα, σύμφωνα με τις ισχύουσες απαιτήσεις της HIPAA, για να παρέχουμε δωρεάν υπηρεσίες γλωσσικής βοήθειας σε άτομα που μιλούν κοινές γλώσσες που πιθανόν να ακούσουμε μέσα στην πρακτική μας και που δεν μιλούν αρκετά καλά αγγλικά για να μας μιλήσουν για την υγειονομική περίθαλψη υπηρεσιών που παρέχουμε.

Korean: 우리는 현재의 HIPAA 요구 사항에 따라 합리적인 조치를 취하여 우리가 실제로 듣고싶어하는 공통 언어를 사용하는 사람들에게 무료 언어 지원 서비스를 제공 할 것이며 건강 관리에 관해 우리에게 충분히 이야기 할 수있는 영어를하지 못합니다 우리가 제공하는 서비스.
.

Albanian:
Ne do të ndërmarrim hapa të arsyeshëm, në përputhje me kërkesat e tanishme të HIPAA, për të ofruar shërbime të asistencës gjuhësore falas për njerëzit që flasin gjuhë të zakonshme që ne mund të dëgjojmë brenda praktikës sonë dhe që nuk flasin anglisht mjaft mirë për të folur me ne për kujdesin shëndetësor shërbim që ne ofrojmë.

Hindi: हम वर्तमान HIPAA आवश्यकर्ाओं के अनुसार, सामान्य भाषा बोलने वाले लोगों को मुफ्र् भाषा सहायर्ा सेवाएं प्रदान करने के ललए उचिर् कदम उठाएंगे, जो कक हमारे अभ्यास के भीर्र सुनने की संभावना है और जो स्वास््य सेवाओं के बारे में हमसे बार् करने के ललए पयातप्र् अंग्रेजी नह ं बोलर्े हैं सेवा हम प्रदान करर्े हैं।

Tagalog:
Magsasagawa kami ng mga makatwirang hakbang, alinsunod sa kasalukuyang mga kinakailangan ng HIPAA, upang magbigay ng mga serbisyo ng tulong sa libreng wika sa mga taong nagsasalita ng mga karaniwang wika na malamang na marinig natin sa loob ng aming pagsasanay at hindi mahusay na nagsasalita ng Ingles upang makipag-usap sa amin tungkol sa pangangalagang pangkalusugan serbisyo na ibinigay namin.

Japanese: 私たちは、現在のHIPAAの要件に従って、私たちが慣れ親しんでいると思う一般的な言語を話し、ヘルスケアについて私たちに十分話すことができない英語を話す人々に無料の言語支援サービスを提供する私達が提供するサービス。

Arabic:

سوف نتخذ خطوات معقولة ، وفقًا لمتطلبات
الحالية ، لتوفير خدمات مساعدة لغوية مجانية
للأشخاص الذين يتحدثون اللغات الشائعة التي من
المرجح أن نسمعها داخل ممارستنا والذين لا يتحدثون
الإنجليزية بشكل جيد للتحدث إلينا حول الرعاية
الصحية الخدمة التي نقدمها.

Polish: Podejmiemy uzasadnione kroki, zgodnie z aktualnymi wymaganiami HIPAA, aby świadczyć bezpłatne usługi pomocy językowej osobom znającym wspólne języki, które prawdopodobnie usłyszymy w naszej praktyce i które nie mówią po angielsku wystarczająco dobrze, aby porozmawiać z nami na temat opieki zdrowotnej. świadczone przez nas usługi.

Vietnamese: Chúng tôi sẽ thực hiện các bước hợp lý, theo các yêu cầu hiện tại của HIPAA, để cung cấp dịch vụ hỗ trợ ngôn ngữ miễn phí cho những người nói ngôn ngữ phổ biến mà chúng tôi có thể nghe trong khi thực hành và những người không nói tiếng Anh đủ tốt để nói chuyện với chúng tôi về chăm sóc sức khỏe dịch vụ chúng tôi cung cấp.

Chinese: 我们将根据当前的HIPAA要求采取合理措施，为在我们的实践中可能会听到的普通语言的人提供免费的语言协助服务，并且他们不会说英语，以便与我们讨论医疗保健我们提供的服务。

Russian: Мы предпримем разумные шаги в соответствии с текущими требованиями HIPAA, чтобы предоставить бесплатные услуги языковой помощи людям, которые говорят на общих языках, которые мы, вероятно, услышим в нашей практике, и которые недостаточно хорошо говорят по-английски, чтобы говорить с нами о здравоохранении Сервис, который мы предоставляем. хорошо говорят по-английски, чтобы говорить с нами о здравоохранении Сервис, который мы предоставляем.