Effective April 14, 2003
DELTA DENTAL OF ILLINOIS
NOTICE OF PRIVACY PRACTICES AND RIGHTS
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU
MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO
THIS INFORMATION.
PLEASE REVIEW THIS NOTICE CAREFULLY.
HOW WE MAY USE AND SHARE YOUR HEALTH INFORMATION
We are allowed to use or share health information
about you for certain purposes without your
authorization. The following categories describe
different ways we use and disclose health
information. Not every use or disclosure in a
category will be listed, but all of the ways we are
permitted to use and disclose information will fall
within one of the categories.
Payment: We may use and disclose your protected
health information to determine eligibility for dental
benefits, to collect premiums, to process claims for
predetermination and payment for treatment you
receive from dental providers, to determine benefits
under your group dental plan or program, and to
coordinate benefit coverage. We may also disclose
health information to another entity subject to the
federal health information privacy laws and regulations
or to a health care provider for the payment activities
of that entity or provider.
For example, we may use or disclose information about
the treatment you received from a dentist in order to
pay you or your dentist for covered services.
Health Care Operations: We may use or disclose your
health information for our health care operations for
the following purposes: quality assessment and
improvement activities, training, licensing, or
credentialing activities, and health care fraud and abuse
detection and compliance programs. We may also
disclose your health information to another entity subject
to the federal health information privacy laws and
regulations. That disclosure may only be made if that
entity has or has had a relationship with you and the
health information pertains to that relationship.
For example, we may use health records to review
participating dentists’ treatment and services an