DentaQuest takes your privacy seriously. We want to tell you about our privacy practices to protect your personal health information.
How do we use health information?
DentaQuest uses your health information to pay providers and others who provide you with health care or services, and to conduct normal business known as health care operations. Examples of how we use your information include:
- Payment — We may pay claims submitted by providers who treat you. We may also discuss your treatment plan with your provider or provide prior authorization for certain services.
- Health Care Operations — Health information is used for quality improvement and for customer service.
We comply with all applicable state and federal laws, including any laws that impact our ability to use your health information for payment and operations.
We may also use information to:
- Inform you of research opportunities or benefits for alternative treatments.
- Tell you about benefits and services.
- Communicate with family or friends involved in your care.
- Communicate with other healthcare providers or business associates for treatment, payment, or health care operations. Business associates must follow our privacy rules.
- Communicate with the sponsor of your health plan.
Information we share
There are limited times when we are permitted or required to disclose health information without your signed permission. These situations are listed below:
- To protect victims of abuse or neglect for federal and state health oversight activities such as fraud investigations.
- For judicial or administrative proceedings.
- If required by law or for law enforcement.
- To coroners, medical examiners, and funeral directors.
- For specialized government functions such as national security and intelligence.
- To Workers' Compensation if you are injured at work.
- To a correctional institution if you are an inmate.
All other uses and disclosures, not previously described, may only be made with your signed authorization. You may revoke your authorization at any time. Click here for the authorization form.
DentaQuest is required by law to:
- Maintain the privacy of your health information.
- Provide this notice of our duties and privacy practices.
- Abide by the terms of the notice currently in effect.
- We reserve the right to change privacy practices, and make the new practices effective for all the information we maintain. Revised notices will be available to you on our website at www.dentaquest.com and will be mailed to you upon request.
You have the right to:
- Request that we restrict how we use or disclose your health information. We may not be able to comply with all requests.
- Request that we use a specific telephone number or address to communicate with you.
- Inspect and copy your health information (fees will apply).*
- Request additions or corrections to your health information.*
- Receive an accounting of how your health information was disclosed (excludes disclosures for treatment, payment, healthcare operations and some required disclosures, as well as disclosures that you authorize).*
- Obtain a paper copy of this notice even if you receive it electronically.
Requests followed by an asterisk (*) must be in writing.
We do not give your financial information to any person or persons not affiliated with DentaQuest. It is important to us that you understand what financial information we gather and how we use it to administer your benefits and serve you better.
- Financial Information — In order to provide your health care services, we may gather financial information about you from you, your employer, your plan sponsor, or your provider with respect to claims, co-payments, and premium payments.
- Security — In compliance with state and federal standards, electronic, procedural, and physical safeguards are in place to limit the collection and use of non-public information to the minimum necessary to provide you with quality products and services. Access to this information is limited to a "need to know" basis for our employees to perform their jobs. This applies to you whether you are a former or current member.
DentaQuest is required by law to provide an EDI Connectivity Guide:
As of January 1st 2013, DentaQuest is compliant with the Phase II CORE 270: Connectivity Rule version 2.2.0 March 2011. The EDI Connectivity Guide is available for download.
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