This Notice describes how health
information about you may be used and disclosed and how you can get access to
this information. PLEASE REVIEW IT CAREFULLY.
Issuing This Notice
This Notice describes the privacy practices of
New England Dental Administrators, LLC, and the privacy practices of any third
party which assists New England Dental Administrators, LLC in the
administration of your dental plan.
The Purpose of This
New England Dental
Administrators, LLC has always maintained the privacy of your personal
information. We are now required by law to maintain the privacy of your
personal information and to give you this Notice of our privacy practices, our
legal duties and your rights concerning your private health information.
New England Dental Administrators, LLC must follow the practices described in
this Notice as long as this Notice is in effect. This Notice will take
effect on April 14, 2003 and will remain in effect until it is replaced.
New England Dental Administrators, LLC reserves the right to revise or change
this Notice at any time. Any such revision will affect information we
already have about you and any information we receive in the future. If
there is any significant change in New England Dental Administrators, LLC's
privacy practices, this Notice will be changed and the new Notice will be
available upon your request. A copy of the current Notice will be
available on the New England Dental Administrators, LLC Web site,
http://www.nedallc.com. You may request a copy of this Notice at
If you have any questions regarding this Notice,
or if you wish to receive another copy, please contact:
HIPAA Privacy Officer
New England Dental Administrators, LLC
PO Box 2006
Concord, NH 03302-2006
Uses and Disclosures
of Your Health Information
New England Dental
Administrators, LLC uses and discloses your personal health information for
purposes of treatment, payment and healthcare operations. For example:
Treatment: We may use or disclose
your personal health information to a physician or other healthcare provider
who is providing treatment to you.
Healthcare Operations: We may use or
disclose your personal health information in connection with the administration
of your dental plan, including such operations as claims adjudication,
professional review, underwriting, coordination of benefits with other plans
providing coverage, fraud and abuse detection programs, audit services and
other administration activities.
Payment: Your medical information
may be used or disclosed to determine and remit proper payment for covered
services under your dental plan.
Disclosures Require by Law: New
England Dental Administrators, LLC may use or disclose your health information
when it is required to do so by law. For example, your health information
may be disclosed to comply with a court order, an administrative order, a
subpoena, a discovery request or other lawful process.
Other Disclosures: New England
Dental Administrators, LLC does not use or disclose your personal health
information for marketing purposes, not does it sell your information for any
purpose other than treatment, payment or healthcare operations or as required
by law, will require your written authorization. You may revoke any such
Disclosure to Health Plan
Sponsor: Your personal health information may be disclosed to the
sponsor of your group dental plan for the purpose of administering benefits
under the plan.
Workers Compensation: New
England Dental Administrators, LLC may provide your personal health information
for workers compensation or similar programs that provide benefits for work
related injuries or illness.
Your Rights Regarding Health
Information About You
You have the following rights
regarding the personal health information we maintain about you:
Rights to Inspect and Copy:
You have the right to inspect and copy your health information which New
England Dental Administrators, LLC maintains. To inspect and copy your
health information, please contact the Privacy Officer at the address or
telephone number given above. If you request a copy of information, we
may charge a fee for the costs of copying, mailing or other supplies needed to
fulfill your request.
Right to Amend: If you
feel your health information maintained by New England Dental Administrators,
LLC is incorrect or incomplete, you may ask to amend the information by
contacting the HIPAA Privacy Office at the address or telephone number listed
above. You may request an amendment for as long as the information is
maintained by New England Dental Administrators, LLC. Your request may be
denied if it does not include a reason to support the request. In
addition, it may be denied if you request to amend information that:
is not part of the health
information maintained by New England Dental Administrators, LLC;
was not created by New England
Dental Administrators, LLC unless the person or entity creating the information
is no longer available to make the amendment;
is not part of the information you
would be permitted to inspect or copy; or
the information you seek to amend is
accurate and complete.
Right to an Accounting of
Disclosures: You have the right to request an "accounting of
disclosures" if any such disclosure was made for any purpose other than
treatment, payment or healthcare operations. To request an accounting of
disclosures, you must submit your request in writing to the HIPAA Privacy
Officer, at the address listed above. Your request must state a time
period, which may not be longer than (6) years and may not include dates prior
to April 14, 2003.
Right to Request Restrictions:
You have the right to request a restriction or limitation on the health
information we use or disclose about you for treatment, payment or healthcare
operations. However, we are not required to agree to your request.
Your request to limit or restrict use of your private health information must
be made in writing to the HIPAA Privacy Officer, at the address listed
above. The request must include the information you wish to limit,
whether you wish to limit, use, disclosure, or both, and to whom the limits may
apply, for example, disclosures to your spouse.
Right to Request Confidential
Communications: You have the right to request that we communicate
with you concerning your private health information only in certain ways or at
certain locations. For example, you may request that we only contact you
at work or by mail. Any such request must be made in writing to the HIPAA
Privacy Officer noted above. Where possible, we will accommodate all
Right to a Paper Copy of this
Notice: Even if you have received this Notice electronically, you
are entitled to receive a paper copy of this Notice. A request for a copy
of the Notice should be sent to the HIPAA Privacy Officer at the address
above. You may also obtain a copy of this at our Web site,
How to File a Complaint:
If you believe your privacy rights have been violated by New England Dental
Administrators, LLC, you may file a written complaint addressed to the HIPAA
Privacy Officer, New England Dental Administrators, LLC, PO Box 2006, Concord,
NH 03302-2006. The complaint must be in writing. Or, you may file a
written complaint with the Secretary of the Department of Health and Human
Services. You will not be penalized or retaliated against for filing a
We do not provide your financial information to any person or persons not affiliated with New England Dental Administrators. It is important that you understand what financial information we gather and how it may be used to administer your dental benefits plan.
Financial Information: To provide services, we may gather financial information about you from you, your employer, your group administrator, or your dentist, with regards to claims and co–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 services. Access to information is limited to a “need to know” basis for our employees to perform their job in administering your claims or to provide customer service. This applies whether you are a former or current subscriber.
Your account information with New England Dental Administrators is password protected for your privacy and security. In certain areas New England Dental Administrators uses industry–standard secure socket layer (SSL) encryption to protect data transmissions. SSL encrypts information transferred between you and our server and renders it unreadable to anyone who may intercept the information.