This notice describes how medical information about you may be used and disclosed and how you can get access to this information. It applies to Delta Dental of South Dakota and dental care provided by the Delta Dental of South Dakota Foundation. Please review it carefully.
This notice is effective May 1, 2021
Download a .pdf copy of our HIPAA notice of privacy practices for your records.
You have the right to:
We may use and share your information as we:
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get a copy of dental and claims records
Ask us to correct dental and claims records
Request confidential communications
Ask us to limit what we use or share
Get a list of those with whom we’ve shared information
Get a copy of this privacy notice
Choose someone to act for you
File a complaint if you feel your rights are violated
Write to: 200 Independence Avenue, S.W., Washington, D.C. 20201
We typically use or share your health information in the following ways:
We can help manage the dental care treatment you receive.
We can use your health information and share it with professionals who are treating you.
Example: On our mobile dental clinic trucks, we use your information to provide high quality dental care. We may also share your information with another dentist who we are referring you to see.
We can run our organization.
We can use and disclose your information to run our organization and contact you when necessary.
Examples: (1) We use health information about you to develop better services for you. In some instances, we do this by requesting that you complete a survey. (2) We use health information about you to manage your treatment and services.
We can pay (or bill) for your dental services.
We can use and disclose your health information as we pay for your dental services.
Example: We may use your information to bill you or your plan sponsor and to coordinate payment for your dental work if you have more than one insurance.
We can administer your plan.
We may disclose your information to your dental plan sponsor for plan administration.
Example: Your company contracts with us to provide a dental plan, and we provide your company with certain statistics to explain the premiums we charge.
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes. More information is available from the US Dept. of Health & Human Services.
We help with public health and safety issues.
We can share health information about you for certain situations, such as:
We do research.
We can use or share your information for health research.
We comply with the law.
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
We respond to requests and work with a medical examiner or funeral director.
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
We address workers’ compensation, law enforcement, and other government requests.
We can use or share health information about you:
We respond to lawsuits and legal actions.
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
For certain information, you can tell us your choices about what we share.
If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
Share information with your family, close friends, or others involved in the care and payment for your care.
Share information in a disaster relief situation.
If you are not able to tell us your preference, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
Use this form to allow Delta Dental of South Dakota to release protected health information (such as dental claims history or benefits information) to someone else (such as a spouse or adult dependent).
We are required by law to maintain the privacy and security of your protected health information.
Changes to the terms of this notice
We can change the terms of this notice, and the changes will apply to all information we have about you. We will post a copy of the current notice on our website.