BENECARE TAKES YOUR PRIVACY SERIOUSLY

USES OF PHI FOR TREATMENT, PAYMENT OR HEALTH CARE OPERATIONS
Under the law, there are certain circumstances under which we may use your PHI or disclose it to others without first seeking your authorization. While we take significant precautions to protect your PHI in these circumstances, we nevertheless may share your PHI without your authorization for the reasons described below.

Facilitating your treatment. We can use your dental information and share it with dental professionals who need the information as part of treating you. Example: We can share information back and forth with your dentist related to your dental conditions, the amount of your annual benefit still available, and other facts the dentist needs to create a treatment plan for you.

Payment purposes related to your coverage and your dental services. We can use and disclose your health information as
we attempt to collect any amounts you owe us, and as we pay your dentist(s) for your covered dental services. Example: We share information about you with your dentist to determine coverage and coordinate payment for your dental work, or to bill your plan sponsor, or otherwise in the payment-related administration of your plan.

Health care operations. We can use and disclose your health information as we engage in operations designed operate our plan, including to assess and improve our clinical standards or to follow policies in place to ensure meeting those standards. Example: We can use or disclose information about you and the services you have received as part of performing an analysis of the quality of care provided by our participating dentists.

OTHER USES OF PHI THAT DO NOT REQUIRE YOUR AUTHORIZATION
We are allowed or required to share your information in other limited ways without your authorization. Generally, these are rare circumstances where disclosure is required either for additional administration of the plan or for public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes, and we continue to take all appropriate precautions with your PHI in these circumstances. Some of these circumstances include:

Disclosures to others involved in your care when you are unable to give authorization. If you have a medical emergency, are incapacitated, or are otherwise unavailable to give your consent, we are allowed to use our best judgment to determine whether to disclose your PHI to a person relevant to your care (for example, a close family member).

Disclosures to your plan sponsor as part of administering the plan. We may disclose certain PHI to your plan’s sponsor (who may be your employer) if that information is required for them to administer the plan. That information may only be used in plan administration.

Public health issues. We are allowed (and in some cases, required) to use and disclose your PHI to government entities or other public service organizations if that information is needed in preventing disease, helping with product recalls, or tracking adverse reactions to medications.

Safety issues. We are allowed (and in some cases, required) to use and disclose your PHI to government entities or other public service organizations if that information is needed in reporting suspected abuse, neglect, or domestic violence, or to prevent or reducing a serious threat to anyone’s health or safety.

Other reasons related to legal compliance, law enforcement requests, or government functions. 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 can also use or share dental information about you for workers’ compensation claims, for certain law enforcement purposes, for health oversight agency activities authorized by law, for special government functions like national security and presidential protective services, and in response to a court or administrative order or subpoena.

USES OF PHI THAT REQUIRE YOUR AUTHORIZATION
Other than for the purposes described above, all uses and disclosures of your PHI require us to obtain your written authorization. This includes, for example, disclosures to a current or prospective employer for any purpose other than plan administration, and using your genetic information for underwriting purposes. Additional protections apply to your PHI when it involves psychotherapy notes, alcohol and drug abuse prevention, treatment, and referrals, HIV/AIDS and other communicable diseases, and genetic testing. We never share your PHI for marketing purposes or sell your PHI.
At any time, you may revoke any written authorization you previously gave us for using or disclosing your PHI. The cancellation must be submitted in writing. The cancellation will not impact disclosures that were made prior to revocation while your authorization was still in effect.