Newsletter Exclusively for Dental Health Services Members

Your Health Privacy Remains Our Priority

WHAT’S INSIDE

LAP & Member Survey...........................2

Five Ways You Benefit.........................3

Children’s Dental Checkups...............4

Brighten Your Smile..............................5

Your Privacy Notice..............................6

3833 Atlantic Ave., Long Beach CA 90807P: 800-637-6453 | F: 562-424-0150 www.dentalhealthservices.com

0813M549 © 2013 Dental Health Services

Dental Health

Your privacy is very important to Dental Health Services. We value our relationship with you, and we strive to earn your trust and maintain it.

This newsletter contains your Confi-dentiality of Information and Privacy Notice. Information about our online Language Assistance Program sur-vey to help us understand and serve your language needs is also included.

Dental Health Services respects the confidentiality of your Protected Health Information (PHI) and will never sell your information or dis-close it to unaffiliated third parties.

Furthermore, our strict company policy mandates that Dental Health Services employees only access your information for the purpose of providing your dental benefits. Each employee-owner has been thoroughly trained in procedures to protect your privacy.

If you have any questions regarding your privacy or Dental Health Ser-vices, please contact your Member Service Specialist at 562-595-6000 or 800-637-6453. You may also visit our website at www.dentalhealthser-vices.com. Our employee-owners are always happy to help you!

Language Assistance Program and Member Survey/ Encuesta del Programa de Asistencia Lingüística

Thank you for your membership with Dental Health Services. We appreciate the opportunity to provide your dental care.

Dental Health Services provides a free Language As-sistance Program (LAP) to help you understand your dental coverage and treatment options in a language other than English.

We are also conducting a language and member sur-vey about your language preferences to help us un-derstand your language needs and find ways to serve them better.

The LAP survey is available on this secure website: www.dentalhealthservices.com/LAPSurvey. Please take a few minutes to complete it. Your information is confidential and will only be used to help shape our Language Assistance Program. Members who com-plete the survey will be entered into a random draw-ing for a chance to win one of these exciting prizes:

• Philips Sonicare Toothbrush• Waterpik• Air floss

The deadline for completing the online survey is five (5) days upon receipt of this newsletter. Win-ners will be notified by email and phone.

You may also request a printed copy of the LAP sur-vey to be mailed to you. Please contact your Member Service Specialist at 800-637-6453 to receive a copy, or if you have any questions. We’re always happy to help you!

Le agradecemos que sea miembro de Dental Health Services. Valoramos la oportunidad de brindarle la atención dental que le corresponde.

Dental Health Services pone a su disposición un Programa de Asistencia Lingüística (Language Assis-tance Program, LAP) gratuito para que usted pueda entender su cobertura y sus opciones de tratamiento en un idioma distinto al inglés.

Además, estamos llevando a cabo una encuesta a los miembros sobre sus preferencias lingüísticas para ayudarnos a entender sus necesidades lingüísticas y encontrar maneras de satisfacerlas mejor.

La encuesta está disponible en este sitio seguro: www.dentalhealthservices.com/LAPSurvey. Por favor dedique unos minutos para responderla. Su información es confidencial y sólo se utilizará para ayudar a dar forma a nuestro Programa de Asistencia Lingüística. Los miembros que respondan la encuesta participarán en un sorteo para tener la oportunidad de ganar uno de estos fantásticos premios:

• Philips Sonicare Toothbrush• Waterpik• Air floss

El plazo límite para responder la encuesta en línea es cinco (5) días posteriores a la fecha en la que recibió esta carta. Se notificará a los ganadores por correo electrónico y teléfono.

También puede solicitar que se le envíe una copia impresa de la encuesta del LAP. Comuníquese con su especialista de servicios para miembros al 800-637-6453 para recibir una copia o si tiene alguna pregun-ta. ¡Siempre estamos encantados de ayudarle!

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IMPORTANT: Can you read this? If not, we can have somebody help you read it. You may also be able to get this information written in your language. For free help, please call right away at 1-866-756-4259. Dental Health Services has a toll free TTY line 1-888-645-1257 for the hearing and speech impaired.

IMPORTANTE: ¿Puedes leer esto? Si no, alguien le puede ayudar a leerla. Además, es posible que reciba esta información escrita en su propio idioma. Para obtener ayuda gratuita, llame ahora mismo al 1-866-756-4259. Dental Health Services también tiene una línea TTY 1-888-645-1257 para personas con dificultades de audición o de hablar.

Language Assistance Program and Member Survey/ Encuesta del Programa de Asistencia Lingüística

qualified dentists are accepted into our exclusive network. All of our participating dentists undergo our highly selective 107-point Quality Assurancesm pro-gram and are required to maintain high standards to make sure you receive the best and safest care possi-ble. Your trusted dentist works and partners with you toward achieving a healthier you!

Commitment to Prevention

Your overall oral health is our top priority, and we believe prevention is key to achieving this goal. As a Dental Health Services member, you have access to a wealth of educational materials to help you make preventive oral health measures part of your daily life. Learn more about proper brushing, flossing, healthy diet and lifestyle habits, and getting the most from your dental benefits - all at no additional cost to you!

We’re Here For You, Ready and Local

Dental Health Services has been serving the dental health needs of individuals, families, unions, groups, associations, and municipalities in California for more than 38 years. We are independently owned and op-erated, and we take pride in being the only employ-ee-owned dental plan in the country. Our employee-owners are your neighbors and friends who work, live, shop, and play right here. When you work with us, you work with real people who continuously advocate for a happier, healthier you!

If you have any questions about your Dental Health Services plan, please call us at 800-637-6453 or visit our website at www.dentalhealthservices.com. Our employee-owners are always happy to help you.

Five More Ways You Benefit From Your Dental Health Services Plan

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You made an excellent choice for your oral health and overall well-being with a Dental Health Services plan - and we’re here to make sure it stays that way. As a current Dental Health Services member, you already enjoy the many benefits our quality, affordable dental plans offer, including no deductibles, no maximums, and no waiting periods. But that’s not all. Here are five more reasons to smile about your Dental Health Services plan.

Predictable Out-of-Pocket Copayments Whether you need to see a dentist for teeth cleaning, or visit a specialist for medically-necessary braces, your Dental Health Services dental plan offers predictable copayments for dental services. Similar to a restaurant menu, your copayment schedule provides a complete list of covered services and their set copayments, so you know exactly how much you’ll owe before you even schedule your appointment. Enjoy affordable, hassle-free coverage with no surprises!

Service is GuaranteedYour 100% satisfaction is our priority, and as an advo-cate for you and your dental health, we work tirelessly to earn and keep your trust. If, for any reason, some-thing’s not right, count on us to resolve your concern as quickly and professionally as we can.

Excellent Care from Your Quality Assured DentistWhen you need dental care from your selected den-tist, you know you will receive excellent care and ser-vice. That’s because only caring, experienced, and

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Children’s Dental CheckupsTaking your child to the dentist regularly to maintain their den-tal health is just as important as brushing and flossing each and ev-ery day. Having your child visit the dentist is a great habit to develop - the earlier, the better. Regular den-tal visits from an early age (ideally at their first birthday or when their first tooth appears) help your child become accustomed to the dental office environment, making it easi-er to return.

A vast majority of dentists are able to treat children’s dental care needs in their practice. A pedodontist, or pediatric dentist, is a dentist with additional formal training in treat-ing children with complex restor-ative oral health needs.

What if my child has never had a cavity? Is it still necessary to visit the dentist each year?Regular dental visits will help your child maintain a cavity-free mouth and lifelong dental health. Pro-fessional teeth cleaning removes built-up debris, while fluoride treatments make teeth stron-

ger and more resistant to cavi-ties. Regular visits also reinforce good brushing and flossing hab-its for your child. Work with your dentist to determine what your child’s needs are, and how of-ten visits should be scheduled.

What happens during a regular dental check-up?The dentist will review your child’s medical and dental history and examine your child’s teeth, oral tissue, and jaw. The teeth may be cleaned, polished, and given a flu-oride treatment as necessary.

The important thing to remem-ber is that you, as a parent, play a huge role in how your child views the dentist. Speak positively of vis-iting the dental office and this will influence your child’s perspective on not only going to the dentist, but the importance of oral health in general. Practicing good dental hygiene early on will save your child from suffering from the effects of tooth decay down the road!

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Ways to Brighten Your SmileA whiter smile can boost your self-confidence and lead to stronger dental health. Obtaining and maintaining a sparkling grin begins with the food and beverage choices you make every day.

Strawberry PowerMalic acid found in strawberries works as a natural bleach. In addi-tion, the seeds and acid in straw-berries act as a scrub.

Citric AcidLemons, oranges and pineapples contain acids that work as bright-ening and lightening agents on tooth enamel. As an added bonus, these acids contain an enzyme that kills bad breath and stops tooth decay.

Scrub While You CrunchEating crunchy foods like apples, celery, and carrots helps naturally scrub teeth because of their abra-sive nature. They are also a great stimulant in the production of sali-va, which deters plaque formation.

Foods To AvoidAny type of food that you would eat with caution while wearing white will stain your teeth. Avoid foods such as soy sauce, tobacco, red wine, coffee, tea, dark fruits and juices. Also, avoid soft drinks as they stain your teeth in two ways. The acids in soft drinks open the pores in teeth; then the dark coloring penetrates deeper causing the stain.While it is inevitable that you will eat or drink something that could

potentially stain your teeth, you can prevent it by rinsing your mouth thoroughly after your meal.

In Between BrushingChewing on snacks that produce saliva and rinsing your mouth periodically between brushes will help stop stains from forming. Sugar-free gum and even certain sugar-free candies increase pro-duction of saliva, which acts as a cleaning agent in your mouth.

Rinsing your mouth after every meal when you can’t brush will take away food particles and other cavity-causing bacteria lingering in your mouth.

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Dental Health Services is devoted to protect-ing your privacy and the confidentiality of your dental, medical, and personal health in-formation that we may obtain or to which we have access. We do not sell our client infor-mation. Your personal information will not be disclosed to nonaffiliated third parties, unless permitted or required by law, or authorized in writing by you.

Throughout this Notice, unless otherwise stated, your medical and dental health infor-mation refers to only health information cre-ated or received by Dental Health Services and identified in this Notice as Protected Health Information (PHI). Please note that your den-tist maintains your dental records, including payments and charges. Dental Health Services will have a record of this portion of your PHI only in special or exceptional circumstances.

Dental Health Services’ privacy policies de-scribe who has access to your PHI within the organization, how it will be used, when your PHI may be disclosed, safeguards to protect the privacy of your PHI and the training we provide our employees regarding maintaining and protecting your privacy.

Under what circumstances must Dental Health Services share my PHI?

Dental Health Services is required to disclose your PHI to you, and to the U.S. Department of Health and Human Services (HHS) when it is conducting an investigation of compli-ance with legal requirements. Dental Health Services is also required to disclose your PHI, subject to certain requirements and limita-tions, if the disclosure is compelled by (any of the following):

• a court order;• a board, commission or administrative

agency pursuant to its lawful authority;• a party to a proceeding pursuant to a sub-

poena, subpoena duces tecum, or other authorized discovery in a proceeding be-fore a court or an administrative agency;

• an arbitrator or panel of arbitrators in a lawfully-requested arbitration;

• a search warrant;• a coroner in the course of an investiga-

tion; or by other law.

This notice describes how your medical and dental information may be used and disclosed and how you can get access to this information. Please review it carefully. This notice is effective August 1, 2009.

Your Privacy & Confidentiality Notice

When may Dental Health Services dis-close my PHI without my authorization?

Dental Health Services is permitted by law to use and disclose your PHI, without your authorization, for purposes of payment and health care administration.

• Payment purposes include activities to collect premiums and to determine or maintain coverage. These include using PHI in billing and collecting premiums, and related data process-ing including how your dentist obtains pre-authorization for certain dental services. For example, Dental Health Services periodically conducts quality assurance inspections of your dentist’s office and during such visits may review your dental records as part of this audit.

• Health Care Administration means basic activities essential to Dental Health Services’ function as a Limited Health Care Service Contractor, and includes reviewing the qualifications and com-petence of your dentist; evaluating the quality of his/her services; providing subscriber services and information in-cluding answering enrollee inquiries but without disclosing PHI. Dental Health Services may, for example, review your dentist’s records to determine if the copayments being charged by the of-fice comply with the contract under which you receive dental coverage.

• In addition, Dental Health Services is permitted to use and disclose your PHI, without your authorization, in a variety of other situations, each subject to limitations imposed by law. These situations include, but are not limited to, the following uses and disclosures:

• public health activities;• concerning victims of abuse, neglect

or domestic violence;• health oversight agency;• judicial and administrative proceed-

ings including the defense by Dental Health Services of a legal action or proceeding brought by you;

• law enforcement purposes, subject to subpoena or law;

• Workers’ Compensation purposes;• parents or guardians of a minor; and• persons or entities who perform

services on behalf of Dental Health Services and from whom Dental Health Services has received con-tractual assurances to protect the privacy of your PHI.

Is Dental Health Services ever required to get my permission before sharing my PHI?

Uses and disclosures of PHI other than those required or permitted by law will be made by Dental Health Services only with your writ-ten authorization. You may revoke any autho-rization given to Dental Health Services at any time by written notice of revocation to Dental Health Services, except to the extent that Dental Health Services has relied on the authorization before receiving your written re-vocation. Uses and disclosures beyond those required or permitted by law, or authorized by you, are prohibited.

Does my employer have the right to access my PHI?

If you are an enrollee under a plan spon-sored by your employer, Dental Health Ser-vices will not disclose PHI to your employ-er except under the following conditions:

• you sign an authorization for release of your medical/dental information; or

• health care services were provided with specific prior written request and ex-pense of the employer, and are relevant in a grievance, arbitration or lawsuit, or describe limitations entitling you to leave from work or limit work performance.

Any such disclosure is subject to Dental Health Services’ “minimum necessary” dis-closures policy. What is Dental Health Services’ “Mini-mum Necessary” Policy?

Dental Health Services uses reasonable ef-forts to limit the use and disclosure of your PHI to the minimum necessary to accomplish the purpose of the use or disclosure. This re-striction includes requests for PHI from an-other entity, and to requests made by Dental Health Services to other entities. This restric-

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tion does not apply to requests by:

• your dentist for treatment purposes;• you; or• disclosures covered by an authorization

you provided to another entity.

What are my rights regarding the privacy of my PHI?

Your rights respecting your PHI, and how you may exercise these rights are summarized here:

• You may request Dental Health Ser-vices to restrict uses and disclosures of your PHI in the performance of its pay-ment or health care operations. How-ever, a written request is required. Your health is the top priority and Dental Health Services is not required to agree to your requested restriction. If Dental Health Services agrees to your requested restriction, the restriction will not ap-ply in situations involving emergency treatment by a health care provider.

• Dental Health Services will comply with your reasonable requests that you wish to receive communications of your PHI by alternative means or at alternative lo-cations. Such requests must be made to Dental Health Services in writing.

• You have a right, subject to certain limita-tions, to inspect and copy your PHI. Your request must be made in writing. Dental Health Services will act on such request within 30 days of receipt of the request.

• You have the right to amend your PHI. The request to amend must be made in writing, and must contain the reason you wish to amend your PHI. Dental Health Services has the right to deny such requests under certain conditions provided by law. Dental Health Services will respond to your request within 60 days of receipt of the request and, in certain circumstances may extend this period for up to an additional 30 days.

• You have the right to receive an account-ing of disclosures of your PHI made by Dental Health Services for up to 6 years preceding such request subject to certain exceptions provided by law. These excep-tions include, but are not limited to:

• disclosures made for payment or health care operations

• disclosures occurring prior to Febru-ary 26, 2003

Your request must be made in writing. Dental Health Services will provide the accounting within 60 days of your request but may extend the period for up to an additional 30 days. The first accounting requested during any 12-month period will be made without charge. There is a $25 charge for each additional ac-counting requested during such 12-month period. You may withdraw or modify any ad-ditional requests within 30 days of the initial request in order to avoid or reduce the fee.

You have the right to receive a copy of this Notice, and any amended Notice, upon writ-ten or telephone request made to Dental Health Services.

All written requests for the purposes described in this section, and all other written communications to Dental Health Services desired or required by this Notice, must be delivered to Dental Health Services, 3833 Atlantic Avenue, Long Beach, CA 90807 by any of the following means:

• personal delivery;• email delivery to:

customercare@dentalhealthservices.com;• first class or certified U.S. Mail; or• overnight or courier delivery, charges pre-

paid

What duties does Dental Health Services agree to perform?

Dental Health Services will maintain the pri-vacy of your PHI and provide you with notice of its legal duties and privacy practices with respect to PHI.

• Dental Health Services will abide by the terms of this Notice and any revised No-tice, during the period that it is in effect.

• Dental Health Services reserves the right to change the terms of this Notice or any revised notice. Any new terms shall be effective for all PHI that it maintains in-cluding PHI created or received by Den-tal Health Services prior to the effective date of the new terms. Each time Dental Health Services makes a revised Notice, it shall 1) post it on its website, www.den-talhealthservices.com and 2) distribute a written copy personally by First Class U.S. Mail to each of its subscribers who are enrolled with Dental Health Services during the period that such revised No-tice remains effective.

What if I am dissatisfied with DentalHealth Services’ compliance with HIPAA (Health Insurance Portability and Ac-countability Act) privacy regulations?

You have the right to express your dissatisfaction or objection to Dental Health Services and to the Secretary of HHS if you believe your privacy rights have been violated. Grievances to Dental Health Services must be made in writing to Dental Health Services, 3833 Atlantic Avenue, Long Beach, CA 90807 Attn: Privacy Officer. Your written dissatisfaction must describe the acts or omissions you believe to be in violation of the provisions of this Notice or applicable laws. Your written objection to HHS or Dental Health Services must be filed within 180 days of when you knew or should have known of the act or omission. You will not be penalized or retaliated against for communicating your dissatisfaction. We are eager to assist you.

Who should I contact if I have any ques-tions regarding my privacy rights with Dental Health Services?

You may obtain further information regarding your PHI privacy rights by contacting your Den-tal Health Services Member Service Specialist at 800-637-6453 during regular office hours or through www.dentalhealthservices.com.

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Your annual notification is now available! Please visit our website at: www.dentalhealthservices.com/privacy.cfm to view your notification online. To receive a print copy in the mail, please contact your Member Service Specialist at 800-637-6453. We’re always happy to help you!

3833 Atlantic Avenue,Long Beach, CA 90807

A Great Reason to Smile sm

www.dentalhealthservices.com

If you are amazed or pleased with your dental plan, let your family and friends know we have excel-lent dental coverage for them, too.

We’ve been providing quality, affordable dental coverage for small and large groups, employers, unions, municipalities, families, as well as individuals, for more than 38 years. Have your family and friends call us at 800-637-6453 or visit our website online at www.dentalhealthservices.com today!

“ ““I have used Dental Health Services’ plan for many years and am very pleased with their customer service. In my personal experience with them, I or my dentist have never encoun-tered a problem, which says a lot about their professionalism and their concern for their clients. I would highly recommend Dental Health Services to anyone.”

- Maria F., Dental Health Services Member

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