You have the right to request to receive confidential communications of your PHI.
You may request to receive communications about your protected health information from us at an alternate location or by an alternate method. If you would like to submit a new request for confidential communications or revise or cancel an existing one, email it to email@example.com, mail it to the address below, or contact us via phone. Your request will be valid until you cancel it or submit a new one.
California Dental Network
C/O Privacy Officer
23291 Mill Creek Drive, Ste 100, Laguna Hills, CA 92653
By email to: firstname.lastname@example.org
By telephone to: CDN’s Member Services at (877) 433-6825
By TDD/TTY: 711
We will implement confidential communications requests within 7 calendar days of receipt of an electronic or telephonic request or within 14 calendar days of receipt by first-class mail.
California law states that you can ask for confidential communications regarding the receipt of sensitive services. These types of services can include:
- Bills and attempts to collect payment
- A Notice of Adverse Benefit Determination(s)
- An Explanation of Benefit notice(s)
- A Plan’s request for additional information regarding a claim
- A notice of a contested claim
- The name and address of a provider, description of services received, and other information related to a visit
- Any verbal, written or electronic communications from the Plan that contain protected health information