Confidential Communications

Newport Dental Plan (“Plan”) does not require a protected individual to obtain the primary subscriber’s or other enrollee’s authorization to receive sensitive services or to submit a claim for sensitive services if the protected individual has the right to consent to care. The Plan will direct communications regarding a protected individual’s receipt of sensitive services directly to the protected individual receiving care as follows: (a) Directly to the protected individual’s designated alternative mailing address, email address, or telephone number; OR, (b) In the absence of an alternative designated mailing address, email address, or telephone number: to the address or telephone number on file in the name of the protected individual. Communications shall include the following written, verbal, or electronic communications related to the receipt of sensitive services:

  • Bills and attempts to collect payment
  • A notice of adverse benefits determinations
  • An explanation of benefits notice
  • 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 provided, and other information related to a visit
  • Any written, oral, or electronic communication from the plan that contains protected health information

All requests for confidential communications will be implemented within 7 calendar days of receipt of an electronic or telephonic request or within 14 calendar days of receipt by first-class mail and the Plan will acknowledge receipt of confidential communication requests and will advise the subscribers or enrollees of the status of implementation of the request if the subscribers or enrollees contacts the Plan. To submit an electronic request, please use the Contact Us link on the Home Page or email NDP@smilebrands.com. To submit a telephonic request, please call toll-free (800) 497-6453. To submit a request by mail, please address the request to Newport Dental Plan, 675 Anton Boulevard, Suite 500, Costa Mesa, CA 92626.