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Patient right to privacy

Oregon law guarantees you the right to have protected health information sent directly to you instead of to the person who pays for your health insurance plan (the primary account holder).

You can have this information shared with you directly through a number of different ways:

  • Email
  • Telephone
  • At a different mailing address

To make this request, complete, sign, and send this form to your insurer. You can send it by mail, fax, or email. Contact your insurance company to find out where to send your form.

Download the Oregon Request for Confidential Communication form.

PLEASE NOTE: If you change insurance companies, you must make a new request to the new insurance company. Until your request is processed, the insurance company may continue to send your protected health insurance to the person who is paying for your health insurance.

What is protected health information?

Protected health information is individually identifiable health information your insurer has or sends out in any form. Confidential communication of protected health insurance covered under this request includes:

  • The name and address of a provider, a description of services provided, and other visit information
  • An explanation of benefits notice
  • Information about an appointment
  • A claim denial
  • A request for additional information about a claim
  • A notice of a contested claim
  • Any written, oral, or electronic communication described on this list to a policyholder, certificate holder, or enrollee that contains protected health information