THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE READ IT CAREFULLY.
Your Personal Health Information
We collect personal health information from you through treatment, payment and related healthcare operations, the application and enrollment process, and/or healthcare providers or health plans, or through other means, as applicable. Your personal health information that is protected by law broadly includes any information, oral, written or recorded, that is created or received by certain health care entities, including health care providers, such as physicians and hospitals, as well as, health insurance companies or plans. The law specifically protects health information that contains data, such as your name, address, social security number, and others, that could be used to identify you as the individual patient who is associated with that health information.
Uses Or Disclosures Of Your Personal Health Information
Generally, we may not use or disclose your personal health information without your permission. Further, once your permission has been obtained, we must use or disclose your personal health information in accordance with the specific terms that permission. The following are the circumstances under which we are permitted by law to use or disclose your personal health information.
Without Your Consent For Treatment, Payment, Or Healthcare Operations
Without your consent, we may use or disclose your personal health information in order to provide you with services and the treatment you require or request, or to collect payment for those services, and to conduct other related health care operations otherwise permitted or required by law. Also, we are permitted to disclose your personal health information within and among our workforce in order to accomplish these same purposes. However, even with your permission, we are still required to limit such uses or disclosures to the minimal amount of personal health information that is reasonably required to provide those services or complete those activities.
Examples of treatment activities include: (A) the provision, coordination, or management of health care and related services by health care providers; (B) consultation between health care providers relating to a patient; or (C) the referral of a patient for health care from one health care provider to another.
Examples of payment activities include: (A) billing and collection activities and related data processing; (B) actions by a health plan or insurer to obtain premiums or to determine or fulfill its responsibilities for coverage and provision of benefits under its health plan or insurance agreement, determinations of eligibility or coverage, adjudication or subrogation of health benefit claims; (C) medical necessity and appropriateness of care reviews, utilization review activities; and (D)disclosure to consumer reporting agencies of information relating to collection of premiums or reimbursement.
Examples of health care operations include: (A) development of clinical guidelines; (B) contacting patients with information about treatment alternatives or communications in connection with case management or care coordination; (C) reviewing the qualifications of and training health care professionals; (D) underwriting and premium rating; (E) medical review, legal services, and auditing functions; and (F) general administrative activities such as customer service and data analysis.
As Required By Law
Without Your Consent For Other Purposes
Upon Your Opportunity To Verbally Agree Or Object
All Other Situations With Your Specific Authorization