THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Privacy Promise
At Healthy Blue, we understand the importance of handling your health records with care. We are committed to protecting the privacy of your health records. State and federal laws require us to make sure that your health records are kept private.
Federal law requires that we provide you with this Notice of Privacy Practices, which describes our legal duties and privacy practices with respect to your health records and your legal rights with respect to our use and disclosure of your health records. By law, we must follow the terms of the notice currently in effect.
This notice went into effect Sept. 23, 2013, and will remain in effect until we change or replace it. We reserve the right to change our privacy practices and the terms of this notice at any time, as long as the law allows. These changes will be effective for all health records we keep, including health records we created or received, including from private and public sources, before we made the changes. When we make a material change to our privacy practices, we will provide a copy of a new notice or information about the changes to our privacy practices and how to get a new notice within 60 days to members who are covered under our health plan at that time.
HOW WE USE OR SHARE YOUR HEALTH RECORDS
We may use or share your health records:
For treatment. For example, we may share information to help your doctor provide your treatment and give you proper care.
For payment. For example, we may use your records to help us pay the bills your provider sends us.
For health care operations. For example, we may use records to help us run our health plan and ensure you receive quality care. We may not use or share genetic information for underwriting purposes.
To help manage your health. For example, we may tell your doctor about a program that could improve your health.
To remind you about a doctor visit.
To tell you about other treatments and programs, like those to stop smoking or lose weight.
To help find ways to make our programs better.
To help resolve a complaint filed by you or one of our doctors.
We also may share your health records with a family member, friend or other person who is involved in your health care or payment for your health care. Before we disclose your health records to that person, we will ask you for your approval. If you are not available or unable to tell us due to illness or injury, we will decide what action is in your best interest.
State and federal law may require us to share your health information:
With state and federal agencies that manage us. For example, we may need to share records with the South Carolina Department of Health and Human Services.
With a public health agency. For example, records may help avoid a serious public health or safety threat.
With a court of law.
With law enforcement. For example, we may have to share health records to help stop child abuse.
With a coroner, medical examiner or funeral director to help find a cause of death.
With a medical facility for organ donor or transplant purposes.
With government officials. For example, we may have to share health records for national security.
For workers’ compensation.
For disaster relief.
Federal law says we must tell you what the law says we have to do to protect personal health information (PHI) that is told to us, in writing or saved on a computer. We also have to tell you how we keep it safe. To protect PHI:
On paper (called physical), we:
Lock our offices and files.
Destroy paper with health information so others cannot get it.
Saved on a computer (called technical), we:
Use passwords so only the right people can get in.
Use special programs to watch our systems.
Used or shared by people who work for us, doctors, or the state, we:
Make rules for keeping information safe, called policies and procedures.
Teach people who work for us to follow the rules.
WHEN WE NEED YOUR APPROVAL TO USE OR SHARE YOUR HEALTH RECORDS
Before we can use or share your health records for any reason other than one of those listed above, we must first get your written approval. If you give us approval and later decide you want to withdraw it, you can let can tell us and we will stop using or sharing your medical records for that reason.
Other than for the reasons listed above, we may not use or share your health records without your written approval. You may give us the right to share your health records with another individual for any reason. We have a form for that purpose and will send it to you upon request. You may take back your approval at any time by telling us in writing.
We must get your approval to use or disclose psychotherapy notes, except when it is required by law. We must get your approval to sell your health records to a third party. We must get your approval to send you information about health-related products or services, except those that are offered by us or associated with your health plan.
RACE, ETHNICITY, LANGUAGE, SEXUAL ORIENTATION, AND GENDER IDENTITY
We get race, ethnicity, language, sexual orientation and gender identity information about you from the state Medicaid agency and the Children’s Health Insurance Program. We protect this information as described in this notice.
We use this information to:
Make sure you get the care you need.
Create programs to improve health outcomes.
Create and send health education information.
Let doctors know about your language needs.
Provide interpretation and translation services.
We do not use this information to:
Issue health insurance.
Decide how much to charge for services.
Determine benefits.
Share with unapproved users.
YOUR PERSONAL INFORMATION
We may ask for, use and share personal information (PI) as we talked about in this notice. Your PI is not public and tells us who you are. It is often taken for insurance reasons.
We may use your PI to make decisions about your:
Health.
Habits.
Hobbies.
We may get PI about you from other people or groups, such as:
Doctors.
Hospitals.
Other insurance companies.
We may share PI with people or groups outside of our company without your OK in some cases.
We will let you know before we do anything where we have to give you a chance to say no.
We will tell you how to let us know if you do not want us to use or share your PI.
You have the right to see and change your PI.
We make sure your PI is kept safe.
YOUR RIGHTS
The following are your rights with respect to your health records:
You have the right to ask us to limit how we use or share your health records. We will try to do as you ask, but the law does not say we have to.
You have the right to look at and get a paper or electronic copy of your health records that we have. This includes anything we use to make decisions about your health care. We will have 30 days to send it to you. If we need more time, we have to let you know.
You have the right to ask us to send your information in another way or to another address. For instance, if you believe you might be in danger if we mail your records to your home address, you can ask us to use another mailing address.
You have the right to ask us to change your health records that we have. For instance, if you believe that information in your health records is missing or incorrect, you can ask us to make the changes. We will have 60 days to respond and send it to you. If we need more time, we have to let you know.
You have the right to receive a list of when we have given your records to others during the past six years. We do not have to include any times we shared information with your approval or as allowed by law. We will have 60 days to send it to you. If we need more time, we have to let you know.
You have the right to notice of breach. You have the right to be notified about a breach of any of your unsecured protected health information.
QUESTIONS AND COMPLAINTS
If you have a question about our privacy practices, or if you want to get a paper copy of this notice, please call Customer Service at 866-781-5094 (TTY: 866-773-9634). We are available Monday through Friday from 8 a.m. to 6 p.m. Eastern time.
Healthy Blue
Privacy Officer
I-20 at Alpine Rd. Mail Code AC-200
Columbia, SC 29219
If you believe we may have violated your privacy rights, you may submit a written complaint to the address below.
You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with that address upon request.
We support your right to the privacy of your health records. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.