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Our Commitment to Your Privacy
As a company responsible for the information that we collect about you, your privacy
is important to us. We are committed to protecting the confidential nature of your
information to the fullest extent of the law. In addition to various laws governing
your privacy, we have our own privacy policies and procedures in place. We understand
how important it is to protect your privacy.
Protected Health Information
This Notice of Privacy Practices describes the type of information that is collected
and your rights with regard to that information.
“Protected health information” means information that is individually identifiable
to you and your covered dependents for healthcare treatment, payment and operations
and includes information created, maintained or transmitted electronically. This
information is obtained from applications for healthcare coverage, surveys, claims
for payment filed by healthcare providers, referrals made by healthcare providers
and your medical records. Personal health information may also be obtained over
the telephone from you. Other sources of protected health information obtained may
be from group health plan administrators, employers, other insurance carriers and
business partners.
Protected health information includes the following:
- Health history
- Medical records
- Name, address and date of birth
- Your marital status
- Gender
- Social Security number
- Information regarding your dependents
- Other similar information that relates to past, present or future medical care
We may use and disclose your protected information without your specific authorization
for the purposes of treatment, payment and healthcare operations. To illustrate:
- Treatment Activities.Your protected health information may be disclosed to
healthcare providers, including doctors, nurses, laboratory technicians, pharmacies,
medical students, hospitals and other healthcare personnel involved in your treatment.
- Payment Activities.Your protected health information may be disclosed to
individuals involved in the payment for your treatment in order to determine eligibility
for payment and eligibility for plan benefits. Your protected health information
may also be shared with persons involved in utilization review, billing, claims
management and collections.
- Healthcare Operation Activities. Your protected health information may be
used for underwriting, premium rating and enrollment, and may be used and disclosed
for claims processing, quality review assessments and improvement, audits, business
planning and development, medical management, fraud and abuse detection, legal services,
and other necessary administrative services. We may also use your protected health
information
to communicate to you specifics of our disease/care management programs, treatment
alternatives or other health-related benefits and services that may interest you.
nHealth may share your protected health information with our contracted business associates
for purposes of utilization reviews, appropriateness of care reviews, pharmacy benefit
management and preferred provider network access. We require our business associates
to sign a contract specifying their compliance with our privacy policy.
In order to ensure the privacy of your protected health information, we have developed
privacy policies and procedures in accordance with the Health Insurance Portability and Accountability
Act (HIPAA) Privacy Laws. Procedures are based on appropriate
administrative, technical
and physical safeguards necessary to maintain confidentiality of your protected
health information. Such information is limited to those individuals who have a
legitimate business need for the information. This protection extends to the use
of your protected health information by nHealth employees.
Non-routine disclosures of personal health information
In situations not covered by your consent, nHealth will ask for your authorization
prior to use or disclosure of your protected health information. We will use or
disclose information in these circumstances pursuant to the specific purpose contained
in your authorization and will only use or disclose the minimum amount of information
necessary to perform the non-routine function. In most circumstances, authorization
may only be made by the person to whom the protected health information pertains.
In some circumstances, authorization may be obtained from a person representing
your interests such as in emergency situations where authorization would be impractical
to obtain or in the case of minor dependents.
Non-routine disclosures may be made to:
- Requests of medical records pertaining to specialized care when required by the
plan
- Organ donation and tissue transplant entities, if you are an organ or tissue donor
- Department of Defense Health Care Program if you are a member or a veteran of the
armed services
- Workers’ compensation carriers
- Public health agencies
- Law enforcement personnel in response to legal requirements
- Coroners, medical examiners, funeral directors
- Legal representative in response to a court order or other legal proceeding
- National security and intelligence agencies as authorized by law
Required disclosures
nHealth is required by law to disclose your protected health information to:
- Secretary of the United States Department of Health and Human Services when performing
government audits for compliance with the privacy laws
- You, should you request copies of documents or any other records containing your
protected health information used to make decisions regarding your information
Other disclosures
We will disclose your protected health information to individuals not involved in
your healthcare operations, but only with written authorization by you. Such individuals
are:
- Personal representatives
- Spouses and/or other family members
Your rights
You have the right to review your protected health information maintained by nHealth
and to obtain a copy of such information.
You have the right to request amendments to your protected health information. Request
for amendments must be made in writing and must include a reason for the requested
amendment.
You have a right to request an accounting of disclosures of your protected
health information made by nHealth. This request must be made in writing and may
not be for a period longer than six (6) years and may not include dates prior to
April 14, 2003.
You have a right to request a restriction on your protected health information that
may be disclosed. nHealth will accommodate all reasonable requests.
You have the right to confidential communication. You may ask us in writing to communicate
with you about your health information in a certain way or at a certain location
such as by mail only to your work address or to contact you only at home.
You have the right to request a copy of this notice at any time. You can obtain
a copy of this notice on our website at www.nHealth.com or you can call Member Services
at 1-877nHealth (643-2584) to request a paper copy.
You have the right to register a complaint with the Privacy Officer of nHealth.
You may also submit a written complaint to the Office of Civil Rights of the Department
of Health and Human Services if you believe your privacy rights have been violated.
nHealth maintains and enforces a policy of nonretaliation against our members, members
of our workforce or members of the public who bring breaches (or potential breaches)
of this notice to the attention of our Privacy Officer or the Department of Health
and Human Services.
If you have questions, concerns, or complaints about this notice or our privacy
practices, please contact: nHealth, Attn: Privacy Officer, 2570 Technical Drive,
Miamisburg, OH 45342.
Changes to Privacy Practices
nHealth reserves the right to change the terms of this notice as allowed or required
by law. If changes are made to the nHealth privacy policies and procedures, an updated
Notice of Privacy Practices will be available on the company’s website at www.nHealth.com.
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