Privacy Notice for Members:
“THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMAITON. PLEASE REVIEW IT CAREFULLY”
Inter Valley Health Plan Protecting your Information
Your personal health information is not shared except for the purposes of treatment, payment or to conduct necessary health care operations. Certain circumstances allow us to share your personal information as permitted by law, or if we receive a written authorization from you giving us permission to do so. Written authorizations may be withdrawn.
Inter Valley Health Plan maintains physical and mechanical systems to facilitate keeping your personal information safe. Unauthorized access to your personal information is ensured by restricted passwords in electronic files, data encryption, or firewall technology. Additional security measures include your protected information being kept in locked files.
Inter Valley Health Plan Employees are bound by our confidentiality policies. Violation of confidentiality policies by employees results in disciplinary action.
Only those employees who need access to private information for treatment, payment or healthcare operations have access to your personal information. This includes information used for benefit determination, care management, quality assessment activities, utilization activities such as medical necessity determinations, customer service, claims payment, operational tasks and information needed to fulfill other legal and/or regulatory requirements.
You have the right to access certain information and to review certain disclosures and the ability to review, amend, correct or copy your information if we are required to do so under state or federal law. Examples of general categories of information that may be received and maintained by Inter Valley Health Plan include:
Information received, provided by you on your application, survey, or our Web Site. This may include your name, address, date of birth, Social Security Number, martial status dependents and your gender.
Information about your transactions and experiences with our affiliates and other such as account balances, payment history policy coverage and premiums.
Information from consumers or medical reporting agencies, medical providers or other third parties such as credit history, medical information and demographic information.
Information Shared with Third Parties
We may disclose the personal information we receive from you with our contracted third parties/Business Associates permitted by law. Certain information may need to be shared for the purpose of treatment, health care operation and/or payment.
Examples of third party include:
Requirements by Law for compliance with a subpoena, fraud prevention, or inquiries from state or federal regulatory agencies.
Financial companies that we have a written business agreement with such as service providers, banks, and insurance companies.
Companies that perform functions on Inter Valley Health Plan behalf such as marketing companies, unless requested otherwise.Your Privacy Option
Inter Valley Health Plan’s goal is to use your information wisely and in accordance with the law. However if you do not want us to share the information with third parties you may call our Customer Service Department and request a form to restrict the disclosure/redisclosure of your health information. The restriction does not apply to sharing information for treatment, payment or health care operation or that which is permitted by state or federal law.
An agreement to restrict the use and disclosure of information does not prevent uses or disclosure made for the following purposes:
- In the event of emergency situations
- As required by law
- For the purpose of certain public health activities
- For the purpose of health agency oversight activities
- For worker’s compensation programs
Appeals/Grievances/Statement of Disagreement:
You have the right to appeal or file a formal grievance or a “Statement of Disagreement” in response to a denial made by Inter Valley for access/amendment requests to your protected/personal health information. (You may not appeal a denial of your information if these notes are psychotherapy notes or records compiled in anticipation of a legal proceeding.) These forms may be obtained by calling our Service To Senior’s Department at Inter Valley Health Plan (909) 623-6333 or (800) 251-8191. TTY Hearing impaired may call (800) 505-7150. You may contact the Secretary of Health and Human Services if you feel that your privacy rights have been violated.