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Notice of Privacy Practices

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Your Information.

Your Rights.

Our Responsibilities.

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.

 

YOUR RIGHTS

When it comes to your health information, you have certain rights.

This section explains your rights and some of our responsibilities to help you. 

To request any of the following rights please call RightCare from Scott & White Health Plan (“SWHP”) at 1-855-TX-RIGHT (1-855-897-4448). 

Get a copy of health and claims records

  • You can ask to see or get a copy of your health and claims records and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
  • You may ask for the copies to be provided in paper or electronic form, if available. 

Ask us to correct or amend health and claims records

  • You can ask us to correct your health and claims records if you think they are incorrect or incomplete. Ask us how to do this.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

  • Request confidential communications
  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will consider all reasonable requests.  We must say “yes” if you tell us you would be in danger if we do not.
  • SWHP will not ask you the reason for your request.
Ask us to limit what we use or share
  • You can ask us not to use or share certain health information for treatment, payment, or our operations.
  • We are not required to agree to your request.  We may say “no” if it would affect your care.

Get a list of those with whom we’ve shared information

  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will list all the information given except for facts about treatment, payment, and health care operations, and other  information you asked us to make. We’ll provide one list a year for free but will charge a reasonable cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time.  Even if you agreed to receive the notice online. We will provide you with a paper copy promptly. You may also view a copy of the Notice on our member web site at www.rightcare.swhp.org.

Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting SWHP at 1-855-TX-RIGHT (1-855-897-4448) or write: 

Scott & White Health Plan
c/o Corporate Compliance
1206 West Campus Drive
Temple, Texas 76502

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

  • You may also file a complaint with the Texas Attorney General’s Office by calling 1-800-252-4056.
  • We will not retaliate against you for filing a complaint.

For questions or other complaints relating to Health Plan Coverage, please call SWHP at 1-855-TX-RIGHT (1-855-897-4448).

 

Your Choices

For certain health information, you can tell us your choices about what we share.

If you have a clear way for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in payment for your care
  • Share information in a disaster relief situation
  • Contact you for fundraising efforts

If you are not able to tell us your choice, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

  • Marketing purposes
  • Sale of your information
  • Other uses or disclosures not described in this notice
  • You may revoke your authorization

 

Our uses and disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Help manage the health care treatment you receive

We can use your health information and share it with professionals who are treating you.

Example: A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services.

Run our organization

  • We can use and disclose your information to run our organization and contact you when necessary.
  • We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans.

Example: We use health information about you to develop better services for you.

Pay for your health services

We can use and disclose your health information as we pay for your health services.

Example: We share information about you with your dental plan to coordinate payment for your dental work.

Administer your plan

We may disclose your health information to your health plan sponsor for plan administration.

Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to explain the premiums we charge.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

Help with public health and safety issues

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

For Underwriting Purposes

  • We may use or disclose your health information for underwriting purposes; however, we will not use or disclose your genetic information for such purposes.

Health Related Programs or Products

  • We may provide your information about alternative medical treatments and programs or about health-related products and services

Reminders

  • We may use or disclose your health information to send you reminders about your benefits or care, such as appointment reminders with providers who provide medical care to you.

Do research

  • We can use or share your information for health research.

Comply with the law

  • We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

  • We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

  • We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address worker’s compensation, law enforcement, and other government requests

We can use or share health information about you:

  • We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

  • We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Business Associates

  • We may share health information with business associates who perform functions on our behalf or provide us with services. 

Student Immunizations to Schools

We can provide proof of your child’s immunizations to their school based on your verbal or written permission to do so.


Additional Restrictions

There may be certain federal or state laws that may require us to restrict the use or disclosure of certain health information including the following types of information:

  • HIV/AIDS
  • Mental health
  • Genetic tests
  • Alcohol and drug abuse
  • Sexually transmitted diseases and reproductive health information
  • Child or adult abuse or neglect, including sexual assault.

OUR RESPONSIBILITIES

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html


Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

This Notice of Privacy Practices applies to the following organizations.

RightCare from Scott & White Health Plan, Scott and White Health Plan, Insurance Company of Scott and White, and its affiliated entities (collectively SWHP), its staff, employees, and volunteers.

 

Effective Date: April 14, 2003

Revised Date:   April 3, 2015