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Notice of Privacy Practices
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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.
This notice tells how the IHCP may use or release your health
information. It also tells you about your rights and the IHCP
requirements about the use and release of your health information.
Your health information will not be shared without your written
authorization except as described in this notice, or when required
or permitted by law. If you give us your written authorization, you
may change your mind by telling us in writing. The IHCP may change
its privacy practices and make the new privacy practices effective
for all protected health information we maintain. If the terms of
this notice change, we will mail you a revised copy of this notice
to the address you have supplied.
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Our Responsibilities and Commitment to You
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We understand that your health care information is personal. We
take responsibility to keep your personal health information
private, very seriously. We are committed to following all state
and federal laws that protect your health information and tell you
about your rights to your health information. We are required to
protect your health information, tell you about your rights to
health information, and to give you this notice explaining our
responsibilities and the ways we use and share your health
information.
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Use and Disclosure of Your Health
Information
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We do not create health records. We receive health information
to help us make decisions on whether you qualify for certain
programs or services. We use your health information to pay for
services provided to you by your health care provider, for health
care operations, and to evaluate the quality of services you
receive. While we cannot describe all cases related to the use of
your health information, the following are some common examples of
how we use your health informatio
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| Doctors, hospitals, and other health care practitioners that
provide services to your submit you health information to us in the
form of a claim payment. They may also give us your health
information in order to obtain prior authorization or to find out
if a service is covered. These requests include information that
identifies you, your diagnosis, and procedures you have received,
or that you might receive in the future. We use this health
information to approve and pay for the services we cover. We may
also share your information with other programs that may pay for
your health care, such as Medicare or private insurance companies
in order to get payments. |
| We may use your health information to review the care and
outcome of your treatment and to compare the outcomes of other
people who receive the same or similar treatment. We use this
information to improve the quality and effectiveness of health care
services. |
| We may also disclose your information to our employees, as well
as companies and persons we have contracts with, so they can
perform the jobs we ask them to do, such as approving services for
you or reviewing payments made to health care practitioners. To
protect your health information we require everyone who has a
contract with us to follow rules protecting your information. |
| We may use and disclose your health information with other
government agencies that may provide public benefits or services to
you. We may also disclose or share your information with other
government agencies permitted by law, including the federal
government, to show how the IHCP is working and to improve the
programs. |
| We may use or disclose your health information in compliance
with the law in a public emergency to notify your family; for
public health activities to prevent or control disease, injury, or
disability or report abuse; to comply with workers' compensation
laws; as required by law including in response to a subpoena,
discovery request, court or administrative order, for issues of
national security, to report vital statistics, or to process organ
donation information. |
| We may disclose your information to researchers when the
information cannot identify you or when their research has been
reviewed and approved by an institutional review board to ensure
the continued privacy and protection of your health
information. |
| You have the right to request that the IHCP not release your
personal health information, release only part of your information,
or release it for reasons you request. We are not required to honor
your request. |
| You have the right to request a paper copy of this notice at
any time, even if you agree to receive it electronically by
e-mail. |
| You have the right to request a list showing each time we
released your personal health information. Your written request
must be submitted to the IHCP Privacy Office and state what time
period you want to cover. The time period may not go back further
than six years and may not include dates before April 14, 2003.
This list will not include personal information that was released
to provide treatment to you, to make or obtain payment for
services, for health care operations, for national security, or for
use by prisons or law enforcement officials. This list will not
include information released to you by the IHCP that you requested
in writing, or information released to persons who are involved in
your care. |
| You have the right to request that we contact you about your
personal health matters in a certain way or at a certain location.
For example, you can request that we only contact you at work or by
e-mail. We will review and accommodate only reasonable requests. To
request a special way or location for us to contact you about your
personal health information, you must write to the IHCP Privacy
Office. If an appeal is filed with the IHCP Privacy Office, an
individual who did not participate in the decision to deny the
request will review the appeal. |
| You have the right to ask that we change health information
that you feel is incorrect or incomplete. Your request may be
denied if we did not create or write the information, it is not
part of the information you can see or copy, or if we decide the
personal health information has no errors and is complete. |
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Contact Information or Filing a Complaint
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Note: All requests about your health information must be in
writing and sent to the IHCP Privacy Office address listed in the
contact information section at the end of this notice.
If you have questions or want additional information, you can
contact the IHCP using the following address or phone number. If
you have a complaint about our health information practices or
believe that we have violated your privacy rights, please submit
the complaint to the IHCP at the following address. All
complaints must be submitted in writing.
IHCP Privacy
Office
P.O. Box 7260
Indianapolis, IN
46207-7260
(317) 713-9627 or 1-800-457-4584
You can also file a complaint with the Secretary of Health and
Human Services at the following address:
Secretary of Health and Human
Services
20 Independence Avenue, SW
Washington, D.C. 20201
We will never take action against you for filing a complaint and
it will not impact the health care services provided to you.
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