Privacy of Your Health Information

To protect your privacy, we will talk only to you about your health information, unless:

You tell us that we can talk to someone else.
We are required or it is legally okay to talk to someone else.

If you want us to talk about your health information to a family member or friend, you must give us a signed release form. In most cases, this is true of minors as well as adults.

For more information or to get a release form, please call the Community Health Plan customer service team at 1-800-440-1561 (toll free). If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.

Community Health Plan Notice of Privacy Practices

The privacy of your health care information is important to us. This page describes in general how health care information about you may be used and given to others and how you can get this information. The information in this section went into effect April 14, 2003, and will remain in effect until it is revised or replaced.

Please review this page carefully. The privacy of your health care information is very important to us.

The complete Community Health Plan privacy policy and procedure are also available to you:

Community Health Plan is required by a federal law called the Health Information Portability and Accountability Act of 1996 (HIPAA) to keep your protected health information private and to give you this notice of our legal duties and privacy practices. Protected health information means any information that is about you, including information on your health care and treatment, your name, age, address, social security number, family, and employer.

How We Use and Share Your Protected Health Information

We use and share with others protected health information about you only for your treatment, payment for your treatment, and some other uses. See below.

The following are examples of how we may use or share information about you:

Treatment. We may share your information with doctors or hospitals to help them give you care. For example, if you are in the hospital, we may share health care records sent to us by your doctor with the hospital.
Payment. We may use and share your information:
- To pay your health care bills, which have been sent to us by doctors and hospitals for payment.
- To determine your eligibility or whether a service is covered under your policy.
- To coordinate benefits if you have other health insurance coverage.
Operations. We may use and share your information:
- To make sure you and other members get quality health care.
- For care coordination or case management.
- To help with any complaints you may have.

We may also use or give information about you to:

Family or friends. To a family member, friend, or other person when you are not able or present to make decisions for yourself and the situation indicates that sharing information would help your health (such as in an emergency or a natural disaster).
Marketing. We may use your information to send you a reminder if you have an appointment, to give you information about other health care treatments and programs, or to inform you about health related products and services that you may be interested in. For example, we sometimes send out information about healthy living such as help with quitting smoking or weight loss. We may also use information about you to explain our health plan or providers to you.
Business associates. These are people or companies who assist us, such as a lawyer or an accountant. We do not share your information with business associates unless they first agree to protect it.
Create deidentified information. This type of information is created by removing any information from your protected health information that could be used to identify you. It is sometimes used for research or auditing purposes.

We may be required to share your protected health information with others for legal or governmental purposes, such as:

Required by law. When we are required to do so by state or federal law, including workers’ compensation laws.
Public health and safety. When necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person, or to prevent or control disease.
Abuse or neglect. To government agencies that must receive reports when we believe there has been child abuse or neglect, or domestic violence.
Oversight agencies. To help with certain activities such as audits, examinations, investigations, inspections, and licensures.
Legal proceedings. If a court or administrative agency orders us to give them information, or in response to a discovery request.
Law enforcement. To law enforcement officials in limited cases for law enforcement purposes, such as to identify a witness or missing person.
Deceased persons. To coroners, health care examiners, and funeral directors to carry out their duties.
Organ donation. If you are an organ donor, to organizations involved in procuring, banking, or transplanting organs and tissues.
Specialized government functions. For national security and intelligence activities authorized by law, and as required by military authorities if you are a member of the armed forces.

Your Rights About Your Protected Health Information

Note: You may use any of the rights below, or ask questions about these rights, by calling the Community Health Plan customer service team at 1-800-440-1561 (toll free). If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.

You have the following rights about this type of information:

Access. You may look at and get a copy of your information that we have, except that we may not let you look at or get a copy of your information that is:

In psychotherapy notes.
Going to be used for a civil, criminal, or administrative action, or certain other legal matters.
Part of the Clinical Laboratory Improvements Amendments of 1988 (42 U.S.C. 263a, 42 CFR 493.3(a)(2).)

Also, in certain other cases, we may not let you look at or get a copy of your information. If so, we will tell you in writing and will give you the right to ask us to review our decision.

We may charge you a reasonable fee for copying and mailing this information.

Amendment. You may ask us to change information we have in our records about you if you think it is not correct or not complete. Your request:

Must be in writing.
Must tell us the information you think is not correct or missing.
Must explain why you want us to change it.

We will reply to you no later than 60 days after we receive your request. If we can’t reply within 60 days, we may take no more than 30 additional days to reply. If we do need that extra time, we will tell you why and also the date by which we will reply.

If we did not create the information you want changed or for certain other reasons, we may not be able to change your protected health information. If so, we will tell you why in writing. You may also send us a written notice that you disagree with our decision. If you send us such a written notice, we will include it whenever we share the information you asked us to change.

If you ask us to change information in your record and we agree, we will make reasonable efforts to tell others who have a need to know, including people you name, of the change. We will also include the changes any time we share that information in the future. You need to know that if we make a change at your request, the law requires us to share that information with any party who already has the information being changed, even if we know that they may use the changed information against you.

Accounting of disclosures. You may ask for a list of the times over the past six years when we shared your protected health information with another person or organization.

The list will not include the times when such information:

Was given to you or your personal representative.
Was used for your treatment.
Was used to pay for your health care.
Was used for our health care operations.
Was used for a facility directory.
Was used for national security or intelligence purposes.
Was given to correctional institutions or law enforcement.
Was shared before April 14, 2003.

We will send you a written list of:

The dates over the last six years when we shared your health care information.
The names and addresses of the persons or organizations with whom we shared your protected health care information.
A description of the health care information we sent them.
The reason why it was shared with them.

We will send you this information within 60 days. We may need extra time and we may take an additional 30 days, but no more than that. Your first list of this information will be free. You can ask for it once every 12 months and we will supply it free of charge. If you ask for it more often than once every 12 months, we may charge you a fee for copying and mailing. When a fee applies, we will tell you how much it will be so that you can decide if you want to change or cancel your request.

Restriction requests. You may request that we restrict how we use or give out your information for treatment, payment, or health care operations. You also have the right to ask us to restrict information we may give to persons involved in your care. Although we may agree to your request for restrictions, we are not required to agree. If we do agree, we will follow your wishes, unless you have a medical emergency and we believe we need to share your information to help you get better.

Confidential communication. You may ask in writing that we communicate with you in confidence at a different location. For example, you may ask that we send material to a post office box instead of to your home address. If you are being treated for problems with reproductive health, sexually transmitted diseases, addiction, or mental health problems, you can request in writing that we not send anything to you by mail at all or call you at home to confirm appointments. If you tell us in writing that giving out all or part of your information could put you in danger, we must go along with any reasonable request to provide you information in a different manner or at a different location.

Can I "Opt Out" of Certain Disclosures?

You may have received notices from other organizations that allow you to "opt out" of certain types of disclosures (giving out information). The most common type is sharing your information with another company so that company can market its products or services to you.

As a health plan, we must follow many federal and state laws that stop us from making these types of disclosures. Because we do not make them, you do not need to complete an "opt out" form or take any action to restrict such disclosures.

What if We Change Our Privacy Practices?

If any of our privacy practices change, we may change the terms of this notice and will give you a new notice about all health care information that we collect. We will tell you of any such change by letter and put the notice on our web site at www.chpw.org. At that time you may also ask that a revised notice be mailed to you.

Exercising Your Rights

You have the right to get a paper copy of this notice if you call us and ask for one. You can also view the notice on this web site, www.chpw.org.

If you have any questions about the notice or about how we use or share information, please call the Community Health Plan customer service team at 1-800-440-1561 (toll free). If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.

If you believe your privacy rights have been violated, you may file a complaint with us by mail or phone at:

Community Health Plan
Attn: Privacy Officer
720 Olive Way, Suite 300
Seattle, WA 98101
206-521-8833 (local) or 1-800-440-1561 (toll free)

You may also send a complaint to the U.S. Department of Health and Human Services at:

Office of the Secretary
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Telephone: 202-619-0257
Toll free: 1-877-696-6775

Your care and the privacy of your health information are our greatest concerns. We will not penalize you in any way if you choose to file a complaint.

For more information about filing a complaint or about your privacy rights, please call the Community Health Plan customer service team at 1-800-440-1561 (toll free). If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.