Privacy Policy
This Notice is intended to comply with the Gramm-Leach-Bliley Act (GLBA) and
the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy
and Security Rules (as amended by the Health Information and Technology for Economic
and Clinical Health Act of 2009 (HITECH)) and DESCRIBES HOW PERSONAL, MEDICAL AND/OR
FINANCIAL INFORMATION WE MAINTAIN ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU
CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. NO RESPONSE IS REQUIRED.
I. Our Privacy Obligations
This Notice describes the privacy practices of CHCS Services Inc. (“we” or “us”
or “our”) as a wholly owned subsidiary of Capgemini America, Inc.. to the extent
that (i) we maintain individual health information, known as protected health information,
that includes virtually all individually identifiable health information (with the
exception of life, disability or any other plans) — whether received in writing,
in an electronic medium, or as an oral communication, or consumers’ nonpublic personal,
financial or personally identifiable information (“Information”); and (ii) we provide
services to you under the terms of you or your groups application or agreement for
services. This Notice does not apply to Information from which identifying information
has been removed.
A. How We Protect Information
We are required to protect the confidentiality of Information. Our employees may
access Information only when there is an appropriate reason to do so, such as to
administer or offer our products or services to you and are required to comply with
our established policies. We endeavor to maintain physical, electronic and procedural
safeguards designed to protect Information in compliance with applicable laws.
B. How We Collect Information
Our access to Information often results directly from you when applying for our
services. If we need to verify Information or need additional Information, we may
obtain Information from third parties such as adult family members, employers, other
insurers, consumer reporting agencies, physicians, hospitals and other medical personnel.
Information collected may relate to your finances, employment, health, avocations
or other personal characteristics as well as transactions with us or with others.
Any information collected is used solely for the purpose of providing services to
you.
C. How We Use Information
We may generally collect and use Information without your permission (known as authorization)
when performing or running our services for you, as necessary for the conduct of
general business management, payment or administration activities, or where disclosure
is required by law or in response to a court or administrative order, subpoena,
discovery request, or other lawful process or other purposes as set forth below
in more detail.
II. Uses and Disclosures of Protected Health Information
The privacy rules generally allow the use and disclose to others of Protected Health
Information without your permission for purposes of health care Treatment, Payment
activities, and Health Care Operations. Some examples of this use and disclose are
as follows:
1. Payment. We may use and disclose Protected Health Information to obtain
payment of premiums/fees, provide reimbursements and to make eligibility determinations
and review services for medical necessity or appropriateness, utilization management
activities, claims management, and billing; as well as “behind the scenes” plan
functions such as risk adjustment, collection, or reinsurance.
2. Health Care Operations. We may use and disclose Protected Health Information
to perform our services which may consist of to do business planning, provide customer
service and conduct quality assessment and improvement activities as well as vendor
evaluations, credentialing, training, accreditation activities, underwriting, premium
rating, arranging for medical review and audit activities, and business planning
and development.
3. Treatment. We may disclose Protected Health Information, such as your
medical information, to a health care provider for coordinating, or managing health
care or your medical treatment including coordination or management of care between
a provider and a third party, and consultation and referrals between providers.
The amount of health information used or disclosed will be limited to the “Minimum
Necessary” for these purposes, as defined.
III. Other Allowable Uses and Disclosures
In certain cases, your Protected Health Information can be disclosed without authorization
to a family member, close friend, or other person you identify who is involved in
your care or payment for your care. Information describing your location, general
condition, or death may be provided to a similar person (or to a public or private
entity authorized to assist in disaster relief efforts). You’ll generally be given
the chance to agree or object to these disclosures (although exceptions may be made,
for example if you’re not present or if you’re incapacitated). In addition, your
health information may be disclosed without authorization to your legal representative.
The Plan also is allowed to use or disclose your health information without your
written authorization, as follows
A. As Required by Law. Use or disclose Protected Health Information when required
to do so by applicable international, federal, state or local law.
B. Business Associates. Disclose Protected Health Information to our business
associates that perform functions or services on our behalf, if the information
is necessary for such functions or services. All of our Business Associates are
contractually obligated, to protect the privacy of such Information and are not
allowed to use or disclose any Information other than as specified.
C. Public Health Activities. We may disclose, in good faith, Protected Health
Information to (1) prevent or lessen a serious and imminent threat to public or
personal health or safety, if made to someone reasonably able to prevent or lessen
the threat; (2) report health information to public health authorities for the purpose
of preventing or controlling disease, injury or disability; (3) to report child
or elder abuse or neglect to the government authority authorized by law to receive
such reports; and (3) to alert to the Food and Drug Administration to collect or
report adverse events or product defects.
D. Victims of Abuse, Neglect or Domestic Violence. We may disclose Protected
Health Information if we reasonably believe you are a victim of abuse, neglect or
domestic violence to the appropriate state agency as required or permitted by applicable
state law.
E. Health Oversight Activities. We may disclose Your Protected Health Information
to a government agency that oversees the health care system or ensures compliance
with the rules of government health programs such as Medicare or Medicaid for which
health information is relevant to beneficiary eligibility, and compliance with regulatory
programs or civil rights laws.
F. Judicial and Administrative Proceedings. We may disclose Protected Health
Information in the course of a judicial or administrative proceeding in response
to a legal order or other lawful process.
G. Law Enforcement Officials. We may disclose Protected Health Information
to the police or other law enforcement officials as required by law or in compliance
with a court order or other lawful process or to identify a suspect, fugitive, witness,
or missing person.
H. Specialized Government Functions. We may disclose Protected Health Information
to units of the government with special functions, such as any branch of the U.S.
military or the U.S. Department of State about individuals who are Armed Forces
personnel or foreign military personnel under appropriate military command.
I. Workers’ Compensation. We may release Protected Health Information for
workers’ compensation or similar programs. These programs provide benefits for work-related
injuries or illness without regard to fault, as authorized by and necessary to comply
with such laws.
J. Research. We may use or disclose Protected Health Information, subject to
approval by institutional or private privacy review boards, for purposes of research
and subject to certain assurances and representations by researchers regarding necessity
of using your health information and treatment of the information during a research
project.
K. Decedents. Disclosures to a coroner or medical examiner to identify the
deceased or determine cause of death; and to funeral directors to carry out their
duties.
L. Organ, eye, or tissue donation. Disclosures to organ procurement organizations
or other entities to facilitate organ, eye, or tissue donation and transplantation
after death.
IV. Your Individual Rights
You have the following rights with respect to your Protected Health Information,
subject to certain limitations, as discussed below. This section of the notice describes
how you may exercise each individual right. See the contact information at the end
of this notice for information on how to submit requests.
A. Right to Request Additional Restrictions. You may request restrictions on
our use and disclosure of Protected Health Information for treatment, payment and
health care operations, except for uses or disclosures required by law. While we
will consider all requests for additional restrictions carefully, we are not required
to agree to a requested restriction. If we do agree, a restriction may later be
terminated by your written request, by agreement between you and us (including an
oral agreement), or unilaterally by us for health information created or received
after you’re notified that we have removed the restrictions. If you wish to request
additional restrictions, your request must be in writing and must be specific regarding
the limits you want to apply and to whom they should apply. You may obtain and submit
such a request form from our Privacy Office as set forth below.
B. Right to Receive Confidential Communications. If you think that disclosure
of Protected Health Information by the usual means could endanger you in some way,
we accommodate any reasonable request for you to receive Your Protected Health Information
by alternative means of communication or at alternative locations. Any such request
must be in writing.
C. Right to Inspect and Copy Your Information. You may request access to or
inspect and request copies of your Protected Health Information in a “Designated
Record Set.” This may include medical and billing records maintained for a health
care provider; enrollment, payment, claims adjudication, and case or medical management
record systems maintained by a plan; or a group of records the Plan uses to make
decisions about individuals. You do not have a right to inspect or obtain copies
of psychotherapy notes or information compiled for civil, criminal, or administrative
proceedings, in which case, we may deny you access to a portion of your records.
Any such request must be in writing. We may also provide you with a summary or explanation
of such Information instead of access to or copies thereof, subject to reasonable
fees for copies or postage.
D. Right to Amend Your Records. You have the right to request that we amend
Protected Health Information maintained in a “Designated Record Set.” We will comply
with your request unless special circumstances apply, such as the Information is
accurate and complete, was not created by us (unless the person or entity that created
the information is no longer available), is not part of the Designated Record Set,
or is not available for inspection (as described above). If your physician or other
health care provider created the information that you desire to amend, you should
contact the provider to amend the information. Any such request must be in writing.
E. Right to Receive an Accounting of Disclosures. Upon written request, you
have the right to receive an accounting of certain disclosures of your Protected
Health Information made by us during the six years prior to your request. This accounting
will not include disclosures of information made: (i) for treatment, payment, and
health care operations purposes; (ii) to you or pursuant to your authorization;
and (iii) to correctional institutions or law enforcement officials; and (iv) other
disclosures for which federal law does not require us to provide an accounting.
If you request an accounting more than once during a twelve (12) month period, we
may charge you per page to complete the requested accounting. You’ll be notified
of the fee in advance and have the opportunity to change or revoke your request.
The right to an accounting of disclosures to a health oversight agency or law enforcement
official may be suspended at the request of the agency or official.
F. Right to Receive Paper Copy of this Notice. Upon request, you may obtain
a paper copy of this Notice.
V. Right to Change Terms of this Notice
We may change the terms of this Notice at any time. If we change this Notice, we
may make the new notice terms effective for all of Your Information that we maintain,
including any information we created or received prior to issuing the new notice.
If we change this Notice. We will post any new notice on our Internet site at: www.chcsservices.com, you also may obtain
any new notice by contacting the Privacy Officer.
VI. Complaints
If you desire further information about your privacy rights, or are concerned that
your privacy rights have been violated, you may contact use as set forth herein
or the Secretary of the U.S. Department of Health and Human Services. Upon request,
we will provide you with the correct address for the Secretary. We will not retaliate
against you if you file a complaint with us or the Secretary. All complaints must
be filed within 180 days of when you first knew or should have known of the alleged
violation.
VII. Contact for additional information
In addition to any other Privacy Notice we may provide, federal law establishes
privacy standards and requires us to make this privacy policy readily available
to you. You may have additional rights under applicable laws. For additional Information
regarding our Privacy Policies, please write to us.
You may contact the Privacy Office at
CHCS Services Inc.
Rebecca Tedjeske Privacy Officer
411 North Baylen Street
Pensacola, FL 32501
E-mail: privacy@chcs-services.com
Web Site Privacy Statement
Collecting and Using Personal Information
We strongly believe in protecting the information you give to us. You can access
information about our products on our website with complete anonymity.
Whenever you do supply personal information to us with reference to a service inquiry,
such as your name, address, telephone number and/or e-mail address, it is kept secure
and used solely to answer your inquiry, comply with your request, or supply you
with information about new products and services to help meet your needs. If you
do choose to provide us with personal information, you can be assured that such
information is kept in secured databases. We treat this information as confidential.
However, we may disclose this information to third parties when we believe it is
necessary in order for us to conduct our business, or where such disclosure is required
by law. For example, we may disclose information to others to enable them to perform
business services for us relating to the services we offer, or who help us to evaluate
requests relating to the services we offer.
E-Mail
Please note that your e-mail, like most, if not all, non-encrypted Internet e-mail
communications, may be accessed and viewed by other Internet users, without your
knowledge and permission, while in transit to us. For that reason, to protect your
privacy, please do not use e-mail to communicate information to us that you consider
confidential. If you wish, you may contact us instead via non-cellular telephone
at the numbers provided on our web pages.
Other Information; “Cookies”
You should also be aware that when you visit our websites, we collect certain information
that does not identify you personally, but provides us with “usage data,” such as
the number of visitors we receive or what pages are visited most often. This data
helps us analyze and improve the usefulness of the information we provide at our
website.
Like most commercial website owners, we may also use what is known as “cookie” technology.
A cookie is an element of data that a website can send to your browser when you
link to that website. It is not a computer program and has no ability to read data
residing on your computer or instruct it to perform any step or function. By assigning
a unique data element to each visitor, the website is able to recognize repeat users,
track usage patterns and better serve you when you return to that site. The cookie
does not extract other personal information about you, such as your name or address.
Most browsers provide a simple procedure that will enable you to control whether
you want to receive cookies by notifying you when a website is about to deposit
a cookie file. Most cookies expire after a defined period of time, or you can delete
your cookie file at any time you choose. In addition, you can set your browser to
notify you when you receive a cookie so that you can decide whether to accept or
reject it.
Security
We have adopted and adhere to stringent security standards designed to protect non-public
personal information at our website against accidental or unauthorized access or
disclosure. Among the safeguards we have developed for this site are administrative,
physical and technical barriers that together form a protective firewall around
the information stored at this site. We periodically subject our site to simulated
intrusion tests and have developed comprehensive disaster recovery plans.
Changes to This Statement
We may change this Statement from time to time without notice. This Statement is
not intended to and does not create any contractual or other legal rights for or
on behalf of any party.