Notice of Privacy Practices
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.
In this notice, we use “the Alliance,” “we,” “us,” and “our” to describe the Central California Alliance for Health.
Why am I receiving this notice? This notice tells you about the ways in which we may collect, use, or disclose (share) your protected health information. We understand that health information about you is personal and we are committed to protecting your privacy. This notice only describes the Alliance’s Privacy Practices. Your doctor may have different policies or notices regarding their use and disclosure of your health information created in the doctor’s office.
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
|Get a copy of your health and claims records
|Ask us to correct health and claims records
|Request confidential communications
|Ask us to limit what we use or share
|Get a list of those with whom we’ve shared information
|Get a copy of this privacy notice
|Choose someone to act for you
|File a complaint if you feel we have violated your rights
For certain health information, you can tell us your choices about what we share.
If you have a clear preference 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 the cases where you can tell us your choices about what we share, you have the right 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 preference, for example if you are unconscious, we may 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:
Sale of your information.
Substance abuse treatment records.
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
|Example: A doctor sends us information about your diagnosis and treatment plan so we can make sure the services are medically necessary and are covered benefits.
|Run our organization
|Example: We use health information about you to develop better services for you.
Example: We share your name and address with a contractor to print and mail our member identification cards.
Pay for your health services
|Example: We share information about you with any other health insurance plan you have to coordinate payment for your health care.
|Administer your plan
|Example: Your company contracts with us to provide your health plan, and we provide for plan administration. your company with certain statistics to explain the premiums we charge.
Example: Your County contracts with us to provide a health plan for IHSS members, and we provide the County 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 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
Health Information Exchange (HIE)
Comply with the law
Respond to organ and tissue donation requests and work with a medical examiner or funeral director
Address workers’ compensation, law enforcement, and other government requests
Respond to lawsuits and legal actions
In some circumstances, there may be other restrictions that may limit what information we can use or share. There are special restrictions on sharing information relating to HIV/AIDS status, mental health treatment, developmental disabilities and drug and alcohol abuse treatment. We comply with these restrictions in our use of your health information.
We are required by law to maintain the privacy and security of your protected health information.
We are required to provide you with this notice describing how we are legally required to protect your protected health information, and how we will do this. We will update this notice if there is a change to the information we can or must share.
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.
How You Can Exercise These Rights
You can exercise any of your rights by calling or sending a written request to our Privacy Officer at the address below, or by contacting Member Services. You can also request a copy of your records by completing a Records Access Request form, which is available on our website at https://thealliance.health/
How to File a Complaint
If you feel your privacy rights have been violated, you may file a complaint with our Privacy Officer. We will not retaliate against you in any way for filing a complaint. Filing a complaint will not affect the quality of the health care services you receive as an Alliance member.
Central California Alliance for Health – Privacy Officer
1600 Green Hills Road, Suite 101
Scotts Valley, CA 95066
1 (800) 700-3874 (toll-free)
1 (877) 735-2929 (TDD – for hearing impaired)
If you are a Medi-Cal member, you may also file a complaint with the California Department of Health Care Services:
c/o Office of HIPAA Compliance
Department of Health Care Services
1501 Capitol Avenue
P.O. Box 997413
Sacramento, CA 95899-7413
Email: [email protected]
Fax: (916) 327-4556
You may also file a complaint with the U.S. Department of Health and Human Services Office of Civil Rights:
U.S. Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Bldg.
Washington, DC 20211
Telephone: 1 (877) 696-6775
Email: [email protected]
For more information see: https://www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/index.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, on our website, and we will mail a copy to you.