As a Member of the Plan, you have the following rights regarding your PHI:
The Plan may charge you a reasonable cost-based fee to process and fulfill your request. If you prefer, you may request that we prepare a summary or an explanation of your PHI for a fee. Contact us using the information listed at the end of this notice for a full explanation of our fee structure. If your request for access is denied, we will provide a written explanation for the denial and your rights regarding the denial.
The Plan does not receive or maintain a file of your treatment records. You have a right to access these records through the treating physician, facility, or other provider that created and/or maintains the records.
The Plan cannot amend demographic information, treatment records or any other information created by others. If you would like to amend any of this information, please contact your personnel office or, to amend your treatment records, you must contact the treating physician, facility or other provider that created these records.
We may deny your request if: 1) we did not create the information; 2) the information is not part of the designated record set maintained by the Plan; 3) you do not have access rights to the information; or 4) we believe the information is accurate and complete.
We do not have to provide you with an accounting of certain excepted disclosures, such as those made for treatment, payment or health care operations purposes or made in accordance with an authorization, so these will not appear on the accounting.
We are not required to agree to these additional restrictions and in some cases will be prohibited from agreeing to them, but if we do agree, we will abide by our agreement (except in an emergency). Generally, the Plan will not agree to requests for restrictions on uses and disclosures of PHI for treatment, payment or health care operations. It is necessary for us to use and disclose PHI for these purposes in order to provide the benefits that are afforded to you. If we do agree to a restriction, our agreement will always be in writing and signed by the Privacy Officer.
Right to Receive a Paper Copy of the Notice
If you receive this notice from our website or by e-mail, you are entitled to receive this notice in writing. Please contact us using the Questions and Complaints Link to obtain this notice in written form.
November 24 - 26
November 27 - 30