Notice of Privacy Practices

You may contact any of the organizations listed below if you want to file a complaint or report a problem with the use or disclosure of your PHI.

Medical Privacy Complaint Division
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Ave. SW, HHH Building, Room 509H
Washington, D.C. 20201

Toll-Free Phone: 1-866-627-7748
TTY: 1-866-788-4989
Email: OCRComplaint@hhs.gov

Common Uses of Health Information

Treatment

Select Health Alliance may use or disclose your PHI with the healthcare providers who are involved in your care. For example, your information may be shared in order to create and carry out a plan for your treatment.

Payment

Select Health Alliance may use or disclose PHI to get payment or to pay for the healthcare services that you receive. For example, to make coverage determinations, administer claims, and coordinate benefits with other coverage you may have.

Appointment Reminders and Other Notifications

Select Health Alliance may use PHI when calling, mailing, or emailing you with reminders for medical care or checkups. Select Health Alliance may use PHI to send you written information about health services that may be of interest to you.

Healthcare Operations

Select Health Alliance may use or disclose PHI in order to manage Select Health Alliance programs and activities. Select Health Alliance may review your PHI to identify health-related services that may be beneficial to your health and then contact you about these services. For example, Select Health Alliance may have a program in place to manage the treatment of chronic conditions, such as diabetes or asthma, and as part of these programs, Select Health Alliance would share information with affiliated providers to facilitate improved coordination of the care you receive for these conditions.

Health Oversight Activities

Select Health Alliance may use or disclose PHI for healthcare oversight activities. Examples of oversight activities include audits, utilization investigations, etc.

Public Health Activities

Select Health Alliance may share PHI with official public health agencies. For example, Select Health Alliance may use and disclose PHI with the Department of Human Services, the public health agency that manages vital records, such as birth and death certificates, and that tracks diseases and population health issues.

Government Programs

Select Health Alliance may use and disclose PHI for public benefits under government programs. For example, Select Health Alliance may disclose information to the Social Security Administration for the determination of Supplemental Security Income (SSI) benefits.

Research

Select Health Alliance uses PHI for studies where the researcher performs a specific type of health-related research and keeps any patient-identifiable information safe and confidential.

Purposes Required by Law and Law Enforcement

Select Health Alliance will share PHI with law enforcement agencies as required or permitted by Federal or State law or by an administrative or court order.

Abuse Reports and Investigations

Select Health Alliance may use and disclose PHI to receive and investigate reports of abuse, as required by law.

Workers’ Compensation

Select Health Alliance may disclose PHI to workers’ compensation insurance programs or like programs, as allowed by law.

Avoidance of Harm

Select Health Alliance may use and disclose PHI in order to avoid a serious threat to your health and safety or to the health and safety of another person or the public.

Disclosures to Personal Representatives and Approved, Family, Friends, and Others

Select Health Alliance may disclose appropriate PHI to your family or other persons who are immediately involved in your medical care as long as you agree or do not object to the disclosure. In the case of an emergency, or if you are incapacitated, Select Health Alliance may use professional judgment to disclose your PHI as the disclosure is in your best interest.

Business Associates

To improve our services to you by allowing companies with whom we contract, called “business associates” to perform certain specialized work for us. The law requires business associates to protect your health information and obey the same privacy laws that we do.

Plan Sponsor

Select Health Alliance may share health information with your plan sponsor. Select Health Alliance will do so if the plan sponsor specifically requests health information for the administration of your health plan.

The law sometimes requires us to share information for specific purposes, including the following:

• To the Department of Health to report communicable diseases, traumatic injuries, or birth defects, or for vital statistics, such as a baby’s birth;
• To a funeral director or an organ-donation agency when a patient dies, or to a medical examiner when appropriate to investigate a suspicious death;
• To state authorities to report child or elderly abuse;
• To law enforcement;
• To a correctional institution, if a patient is an inmate, to ensure the correctional institution’s safety;
• To the Secret Service or NSA to protect, for example, the country or the President;
• To a medical device’s manufacturer, as required by the FDA, to monitor the safety of a medical device;
• To court officers, as required by law, in response to a court order or a valid subpoena;
• To governmental authorities to prevent serious threats to the public’s health or safety;
• To governmental agencies and other affected parties, to report a breach of health-information privacy;
• To a worker’s compensation program if a person is injured at work and claims benefits under that program.

Your preferences matter. If you let us know how you want us to disclose your information in the following situation, we will follow your directions.

You decide if you want us to share any health or payment information related to your care with your family members or friends. Please let our Select Health Alliance employees know what you want us to share. If you can’t tell us what health or payment information you want us to share, we may use our professional judgment to decide what to share with your family or friends for them to be able to help you.

Any sharing of your health information, other than as explained above, requires your written authorization. For example, we will not use your health information unless you authorize us in writing to share any of your health information with marketing companies.

You can change your mind at any time about sharing your health information. Simply notify Select Health Alliance in writing. Please understand that we may not be able to get back health information that was shared before you changed your mind.

Select Health Alliance complies with federal laws that require extra protection for your health information if you receive treatment in an addiction treatment program, or from a psychotherapist who keeps notes on your therapy that are kept outside of your regular medical record.

Select Health Alliance’s Privacy Officer can help you with any questions you may have about the privacy of your health information. The Privacy Officer can also address any privacy concerns you may have about your health information and can help you fill out any forms that are needed to exercise your privacy rights.

This privacy notice became effective on May 22, 2014. We may change this privacy notice at any time. We always post our current privacy notice on our website at www.selecthealthalliance.com.

You can also obtain a copy of this notice from any of Select Health Alliance staff member by asking for a copy.

This notice of privacy practices describes the practices of Select Health Alliance.