Thank you for giving True Health New Mexico the opportunity to serve you. In the normal course of doing business, True Health creates records about you and the treatment and services you receive from medical providers. The information we collect is called Protected Health Information (PHI). True Health is committed to maintaining and protecting your privacy. We are required by federal and state law to protect the privacy of your PHI and to provide you with this Notice about how we safeguard and use it. You may ask for a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically. We will promptly provide you with a paper copy. When we use or disclose your PHI, we are bound by the terms of this Notice. This Notice applies to all oral, electronic or paper records we create, obtain and/or maintain that contain your PHI. 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. How we protect your oral, written and electronic information We understand the importance of protecting your PHI. We restrict access to your PHI to authorized workforce members who need that information for your treatment, for payment purposes and/or for healthcare operations. We will not disclose your PHI without your authorization unless it is necessary to provide your health benefits, administer your benefit Plan, support Plan programs or services, or as required or permitted by law. If we need to disclose your PHI, we will follow the policies described in this Notice to protect your privacy. True Health protects your PHI by following processes and procedures for accessing, labeling and storing confidential records. Access to our facilities is limited only to authorized personnel. Internal access to your PHI is restricted to Plan employees who need the information to conduct Plan business. We train our workforce members on policies and procedures designed to protect you and your privacy. Each department at True Health New Mexico is responsible for monitoring the policies and procedures and ensuring that they are being followed. Our Compliance department arranges for new hire and annual training on this important topic. Notice of confidentiality of domestic abuse information The Domestic Abuse Insurance Protection Act (DAIPA) is a state confidentiality law. It protects a member’s confidential information if he or she is or has been involved in domestic abuse. This act regulates insurers’ and insurance support organizations’ use of confidential abuse information. In processing your application for insurance or a claim for insurance benefits, we may receive confidential domestic abuse information from sources other than you. If this happens, we are prohibited from using it or any other confidential abuse information, or your status as a victim of domestic abuse, as a basis for: • Denying or refusing to insure, renewing or reissuing, canceling or otherwise terminating (ending) your healthcare coverage. • Restricting or excluding coverage. • Charging a higher premium for health coverage. You have the right to access and correct all confidential domestic abuse information we may have about you. You have the right to inform us of your wish to be designated as a protected person. As a protected person, confidential information, such as your address and phone number, will remain confidential. We will disclose and transfer it only in accordance with state and federal laws. If you wish to be designated as a protected person, please contact True Health at 844-508-4677. How we use and disclose your confidential information We may disclose your PHI without your written authorization if necessary while providing your health benefits. We may disclose your PHI for the following purposes: • Treatment. We may disclose your PHI to your healthcare provider for Plan coordination; to help obtain services and treatment you may need; or to coordinate your healthcare and related services. • Payment. We may use and disclose your PHI to make coverage determinations; to obtain payment of premiums for your coverage; and to determine and fulfill our responsibility to provide your benefits. However, we are prohibited from using or disclosing genetic information to make any coverage determinations, such as eligibility or rate setting. We may also disclose your PHI to another health plan or a healthcare provider for its payment activities. • Healthcare operations. We may use and disclose your PHI for our healthcare operations, such as providing customer service; to support and/or improve the programs or services we offer you; or to assist you in managing your health. We may also disclose your PHI to another health plan or a provider who has a relationship with you so that it can conduct quality assessment and improvement activities. • Appointment reminders and treatment alternatives. We may use and disclose your PHI for appointment reminders or send you information about treatment alternatives or other health-related benefits and services. You will have an opportunity to opt out of future communications. • Disclosure to Plan vendors and accreditation organizations. We may disclose your PHI to companies with whom we contract if they need the information to perform the services they provide to us. We may also disclose your PHI to accreditation organizations such as the National Committee for Quality Assurance (NCQA) when the NCQA auditors collect Health Employer Data and Information Set (HEDIS®) data for quality measurement purposes. When we enter into these types of arrangements, we obtain a written agreement to protect your PHI. • Public health activities. We may use and disclose your PHI for public health activities authorized by law, such as preventing or controlling disease, reporting child or adult abuse or neglect to government authorities, or to close friends or family members who are involved in or help pay for your care. We may also advise your family Privacy Commitment { FALL 2022 P R I V A C Y P O L I C Y }
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