How does Partnership HealthPlan of California use and disclose my health information?
Partnership stores health-related records about you, including your claims history, health plan enrollment information, case management records, and prior authorizations for treatment you receive. We use this information and disclose it to others for the following purposes:
Treatment. Partnership uses your health information to coordinate your health care, and we disclose it to hospitals, clinics, physicians and other health care providers to enable them to provide health care services to you.
Payment. Partnership uses and discloses your health information to facilitate payment for health care services you receive, including determining your eligibility for benefits, and your provider's eligibility for payment. For example, we inform providers that you are a member of our plan, and tell them your eligible benefits.
Health care operations. Partnership uses and discloses your health information as necessary to enable us to operate our health plan. For example, we use our members' claims information for conducting quality assessment and improvement activities, patient safety activities, business management and general administrative activities, and reviewing competence or qualifications of health care professionals.
For underwriting or related purposes, such as premium rating or other activities related to the creation, renewal or replacement of a contract of health insurance or benefits as required by law, but may not include genetic information.
Business Associates. Partnership may contract with business associates to perform certain functions or activities on our behalf, such as facilitating a health-information exchange, where your health information can be quickly accessed by your doctors or to provide appointment reminders.
Health Information Exchange (HIE). Partnership participates in multiple Health Information Exchange’s (HIE’s), which allow providers to coordinate care and provide faster access to our members. HIE’s assist providers and public health officials in making more informed decisions, avoiding duplicate care (such as tests), and reducing the likelihood of medical errors. By participating in an HIE, Partnership may share your health information with other providers and participants as permitted by law. If you do not want your medical information shared in the HIE, you must make this request directly to Partnership. The ‘Individual Rights’ section below tells you how.
(Note: In some circumstances, your health information may not be disclosed. For example, mental health diagnosis and treatment, diagnosis or treatment for drug or alcohol abuse, and STD; birth control; or HIV test results are all considered ‘Protected Records’ and require your direct authorization to be shared.
When working to process payment, provide care to our members, or within our daily operations, Partnership may disclose your health information to our contractors. Before we make any disclosures for payment or operational purposes, we obtain a confidentiality agreement from each contractor. For example, companies that provide or maintain our computer services may have access to health information within the course of providing services. Partnership works to ensure that our providers have as minimal contact with your health information as possible.
Communication and Marketing. Partnership will not use your health information for marketing purposes for which we receive payment without your prior written authorization. We may use your health information for case management or care coordination purposes and related functions without your authorization. We may provide appointment or prescription refill reminders or describe a product or service that is included in your benefit plan, such as our health provider network. We may also discuss health-related products or services available to you that add value, but are not part of your benefit plan.
Sale of your health information. We will not sell your health information for financial payment without your prior written authorization.
