3 / 6
Thank you for giving New Mexico Health Connections
(NMHC) the opportunity to serve you. In the normal course
of doing business, NMHC creates records about you and
the treatment and services you receive from medical
providers. The information we collect is called
Protected
Health Information (PHI)
. NMHC 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.
NMHC 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. Our Privacy Officer monitors the policies
and procedures and ensures that they are being followed
and 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 NMHC at
855-769-6642
.
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.
Safe
and
secure
Privacy Commitment
{
2016
/
2017
P R I V A C Y P O L I C Y }