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Privacy PolicyTHIS 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. Comprehensive Care Management (CCM) is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. If you have questions about any part of this Notice or if you want more information about the privacy practices at CCM, please contact: Virginia Murray, Privacy Officer, at 347-640-6220.
How CCM May Use or Disclose Your Health Information Payment Functions. We may use or disclose health information about you to determine eligibility for plan benefits, obtain premiums, facilitate payment for the treatment and services you receive from health care providers, determine plan responsibility for benefits, and to coordinate benefits. For example, payment functions may include reviewing the medical necessity of health care services, determining whether a particular treatment is experimental or investigational, or determining whether a treatment is covered by your plan. Health Care Operations. We may use and disclose health information about you to carry out necessary insurance-related activities. For example, such activities may include underwriting, premium rating and other activities relating to plan coverage; conducting quality assessment and improvement activities; submitting claims for stop-loss coverage; conducting or arranging for medical review, legal services, audit services, and fraud and abuse detection programs; and business planning, management and general administration. Required by Law. As required by law, we may use and disclose your health information. For example, we may disclose medical information when required by a court order in a litigation proceeding such as a malpractice action. Public Health. As required by law, we may use and disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting abuse or neglect; reporting domestic violence; reporting problems with products and adverse reactions to medications to the Food and Drug Administration; and reporting disease or infection exposure. Health Oversight Activities. We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure and other proceedings related to oversight of the health care system. Judicial and Administrative Proceedings. We may disclose your health information in the course of any administrative or judicial proceeding. Law Enforcement. We may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order, subpoena or other law enforcement purposes. Coroners, Medical Examiners and Funeral Directors. We may disclose your health information to coroners, medical examiners and funeral directors. For example, this may be necessary to identify a deceased person or determine the cause of death. Organ and Tissue Donation. We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues, as necessary. Public Safety. We may disclose your health information to appropriate persons in order to prevent or lessen a serious imminent threat to the health and safety of a particular person or the general public. National Security. We may disclose your health information for military, national security, prisoner and government benefits purposes. Worker's Compensation. We may disclose your health information as necessary to comply with worker's compensation or similar laws. Marketing. We may contact you to give you information about health-related benefits and services that may be of interest to you. Disclosures to Plan Sponsors. We may disclose your health information to the sponsor of your group health, for purposes of administering benefits under the plan.
When CCM May Not Use or Disclose Your Health Information Statement of Your Health Information Rights Right to Request Restrictions. Your have the right to request restrictions on certain uses and disclosures of your health information. CCM is not required to agree to the restrictions you request. If you would like to make a request for restrictions, you must submit your request in writing to: Virginia Murray, Privacy Officer, Comprehensive Care Management, 1250 Waters Place, Tower 1, Suite 602, Bronx, NY 10461. Right to Request Confidential Communications. You have the right to receive your health information through a reasonable alternative means or at an alternative location. To request confidential communications, you must submit your request in writing to: Virginia Murray, Privacy Officer, Comprehensive Care Management,1250 Waters Place, Tower 1, Suite 602, Bronx, NY 10461. We are not required to honor your request. Right to Inspect and Copy. You have the right to inspect and copy health information about you that may be used to make decisions about your plan benefits. To inspect and copy such information, you must submit your request in writing to Virginia Murray, Privacy Officer, Comprehensive Care Management, 1250 Waters Place, Tower 1, Suite 602, Bronx, NY 10461. If you request a copy of the information, we may charge you a reasonable fee to cover expenses associated with your request. Right to Request Amendment. You have a right to request that CCM amend your health information that you believe is incorrect or incomplete. We are not required to change your health information and if your request is denied, we will provide you with information about our denial and how you can disagree with the denial. To request an amendment, you must make a request in writing to: Virginia Murray, Privacy Officer, Comprehensive Care Management, 1250 Waters Place, Tower 1, Suite 602, Bronx, NY 10461. You must also provide a reason for your request. Right to Accounting of Disclosures. You have the right to receive a list or "accounting of disclosures" of your health information made by us, except that we do not have to account for disclosures made for purposes of payment functions or health care operations, or those made to you. To request this accounting of disclosures, you must submit your request in writing to: Virginia Murray, Privacy Officer, Comprehensive Care Management, 1250 Waters Place, Tower 1, Suite 602, Bronx, NY 10461. Your request should specify a time period of up to seven years and may not include dates before April 14, 2005. CCM will provide one list per 12-month period free of charge; we may charge you for additional lists. Right to Paper Copy. You have a right to receive a paper copy of this Notice of Privacy Practices at any time. To obtain a paper copy of this Notice, send your written request to: Virginia Murray, Privacy Officer, Comprehensive Care Management, 1250 Waters Place, Tower 1, Suite 602, Bronx, NY 10461. You may also obtain a copy of this Notice on our website, http://www.comprehensivecaremanagement.com/direct.html. If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact: Virginia Murray, Privacy Officer, Comprehensive Care Management, 1250 Waters Place, Tower 1, Suite 602, Bronx, NY 10461, 347-640-6220.
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We welcome your inquiries. Please call our Member Services Department at 1-877-226-8500 7 days a week from 8:00 AM through 8:00 PM. TTY users should call 1-800-650-2774. You can also email us at CCM-MemberServices@bethabe.org or write to us at: Comprehensive Care Management Comprehensive Care Management (CCM) is a member of the Beth Abraham Family of Health Services. CCM is a Health Maintenance Organization with a Medicare Advantage Contract. H5989_WEB_2009_003v2 05/2010 This page was last modified on June 7, 2010. |