THIS NOTICE DESCRIBES HOW CLAIMS OR MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
By law, Arkansas Blue Cross and Blue Shield and its affiliated company, Health Advantage,
(sometimes referred to in this notice for convenience as a group as "Arkansas Blue
Cross") are required to protect the privacy of your protected health information.
We must also give you this notice to tell you how we may use and release ("Disclose")
your protected health information held by us.
Throughout this notice, we will use the name "Arkansas Blue Cross" as a short-hand reference for not only Arkansas Blue Cross and Blue Shield, but also for its affiliated company, HMO Partners, Inc., d/b/a Health Advantage. Please note that although we are combining this privacy notice in this way for convenient, short-hand reference, and to make it more efficient to inform you about your privacy rights, these companies remain separate companies, each with their own operations, management and compliance responsibilities.
Arkansas Blue Cross must use and release your protected health information to provide
Arkansas Blue Cross has the right to use and release your protected health information
to evaluate and process your health plan or health insurance claims, enroll and
disenroll you and your dependents, and perform related business operations.
Arkansas Blue Cross may use or give out your protected health information for the
following purposes, under limited circumstances:
By law, Arkansas Blue Cross must have your written permission (an "authorization") to use or release your protected health information for any purpose other than treatment, payment or healthcare operations or other limited exceptions outlined here or in the Privacy regulation or other applicable law. Once you have given your permission for us to release your protected health information you may take it back ("revoke") at any time by giving written notice to us, except if we have already acted based on your original permission. To the extent (if any) that we maintain or receive psychotherapy notes about you, most disclosures of these notes require your authorization. Also, to the extent (if any) that we use or disclose your information for our fundraising practices, we will provide you with the ability to opt out of future fundraising communications. In addition, most (but not all) uses and disclosures of medical information for marketing purposes, and disclosures that constitute a sale of protected health information, require your authorization.
If you have a health benefit plan issued by Arkansas Blue Cross or Health Advantage
on or after October 1, 2007, you have a Personal Health Record (PHR). Your PHR contains
a summary of claims submitted for services you received while you are or were covered
by your health benefit plan, as well as non-claims data you choose to enter yourself.
Your PHR will continue to exist, even if you discontinue coverage under your health
benefit plan. You have access to your PHR through the Arkansas Blue Cross or Health
Advantage websites. In addition, unless you limit access, your physician and other
healthcare providers who provide you treatment have access to your PHR. Certain information that may exist in the claims records will not be made available to your physician and other healthcare providers automatically.
To protect your privacy, information about treatment for certain sensitive medical
conditions such as HIV/AIDS, sexually transmitted diseases, mental health, drug
or alcohol abuse or family planning will be viewable by you alone, unless you choose
to make this information available to the medical personnel who treat you. Similarly,
non-claims data, such as your medical, family and social history, will only appear
in your PHR if you choose to enter it yourself. It is important to note, that you
have the option to prohibit access to your PHR completely, either by electronically
selecting to prohibit access or by sending a written request to prohibit access
to the Privacy Office at the address below.
We are prohibited by law from collecting or using genetic information for purposes
of underwriting, setting premium, determining eligibility for benefits or applying
any preexisting condition exclusion under an insurance policy or health plan. Genetic
information means not only genetic tests that you have received, but also any genetic
tests of your family members, or any manifestations of a disease or disorder among
your family members. Except for preexisting condition exclusions, we may obtain
and use genetic information in making a payment or denial decision or otherwise
processing a claim for benefits under your health plan or insurance policy, to the
extent that genetic information is relevant to the payment or denial decision or
proper processing of your claim.
You have the right to:
In the event of breach of your unsecured health information, we will provide you
notification of such a breach as required by law or where we otherwise deem such
If you would like to contact Arkansas Blue Cross or Health Advantage for further
information regarding this notice or exercise any of the rights described in this
notice, you may do so by contacting Customer Service at the following toll-free
Arkansas Blue Cross 1-800-238-8379
Health Advantage 1-800-843-1329
You may also get complete instructions and request forms from our companies' websites, which are:
We are required by law to abide by the terms of this notice. We reserve the right
to change this notice and make the revised or changed notice effective for claims
or medical information we already have about you as well as any future information
we receive. When we make changes, we will notify you by sending a revised notice
to the last known address we have for you or by alternative means allowed by law
or regulation. We will also post a copy of the current notice on Arkansas Blue Cross
and Health Advantage websites.
If you believe your privacy rights have been violated, you may
file a complaint with Arkansas Blue Cross or its affiliated company, Health
Advantage, or with the Secretary of the Department of Health and Human Services.
You may file a complaint with Arkansas Blue Cross or its affiliated company, Health
Advantage, by writing to the following address:
ATTN: Privacy Officer
P.O. Box 3216
Little Rock, AR 72201
We will not penalize or in any other way retaliate against you for filing a complaint
with the Secretary or with us. You may also file a complaint with the Secretary
of the U.S. Department of Health and Human Services. Complaints filed directly with
the Secretary must: (1) be in writing; (2) contain the name of the entity against
which the complaint is lodged; (3) describe the relevant problems; and (4) be filed
within 180 days of the time you became or should have become aware of the problem.
Last revision 05/2013
Arkansas Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross
and Blue Shield Association and is licensed to offer health plans in all 75 counties
of Arkansas. Copyright © 2001-2015 Arkansas Blue Cross and Blue Shield