OF PRIVACY RIGHTS
We protect the confidentiality
of our membersí personal financial and health information as
required by law, accreditation standards and our internal policies
and procedures. This Notice of Privacy Rights explains your
rights, our legal duties and our privacy practices.
In order to make
available certain preventive and primary health services to
uninsured children in California, we collect and use several
different types of financial information. This includes information
that you provide directly to us on applications or other forms,
such as your name, address, age, and information about dependents,
as well as information regarding your personal and/or family
income and other financial data. We accumulate such information
in order to make determinations regarding your childís or childrenís
eligibility for participation in CaliforniaKids (ìCalKidsî)
to receive health care services through participating health
plans and insurers. We also obtain such information in order
to determine the premium you will be required to pay so your
child/children to receive health care services under CalKids
program. We also accumulate information about your transactions
with our affiliates, others, or us such as the requirement for
payment of premiums and co-payments and your payment history.
We also retain any information we may receive from a consumer-reporting
agency such as your credit history.
We use physical, electronic, and procedural safeguards to protect
your confidential information. We make it available only to
our employees, affiliates or others who need it to determine
eligibility, effect enrollment, or maintain your childís/childrenís
coverage, to conduct insurance transactions and functions, or
for other legally permitted or required purposes.
DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR CHILD OR CHILDREN
MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION. PLEASE REVIEW IT CAREFULLY.
We collect, use and
disclose information provided by and about you, your child or
children for health care operations and premium payment, or
when we are otherwise permitted or required by law to do so.
For Payment: We may
use and disclose information about you and your child to verify
eligibility, to enroll your child with participating health
plans and insurers, and pay for your childís health benefits
arranged through CalKids. In addition, we may use and disclose
information about you and your child to coordinate the payment
of claims for the medical care your child receives through participating
health plans and insurers. For example, we will use and disclose
the information to enroll your child to receive certain health
care benefits from participating health plans and insurers as
well as to make payments for coverage.
For Health Care Operations:
We may use and disclose medical information about you or your
child for our operations, including the collection of premiums.
For example, we may use or disclose information to review the
quality of care and services you receive from participating
health plans and insurers or to assist you with problems concerning
payment of claims or questions about health care benefits provided
by participating health plans and insurers.
We may contact you
to provide information about changes in levels or types of care
arranged through CalKids or changes in health-related benefits
and services offered through participating health plans and
insurers. For example, when you or your dependents reach a certain
age, we may notify you about additional products or programs
for which you may become eligible, such as Medicare supplements
or individual coverage.
As Permitted or Required
by Law: Information about you, your child or children may be
used or disclosed to regulatory agencies, such as during audits,
licensure or other proceedings involving our activities; for
administrative or judicial proceedings; to public health authorities;
for law enforcement activities, such as to comply with a court
order or subpoena; or to federal officials for intelligence,
counterintelligence, and other national security activities
to the extent authorized by law.
Fundraising: We may
use information about you to contact you in an effort to raise
money for CalKids its operations.
We may disclose medical information to those that we contract
with as business associates so that they may perform services
for us or on our behalf. For example, we may send tapes to an
outside vendor for transcription. We require that business associates
implement appropriate safeguards to protect your medical information.
uses and disclosures of protected health information will be
made only with your written permission, referred to as an authorization,
unless otherwise permitted or required by law. An authorization
will state the information to be disclosed, the particular individual(s)
to which such information may be disclosed, and the purposes
for such disclosure. It will include a specific date or event
after which the authorization will no longer be valid. Also,
you may revoke an authorization, at any time, in writing. We
will then stop using or disclosing your information for that
purpose. However, if we have already used your information based
on your authorization, you cannot take back your agreement for
those past situations.
You have the following
rights regarding medical information we maintain about you:
- Inspect and Copy Your Health Information. You have the right
to send us a written request to see or get a copy of information
that we have about you.
Your Health Information. You have the right to amend health
information about your child or children that you believe
is incomplete or inaccurate. If we did not create the information,
we will refer you to the source, such as your physician or
hospital. We may deny the request if it does not include a
reason to support the amendment.
- Request Restrictions. You have the right to request additional restrictions on uses and disclosures of your health information. We are not required to agree to these requests.
- Receive Confidential Communications. You have the right to request that we communicate with you about medical matters using reasonable alternative means or at an alternative address or telephone number, if communications to your home address could endanger you.
- Receive an Accounting. You have the right to request in writing and receive an accounting of our disclosures of your medical information, except when those disclosures that are made for treatment, payment or health care operations, or the law otherwise provides an exception to the accounting. We are not required to give you a list of disclosures made before April 14, 2004. Your request should specify the time period for which you are requesting the information but may not start before April 14, 2004.
You have the right
to receive an additional copy of this Notice of Privacy Rights
at any time. Even if you have agreed to receive this notice
electronically, for example, by e-mail, you are still entitled
to a paper copy.
We reserve the right
to revise this Notice of Privacy Rights. A revised notice will
be effective for information we already have about you as well
as any information we may receive in the future. We are required
by law to comply with whatever privacy notice is currently in
effect. We will promptly communicate any changes to our privacy
notice through subscriber newsletters, direct mail, and/or our
If you believe your
privacy rights have been violated, you have the right to file
a complaint with us, or with the federal government. You will
not be penalized for filing a complaint. (See ìContact Informationî
(below) for information as to where to file a complaint.)
If you want to exercise
your rights under this notice or if you wish to communicate
with us about privacy issues or to file a complaint with us,
please contact Michael Koch, Executive Director and Privacy
Official at (818) 755-9706.
If you would like
hard copy of the HIPAA Notice of Privacy Rights in English or
Spanish, please contact our customer service department, at