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Notice of Privacy Practices: For Your Personal Health and Financial Information

CarePlus has worked diligently to comply with privacy provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), a federal law designed to ensure the privacy of personal and health information. In addition to all federal laws, CarePlus also complies with all state laws and regulations.

Review the documents to get a thorough understanding of how CarePlus uses and discloses personal health information.

Individual Rights Forms

The following is a brief description of the various HIPAA individual rights and the appropriate form to invoke one of these rights.

Consent for Release of Protected Health Information

This form grants CarePlus permission to share your information to a trusted individual(s) that you choose. This form was last updated in July 2019.

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Revocation of Consent for Release of Protected Health Information

This form terminates previously granted permission for CarePlus to release or disclose a member's protected health information to other individuals named on the form. This form was last updated in July 2019.

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Request for Accounting of Disclosures

This form requests a list of disclosures CarePlus made of a member's protected health information. Disclosures made for payment and health plan operations are excluded from this process. This form was last updated in July 2019.

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Request for Amendment of Protected Health Information (PHI)

This form requests a correction to CarePlus-created protected health information that a member feels is inaccurate or incomplete. This form was last updated in July 2019.

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Request to Access Protected Health Information

This form requests an inspection or copy of CarePlus-maintained protected health information about a member. This form was last updated in July 2019.

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Request for Restriction of Protected Health Information

This form requests limitation or restriction of disclosures of a member's protected health information to others such as a family member, friend, spouse, doctor, or any other party. This form was last updated in July 2019.

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Request for Restriction Termination

This form withdraws a previously requested restriction of a member's protected health information. This form was last updated in July 2019.

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Request for Alternate Communications

This form requests that CarePlus communicate with a member about protected health information in a different way during life-threatening situations. Examples of alternate means could include telephone, mail, e-mail, or different address. This form was last updated in July 2019.

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Privacy Complaint Form

This form documents an issue or concern if a member believes his or her privacy rights may have been violated. This form was last updated in July 2019.

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