Health Insurance Portability and Accountability Act (HIPAA)

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 requires significant changes by health plans. Many of these changes are related to HIPAA's Privacy Standards, which were effective April 14, 2003.
Preferred Choices has involved all employees in ongoing HIPAA training sessions to ensure that all of our staff members are well educated about HIPAA and to ensure that HIPAA Privacy Standards are maintained at all times.

Q. What are the HIPAA Privacy Standards?
Q. What is considered protected health information under HIPAA?
Q. How will Preferred Choices handle inquiries that include protected health information?
Q. How does Preferred Choices safeguard the privacy of your protected health information?
Q. When will a Preferred Choices Authorization Form be required?
Q. How can you obtain a copy of the Preferred Choices Authorization Form?
Q. How can you receive additional HIPAA information from Preferred Choices?

Q. What are the HIPAA Privacy Standards?
A. The federal HIPAA Act requires health plans to protect the privacy of each member's individually identifiable health care information. When you are enrolled in a PPO, your employer’s health benefit plan is the “health plan” as defined by HIPAA.

Specific privacy requirements of HIPAA include the following:

• Defines Protected Health Information (PHI) as health-related information which identifies an individual member or provides a reasonable basis to believe that the information could be used to identify a member.
• Provides health plans with the ability to use PHI for treatment, payment and health care operations (TPO) purposes without member authorizations.
• Requires health plans and providers to make reasonable efforts to limit the use and disclosure of PHI to the minimum necessary in required circumstances.
• Requires member authorization for certain non-TPO uses and disclosures of PHI.
• Permits a health plan to disclose PHI to its business associates to perform services on behalf of the health plan.
• Provides members with the right to access their PHI.

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Q. What is considered protected health information (PHI) under HIPAA?
A. PHI includes such information as a member's name, address, phone number, Social Security number, other demographic information, and any information related to their health condition or diagnosis.

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Q. How will Preferred Choices handle inquiries that include protected health information?
A. Preferred Choices understand that the privacy of your health information is important. Preferred Choices acts as a business associate of your employer’s group health plan. This means that Preferred Choices ability to use and disclose protected health information is limited by its contract with your employer group health plan to assure that uses and disclosures of protected health information by Preferred Choices comply with state and federal laws regarding that privacy and confidentiality.

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Q. How does Preferred Choices safeguard the privacy of your protected health information?
A. Preferred Choices has the following safeguards in place across our organization to protect any information about you that is provided to us orally, in writing and/or electronically:

• After five minutes of inactivity, computers automatically time out. A screensaver appears and a password is required to unlock the screensaver. Each user has his or her own password that expires every 90 days. Sharing of passwords is strictly prohibited.
• Shredding bins are located throughout the company to hold confidential documents that need to be destroyed. Bins are picked up weekly for disposal.
• All employees are required to sign a confidentiality agreement annually, acknowledging they understand and will follow all company security policies.
• Antivirus protection software is installed on all computer systems, networks, and firewalls. All information is backed-up daily and securely maintained, therefore information can be restored with minimum loss.
• Unique user identifiers and passwords are required for email and voicemail messages.
• Employees must wear a photo ID key card, ensuring that only employees have access to the 24-hour locked offices.

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Q. When will a Preferred Choices Authorization Form be required?
A. An Authorization Form (PDF Document) will be required in many circumstances involving disclosures of PHI to someone other than the member. For example, an authorization will usually be required if the member wishes to authorize another party to discuss an issue involving their PHI.

Authorization Form

Q. How can you obtain a copy of the Preferred Choices Authorization Form?
A. Click here to download a PDF copy of the Preferred Choices Authorization Form which you can print, complete and mail to Preferred Choices. You may also request a copy from our Customer Service department by calling (800) 992-6837.

Authorization Form

Q. How can you receive additional HIPAA information?
A. For more information on the HIPAA standards, please click on the following website: www.hhs.gov/ocr/hipaa/

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