This privacy notice applies to MHS and all of its partners including Cenpatico. Your privacy is important to us. We will do all we can to protect your health records. By law, we must protect your health records and send you this notice.
This notice tells you how we use your health records. It describes when we can share your records with others. It explains your rights about the use of your health records. It also tells you how to use those rights and who can see your health records. This notice does not apply to information that does not identify you.
When we talk about your health records in this notice, it includes any information about your past, present or future physical or mental health while you are a member of MHS. This includes providing healthcare to you. It also includes payment for your healthcare while you are our member.
Please note: You will also receive a Privacy Notice from the State of Wisconsin outlining their rules for your health records. Other health plans and healthcare providers may have other rules when using or sharing your health records. We ask that you get a copy of their Privacy Notice and read it carefully.
How We Use or Share Your Health Records
Here are ways we may use or share your health records:
- To help pay your medical bills given to us by healthcare providers.
- To help your healthcare providers give you the proper care. For example, if you are in the hospital, we may give them your records sent to us by your doctor.
- To help manage your healthcare. For example, we might talk to your doctor to suggest a disease or wellness program that could help improve your health.
- To help resolve any appeals or grievances filed by you or a healthcare provider with MHS or the State of Wisconsin.
- To assist others who help us provide health services. We will not share your records with these outside groups unless they agree to protect your records.
- For public health or disaster relief efforts.
- To remind you if you have a doctor’s visit coming up.
- To give you information about other healthcare treatments and programs, such as information on how to stop smoking or lose weight.
State/Federal laws may require us to give your health records to others for these reasons:
- To State and Federal agencies that control us, such as the Wisconsin Office of the Commissioner of Insurance and the Wisconsin Department of Health and Family Services.
- For public health actions. For example, the Food and Drug Administration may need to check or track medicines and medical device problems.
- To public health groups if we believe there is a serious public health or safety threat.
- To a health agency for certain activities, such as audits, inspections, licensure and disciplinary actions.
- To a court or administrative agency.
- To law enforcement. For example, we may give your records to a law enforcement officer to identify or locate a suspect, fugitive, material witness or missing person.
- To a government person about child abuse, neglect, or violence in your home.
- To a coroner or medical examiner to identify a dead person or help find a cause of death or to a funeral director to help them carry out their duties.
- For procurement, banking or transplantation of organs.
- For special government roles, such as military and veteran activities, national security and intelligence activities, and to help protect the President and others.
If one of the above reasons does not apply, we must get your written approval to use or share your health records with others. If you change your mind, you may stop your written approval at any time.
If sharing your health information is not allowed by or limited by a state law, we will obey the law that better protects your health information.
What are Your Rights?
The following are your rights about your health records. If you would like to use any of these rights, please contact us.
You have the right to ask us to give your records only to certain people or groups, and you have the right to say for what reasons. You also have the right to ask us to stop your records from being given to family members. You have the right to ask us to stop your records from being given to others involved in your care. While we try hard to obey your wishes, the law does not make us.
- You have the right to ask for a private exchange of your records. If you believe that you would be harmed if we mailed your records to your home address, you can ask us to send them another way, maybe by fax or mailed to another address or to your doctor.
- You have the right to view and get a copy of all the records we keep about you. This is anything we use to make decisions about your health. It includes enrollment and payment. It also includes claims and medical management records
- You do not have the right to get certain types of health records. We may decide not to give you:
- Records that have psychotherapy notes
- Records collected for use in a court case or other legal action
Records subject to federal laws about biological products and clinical laboratories
In some cases, we may refuse to give out copies of your records. You will be informed in writing. You may have the right to have our action reviewed.
You have the right to ask us to make changes to wrong or incomplete records. These changes are known as amendments. You must ask for the change in writing. You need to give a reason for your change(s). We will get back to you in writing no later than 60 days after we get your letter.
If we need more time, we can take up to another 30 days. We will inform you of any missed dates and tell you when we will get back to you. If we make your changes, we will let you know when they were made. We will also give your changes to others who we know have your records and to other persons you name.
If we choose not to make your changes, we will let you know why in writing. You will have the right to send us a letter disagreeing with us. We have the right to answer your letter. You then have the right to ask that your original request for changes, our denial and your second letter disagreeing with us be put with your records.
You have the right to receive a list of when we have given your records to others in the past six years.
By law, we do not have to give you a list of the following:
- Any records collected prior to 4/14/2003
- Records given or used for treatment, payment and healthcare operations purposes
- Records given to you or others with your written approval
- Records that are incidental to a use or disclosure otherwise permitted
- Records given to persons involved in your care or for other notification purposes
- Records used for national security or intelligence purposes
- Records given to prisons, police or to FBI and others who enforce laws
- Records given to health oversight agencies
Records given or used as part of a data set for research or for public health or healthcare operations purposes
Your request for a list of disclosures has to be in writing. We will act on your request within 60 calendar days. If we need more time, we may take up to another 30 calendar days. We will give you one free list every 12 months.
Using Your Rights
You have a right to get a copy of this notice at any time. We have the right to change the terms of this notice. Any changes in our privacy practices will apply to all the health records we keep. If we make changes, we will send you a new notice.
If you believe your rights have been broken, you may file a complaint in writing to:
Managed Health Services
10700 W. Research Dr., Suite 300
Milwaukee, WI 53226
Office for Civil Rights – Region V
U.S. Department of Health and Human Services
233 N. Michigan Ave., Suite 240
Chicago, IL 60601
(312) 353-5693 (TDD/TTY)
(312) 886-1807 (Fax)