Notice of Privacy Practices

Important information about your rights and our responsibilities

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ CAREFULLY

State Notice of Privacy Practices

When it comes to handling your health information, we follow relevant state laws, which are sometimes stricter than the federal HIPAA privacy law. This notice explains your rights and our duties under state law.

Your state may give you additional rights to limit sharing your health information. Please contact CarelonRx Privacy at:

CarelonRx Pharmacy, Inc

Privacy Officer, Privacy Office

220 Virginia Avenue

Indianapolis, IN 46204

Or you can email at [email protected]

Your Personal Information

Your nonpublic (private) personal information (PI) identifies you. You have the right to see and correct your PI. We may collect, use and share your PI as described in this notice. Our goal is to protect your PI because your information can be used to make judgments about your health, finances, character, habits, hobbies, reputation, career and credit.

We may receive your PI from others, such as hospitals, insurance companies, or other doctors. We may also share your PI with others outside our company — without your approval, in some cases. But we take reasonable measures to protect your information.

If an activity requires us to give you a chance to opt out, we’ll let you know, and we’ll let you know how to tell us you don’t want your PI used or shared for an activity you can opt out of

HIPAA Notice of Privacy Practices

We keep the health and financial information of our current and former patients private as required by law and our own internal rules. We’re also required by federal law to give you this notice to explain your rights and our legal duties and privacy practices.

Your Protected Health Information

There are times we may collect, use and share your Protected Health Information (PHI) as allowed or required by law, including the HIPAA Privacy rule. Here are some of those times:

Payment: We collect, use and share PHI to get payment for the medical care you receive from us or share information with the doctors, clinics, and others who bill us for your care.

Healthcare operations: We collect, use and share PHI for our healthcare operations.

Treatment activities: We collect, use and share PHI to provide the care, medicine, and services you need or to help doctors, hospitals, and others get you the care you need. Examples of ways we use your information

• We may share PHI with your other doctors or your hospital so that they may treat you.
• We may use PHI to review the quality of care and services you get.
• We may use PHI to help you with services for conditions like asthma, diabetes, or traumatic injury.
• We may collect and use publicly and/or commercially available data about you to support you and help you get available health services.
• We may use your PHI to create, use or share de-identified data as allowed by HIPAA.
• We may also use and share PHI directly or indirectly with health information exchanges for payment, healthcare operations and treatment. If you don’t want your PHI to be shared in these situations, contact Carelon Health Privacy at (562) 741-4521 for more information.
• We may also send you reminders about routine medical checkups and tests.
• We may share your information in an emergency or disaster relief situation.

Sharing your PHI with you: We must give you access to your own PHI.

You may get emails that have limited PHI, such as appointment reminders. We’ll ask your permission and preferences for how we contact you.

Sharing your PHI with others: In most cases, if we use or share your PHI outside of treatment, payment, operations, or research activities, we have to get your permission in writing first. We must also get your written permission before:

• Using your PHI for certain marketing activities.
• Selling your PHI.
• Sharing any psychotherapy notes from your doctor or therapist.

You have the right and choice to tell us to:

Share information with your family, close friends or others involved with your current treatment or payment for your care.

Other reasons we may use or share your information:

We are allowed, and in some cases required, to share your information in other ways — usually for the good of the public, such as public health and research. We can share your information for these specific
purposes:

• Helping with public health and safety issues, such as:
  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medicines
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety.
• Doing health research.
• Obeying the law, if it requires sharing your information.
• Responding to organ donation groups for research and certain reasons.
• Addressing workers’ compensation, law enforcement and other government requests, and to alert
  proper authorities if we believe you may be a victim of abuse or other crimes.
• To work with a medical examiner or funeral director.
• Responding to lawsuits and legal actions

Authorization: We’ll get your written permission before we use or share your PHI for any purpose not stated in this notice. You may cancel your permission at any time, in writing. We will then stop using your PHI for that purpose. But if we’ve already used or shared your PHI with your permission, we cannot undo any actions we took before you told us to stop.

Race, ethnicity, language, sexual orientation and gender identity: We may infer, receive and/or maintain race, ethnicity, language, sexual orientation and gender identity information about you and protect this information as described in this notice. We may use this information to help you, including identifying your specific needs, developing programs and educational materials and offering interpretation services. We don’t share this information with unauthorized persons.

Your Rights

Under federal law, you have the right to:

• • Send us a written request to see or get a copy of your PHI, including a request for a copy of your PHI through email. Remember, there’s a risk your PHI could be read by a third party when it’s sent unencrypted, meaning regular email. So, we will first confirm that you want to get your PHI by unencrypted email before sending it to you. We will provide you a copy of your PHI usually within 30 days of your request, unless a more stringent state requirement applies. If we need more time, we will let you know.
  • Ask that we correct your PHI that you believe is wrong or incomplete. If someone else, such as another doctor, gave us the PHI, we’ll let you know so you can ask him or her to correct it. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
  • Send us a written request not to use your PHI for treatment, payment or healthcare operations activities. We may say “no” to your request, but we’ll tell you why in writing.
  • Request confidential communications. You can ask us to send your PHI or contact you using other ways that are reasonable. Also, let us know if you want us to send your mail to a different address if sending it to your home could put you in danger.
  • Send us a written request to ask us for a list of those with whom we’ve shared your PHI. We will provide you a list usually within 60 days of your request. If we need more time, we will let you know.
  • Ask for a restriction for services you pay for out of your own pocket: If you pay in full for any medical services out of your own pocket, you have the right to ask for a restriction. The restriction would prevent the use or sharing of that PHI for treatment, payment or operations reasons. If a law requires sharing your information, we don’t have to agree to your restriction.
  • Contact CarelonRx Privacy at:
    CarelonRx Pharmacy, Inc
    Privacy Officer, Privacy Office
    220 Virginia Avenue
    Indianapolis, IN 46204
    Or you can email at [email protected]

How we protect information

We’re dedicated to protecting your PHI, and we’ve set up a number of policies and information practices to help keep your PHI secure and private. If we believe your PHI has been breached, we must let you know.

We keep your oral, written and electronic PHI safe using the right procedures, and through physical and electronic ways. These safety measures follow federal and state laws. Some of the ways we keep your PHI safe include securing offices that hold PHI, password-protecting computers, and locking storage areas and filing cabinets. We require our employees to protect PHI through written policies and procedures. These policies limit access to PHI to only those employees who need the data to do their
jobs. Employees are also required to wear ID badges to help keep unauthorized people out of areas where your PHI is kept. Also, where required by law, our business partners must protect the privacy of data we share with them as they work with us. They’re not allowed to give your PHI to others without your written permission, unless the law allows it and it’s stated in this notice.

Potential impact of other applicable laws

HIPAA, the federal privacy law, generally doesn’t cancel other laws that give people greater privacy protections. As a result, if any state or federal privacy law requires us to give you more privacy protections, then we must follow that law in addition to HIPAA

To see more information

To read more information about how we collect and use your information, your privacy rights, and details about other state and federal privacy laws, please visit CarelonRx’s Privacy web page at https://www.elevancehealth.com/privacy-policy.

Calling or texting you

We, including our affiliates and/or vendors, may call or text you by using an automatic telephone dialing system and/or an artificial voice. But we only do this in accordance with the Telephone Consumer Protection Act (TCPA). The calls may be about treatment options or other health-related benefits and services for you. If you don’t want to be contacted by phone, just let the caller know or contact CarelonRX Privacy at [email protected] to add your phone number to our Do Not Call
list. We will then no longer call or text you.

Complaints

If you think we haven’t protected your privacy, you can file a complaint with us by calling the patient services number on the back of your ID card. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html. We will not take action against you for filing a complaint.

Contact information

You may call us at CarelonRx Privacy to apply your rights, file a complaint or talk with you about privacy issues at:
CarelonRx Pharmacy, Inc
Privacy Officer, Privacy Office
220 Virginia Avenue
Indianapolis, IN 46204
Or you can email at [email protected]

Copies and changes

You have the right to get a new copy of this notice at any time. Even if you have agreed to get this notice by electronic means, you still have the right to ask for a paper copy. We reserve the right to change this notice. A revised notice will apply to PHI we already have about you, as well as any PHI we may get in the future. We’re required by law to follow the privacy notice that’s in effect at this time. We may tell  you about any changes to our notice through a newsletter, our website or a letter.

Effective date of this notice

The original effective date of this Notice was April 14, 2003. The most recent revision is June 1, 2024.

It’s important we treat you fairly.

We follow federal civil rights laws in our health programs and activities. We don’t discriminate, exclude people, or treat them differently based on race, color, national origin, sex, age or disability. If you have disabilities, we offer free aids and services. If your main language isn’t English, we offer help for free through interpreters and other written languages. Call your clinic for help (TTY/TDD:711).

If you think we failed to offer these services or discriminated based on race, color, national origin, age, disability, or sex, you can file a complaint, also known as a grievance. You can file a complaint through one of these ways:

• Write to Compliance Coordinator, P.O. Box 27401, Mail Drop VA2002-N160, Richmond, VA 23279.
• File a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights at
  200 Independence Avenue, SW; Room 509F, HHH Building; Washington, D.C. 20201.
• Call 1-800-368-1019 (TDD: 1-800-537-7697).
• Go online at https://ocrportal.hhs.gov/ocr/smartscreen/main.js

Get help in your language

One more right that you have the right to get this information in your language for free. If you’d like extra help to understand this in another language, call your clinic for help. (TTY/TDD: 711).

Aside from helping you understand your privacy rights in another language, we also offer this notice in a different format for members with visual impairments. If you need a different format, please call your clinic for help

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