Bravo Health

At “Bravo Health, Inc.” and its affiliates, “Bravo Health Insurance Company, Inc., Bravo Health Mid-Atlantic, Inc., Bravo Health Pennsylvania, Inc., and Bravo Health Texas, Inc.” (throughout, “Bravo Health”), we know that your privacy is important to you. We will always respect your right to privacy when it comes to your personal information and health care, and we are committed to protecting your personal information. We will not give out your information to anyone without getting consent from you or an authorized person(s), unless we are permitted to do so by law. Because you are a valued member, we want you to know the steps we have taken to protect your privacy. This includes how we gather and use your personal information. Our privacy practices apply to all of our past, present, and future members.

When you sign up for health insurance benefits from Bravo Health, you agree to give us access to personally identifiable information for you. This agreement allows us to work with doctors, hospitals, and other providers to decide what insurance benefits apply and to pay your claims for health care services using your medical records. Medical records and claims are generally used to review treatment and to do quality assurance activities. It also allows us to look at how care is delivered and carry out programs to improve the quality of care you receive. This information also helps us manage the treatment of diseases to improve our customers’ quality of life.

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

Bravo Health collects, uses, and discloses information provided by and about you for health care payment and operations, or when we are otherwise permitted or required by law to do so.

For Payment: We may use and disclose information about you in managing your account or benefits and paying claims for medical care you receive through your Bravo Health plan. For example, we maintain information on a doctor’s office to confirm your eligibility for benefits, or we may ask a hospital for details about your treatment so that we may review and pay the claim for your care.

For Health Care Operations: We may use and disclose medical information about you for our operations purposes. For example, we may use information about you to review the quality of care and services you receive, to provide you case management or care coordination services, such as for Congestive Health Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), Diabetes or traumatic injury, or to seek accreditation.

As Permitted or Required by Law: Information about you may be used or disclosed to regulatory agencies, such as during audits, licensure or other proceedings, for administrative or judicial proceedings, to public health authorities, or to law enforcement officials, such as to comply with a court order or subpoena.

Authorization: Other uses and disclosures of protected health information will be made only with your written permission, unless otherwise permitted or required by law. You have the right to request that Bravo Health restrict how it uses and discloses your protected health information.

Under regulations that went into effect in April 2003, you have additional rights over your health information. Under these rules, you have the right to:

Send us a written request to see or get a copy of information that we have about you, or amend your personal information that you believe is incomplete or inaccurate. If we did not create the information, we will refer you to its source, such as your physician or hospital.

Request that we communicate with you about medical matters using reasonable alternative means or at an alternative address if communications to your home address could endanger you.

Receive an accounting of our disclosures of your medical information, except when those disclosures are for treatment, payment, or health care operations, or when the law otherwise restricts the accounting. We are not required to give you a list of disclosures made before April 14, 2003.

If you believe your right to privacy has been violated, you have the right to file a complaint with Bravo Health or with the federal government. You will not be penalized for filing a complaint.

We reserve the right to revise this notice. A revised notice will be effective for information we 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 communicate any changes to our notice through member newsletters or direct mail.

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 Bravo Health’s Member Services Department at: 1-800-556-1570 (Maryland), 1-800-291-0396 (Pennsylvania), and 1-888-353-3789 (Texas). TTY users please call 1-800-964-2561. We are open between the hours of 8:00 a.m. to 8:00 p.m., Monday through Friday.

Because of our commitment to protecting your privacy, Bravo Health has instituted tight security with respect to protecting your health information.

Only those staff members with a clinical or business need to know such information have access to your information. The security level of such access is commensurate with the staff member’s role.

Department supervisors working with the Compliance/Privacy Officer identify and report to Bravo Health’s Information Technology Department those staff members who need access to Bravo Health’s systems that contain your information. Supervisors additionally identify which staff members need to read, write, and reproduce such information.

All staff members who have access to your information must sign a confidentiality and non-disclosure agreement. If a staff member violates any portion of the agreement, disciplinary action up to and including termination of employment will occur.

All Bravo Health computers are equipped with screen savers and lock-downs to ensure that, should staff step away from their computer, any information displayed on their screen will be closed until they return and enter their password.

Quarterly audits are done to determine what information staff have had access to, what information has been used, what information has been disclosed, and to whom that information has been disclosed.

Patient information may not be included in any electronic document unless it is for business or medical use. If used for business or medical purposes, the electronic document is adequately secured.

No documents containing patient information may be transmitted via fax machine or fax server without the following:

Authorized Bravo Health cover page

Sender’s name

Sender’s phone number and extension

Sender’s fax machine number

Receiver’s name

Receiver’s phone and fax number

All hard copy documents with your personal information are kept in secure locations under lock and key. Only specific staff members have access to that information.

All Bravo Health staff are trained regarding how and when your personal information can be used and/or disclosed. This includes speaking to any individual other than you, your doctors, or any person you specifically authorized us to talk to.