As your contractor for a Medicare Advantage plan, ATRIO Health Plans provides you with health services. ATRIO staff must collect information about you to provide these services.  ATRIO knows that information we collect about you and your health is private. ATRIO is required to protect this information by federal and state law. We call this information “Protected Health Information” (PHI).

 

This Notice of Privacy Practices tells you how ATRIO may use or disclose information about you. Not all situations will be described. ATRIO is required to give you notice of our privacy practices for the information we collect and keep about you. ATRIO is required to follow the terms of the notice currently in effect.

 

 

In order to manage your health benefits effectively, ATRIO may use and disclose your PHI in certain way, without your authorization. The following are the types of disclosure we may make as allowed or required by law:

 

·   For Treatment. ATRIO may use or disclose information with health care providers who are involved in your health care.  For example, information may be shared to create and carry out a plan for your treatment.

 

·   For Payment. To make sure that claims are paid correctly and you receive the benefits you are entitled to, we may use and disclose your PHI to determine plan eligibility and responsibility for coverage and benefits. For example, ATRIO may use your information to facilitate payment for the care you receive from health care providers, coordinate benefits with other plans and facilitate the adjudication or subrogation of health care claims. We may also use or disclose PHI to review health care services for medical necessity, appropriateness of care or justification for charges, and to facilitate utilization review activities, including precertification and preauthorization of services, concurrent and retrospective review.

 

·   For Health Care Operations. ATRIO may use or disclose information in order to manage its programs and activities.  For example, ATRIO may use PHI to review the quality of services you receive.

 

·   Appointments and Other Health Information. ATRIO may send you reminders for medical care checkups.  ATRIO may send you information about health services that may be of interest to you.

 

·   For Public Health Activities. ATRIO may provide information to DHS, the public health agency that keeps and updates vital records, such as births and deaths, and tracks some diseases.

 

·   For Health Oversight Activities. ATRIO may use or disclose information to inspect or investigate health care providers.

 

·   As Required by Law and For Law Enforcement. ATRIO will use and disclose information when required or permitted by federal or state law, or by court order.

 

·   For Abuse Reports and Investigations. ATRIO is required by law to receive and investigate reports of abuse.

 

·   For Government Programs. ATRIO may use and disclose information for public benefits under other government programs.  For example, ATRIO may disclose information for the determination of Supplemental Security Income (SSI) benefits.

 

·   To Avoid Harm. ATRIO may disclose PHI to law enforcement in order to avoid a serious threat to the health and safety of a person or the public.

 

·   For Research. ATRIO uses information for studies and to develop reports.  These reports do not identify specific people.

 

·   Disclosures to Family, Friends and Others Who Are Involved In Your Medical Care. ATRIO may disclose information to your family or other persons who are involved in your medical care.  You have the right to object to the sharing of this information.

 

·   Other Uses and Disclosures Require Your Written Authorization. For other situations, ATRIO will ask for your written authorization before using or disclosing information.  You may cancel this authorization at any time in writing.  ATRIO cannot take back any uses or disclosures already made with your authorization.

 

 

 

You have the following rights regarding health information ATRIO maintains about you:

 

·   Right to See and Get Copies of Your Records. In most cases, you have the right to look at or get copies of your records.  You must make the request in writing.  You may be charged a fee for the cost of copying your records. We may deny your request to inspect and/or copy records in certain limited circumstances. If you are denied copies of, or access to, health information that we keep about you, you may ask that our denial be reviewed. If the law gives you a right to have our denial reviewed, we will select a licensed health care professional to review your request and our denial. The person conducting the review will not be the person who denied your request and we will comply with the outcome of the review.

 

·   Right to Request a Correction or Update of Your Records. You may ask ATRIO to change or add missing information to your records if you think there is a mistake.  You must make the request in writing and provide a reason for your request.

 

·   Right to Get a List of Disclosures. You have the right to ask ATRIO for a list of disclosures made after June 1, 2005.  This list will include disclosures made for purposes other than treatment, payment, health care operations, and in special circumstances involving national security, correctional institutions and law enforcement.  The list will also exclude any disclosures we have made based on your written authorization. You must make the request in writing and indicate the time period for the disclosures made, which may not exceed 10 years. There is no fee for the first list you request within a 12-month period however you may be charged for additional lists.

 

·   Right to Request Limits on Uses or Disclosures of PHI. You have the right to ask that ATRIO limit how your information is used or disclosed.  Your must make the request in writing and describe what information you want to limit and to whom you want the limits to apply.  ATRIO is not required to agree to the restriction(s).  You can request that the restriction(s) be terminated in writing or verbally.

 

·   Right to Revoke Permission. If you are asked to sign an authorization to use or disclose information, you can cancel that authorization at any time.  You must make the request in writing.  This will not affect information that has already been shared.

 

·   Right to Choose How We Communicate with You. You have the right to ask that ATRIO share information with you in a certain way or in a certain place.  For example, you may ask ATRIO to send information to your work address instead of your home address.  You must make this request in writing.  You do not have to explain the basis for your request.

 

·   Right to File a Complaint. You have the right to file a complaint if you do not agree with how ATRIO has used or disclosed information about you.

 

·   Right to Get a Paper Copy of this Notice. You have the right to ask for a paper copy of this notice at any time.

 

 

 

You may contact ATRIO or the ATRIO Privacy Officer at the address listed at the end of this notice to:

·   Ask to look at or copy your records

·   Ask to limit how information about you is used or disclosed

·   Ask to cancel your authorization

·   Ask to correct or change your records

·   Ask for a list of the times ATRIO disclosed information about you

 

ATRIO may deny your request to look at, copy or change your records. If ATRIO denies your request, ATRIO will send you a letter that tells you why the request is being denied and how you can ask for a review of the denial. You will also receive information about how to file a complaint with ATRIO or with the U.S. Department of Health and Human Services.

 

 

If you want additional information regarding our Privacy Practices, or if you believe we have violated any of your rights listed in this notice, you may contact ATRIO at the address or phone numbers listed below. If you have a complaint, you also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complain with the U.S. Department of Health and Human Services upon request. Your benefits will not be affected by any complaints you make.  ATRIO cannot retaliate against you for filing a complaint, cooperating in an investigation, or refusing to agree to something that you believe to be unlawful.

 

ATRIO Health Plans

 

 

 

Changes to this Notice 

In the future, ATRIO may change its Notice of Privacy Practices.  Any changes will apply to information ATRIO already has, as well as information ATRIO receives in the future.  A copy of the new notice will be posted at ATRIO as required by law.  You may ask for a copy of the current notice any time you visit, contact ATRIO, or get it on our website at www.ATRIOhp.com.