Last Modified: November 1, 2020
CSS Health Website Disclaimer
CSS Health maintains this website for the purpose of demonstrating the scope of our products and services to health plans, providers, and other entities in the health care delivery system. While we endeavor to keep it as up to date as possible, we cannot assure its completeness and therefore encourage you to contact us for full details. Existing and Prospective Clients and those with general enquiries are welcome to contact us using the link and contact information below.
CSS Health is committed to protecting the privacy and security of the personal health information of patients and their families, and are fully HIPAA compliant. If you are an individual seeking to contact us regarding personal matters, please read the following Notice carefully regarding transmission to us of any of your protected health information.
NOTICE To Individuals
About Privacy and Security of Personal Health Information
On this Website
CSS Health does not create or maintain health records, nor conduct electronic health care transactions. We encourage individuals seeking information about any of these matters to first contact your health plan or providers directly.
If you do choose to contact us, we ask you to please not send us individually identifiable protected health information about yourself through the link below. It is not a patient portal and should not be used as a confidential transmission to us. If you choose to send us this information anyway, we cannot guarantee its security or privacy in transit or upon receipt. We would ask you instead to please email a general contact request message to our privacy and security compliance office at firstname.lastname@example.org or to call us at (716) 541-0273. Thank you.
PRIVACY AND SECURITY NOTICE
For a copy of our HIPAA Notice of Privacy practices or any other information or comments regarding our commitment to Privacy and Security, please contact our privacy and security compliance office at email@example.com or call us at (716) 541-0273.
HIPAA Notice of Privacy Practices
CSS Health assists health plans, companies, providers and other clients to improve their health care operations. In the course of performing our services, data regarding individuals may be shared with us as their Business Associate. We strictly adhere to all privacy and security requirements regarding the handling of protected health information required by them and by the law.
When your health plan or provider shares your information with us, you have rights and we have responsibilities. This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
CSS Health does not create or maintain any patient health records, or process any electric health claims. We encourage you to obtain this information from your health care providers and plans.
We do not use this website to gather or share personal information about individuals. If you choose to contact us using the Contact Us page on this website, please read the important privacy and security information notice on that page.
You should contact your health providers and insurers first and directly, to exercise any or all of the following rights. You also have the right to contact us.
You have the right to:
• Get a copy of your health and claims records
• Correct your health and claims records
• Request you be contacted using confidential communications
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated
You have some choices in the way that we use and share information as we:
• Administer efficiency in the delivery of health care operations services
• Provide disaster relief and data recovery services
• Market our services and sell your information
Our Uses and Disclosures
We generally do not re-disclose information provided to us in the course of delivering our services to health plans and providers. We may use and share your information as we:
• Help manage the health care administration services you receive
• Run our organization
• Administer your health plan and the costs of your health services
• Help with public health and safety issues
• Do research
• Comply with the law
• Respond to a medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you:
Get a copy of health and claims records
• You can ask to see or get a copy of whatever information has been shared with us regarding your health and claims records and other health information we have about you. Remember, we did not create the record so it is best if you contact your health plans and providers directly. Ask us how to do this.
• We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct health and claims records
• You can ask us to correct your health and claims records we have been given about you, if you think they are incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
• You can ask us to contact you in a specific way (for example, home or office phone) or to send communications to a specific address or email address.
• We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not.
Ask us to limit what we use or share
• You can ask us not to use or share certain health information for treatment, payment, or our operations.
• We are not required to agree to your request, and we may say “no” if it would affect your care.
Get a list of those with whom we’ve shared information
• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
• You can complain if you feel we have violated your rights by contacting us using the information on page 1.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
• Share information with your family, close friends, or others involved in payment for your care
• Share information in a disaster relief situation
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
• Marketing purposes
• Sale of your information
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
Help manage the health care treatment you receive
We can use your health information and share it with professional health plans and providers you have engaged to deliver health services to you
Example: A health plan sends us information about your diagnosis and prescription medications so we can coordinate delivery of their coverage services to you.
Run our organization
• We can use and disclose your information to run our organization and contact you when necessary.
• We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans.
Example: We use health information about you to develop better services for you.
Pay for your health services
We can use and disclose your health information with your health plan regarding payment for your health services.
Example: We share information about you with your pharmaceutical plan to coordinate payment for your prescription medications.
Assist your health plan and providers to administer their health care operations
We may disclose your health information to your health plan for plan administration.
Example: Your health plan contracts with us to provide services, and we provide them with certain statistics to explain our charges.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests and work with a medical examiner or funeral director
• We can share health information about you with organ procurement organizations.
• We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
• We are required by law to maintain the privacy and security of your protected health information.
• We will advise your health plan or provider to let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our web site, and if you request, we will mail a copy to you.
The Effective Date of this Notice is October 6, 2020.
The name, email address and telephone number of our Privacy officer is: James A. Clair, firstname.lastname@example.org or call us at (716) 541-0273.
We do not create or maintain any patient health records. Please contact your health care providers directly.
We do not create or process any electronic claims transactions. Please contact your health plan directly.
Disclosure of Mental Health and Substance Abuse information about individuals is given heightened priority, privacy, and security protections. Please ask us for details.
HIPAA permits the use and disclosure of protected health information of individuals even in the absence of a signed authorization to do so, when made necessary by the individual’s health treatment, payment for health treatment, or the health care operations of health plans and payors.
There is no private cause of action for perceived HIPAA breaches or violations.
Individual state privacy laws also have requirements for keeping and maintaining the privacy of individuals.
This notice applies to CSS Health, its affiliates and parent company.