Notice of Privacy Practices

The following is 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 federal Health Insurance Portability and Accountability Act (HIPAA) privacy laws. This notice explains your rights and our duties under state law.

California Consumer Privacy Act (CCPA) Privacy Notice and Virginia Consumer Data Protection Act (VCDPA) Notice (Note: These privacy notices are not applicable to your health plan. Health plan members and applicants should refer to their plan's HIPAA Notice of Privacy Practices.)

Privacy Notice for California Residents 

Your state may give you additional rights to limit the sharing of your health information. Please call Carelon Health Privacy at 562-741-4521 for details.

Your personal information

Your 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 allow you to opt out, we’ll let you know and give you instructions on how to tell us you don’t want your PI used or shared.

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 to 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 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 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 must get your permission in writing first. We must also obtain your written authorization 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 in 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 other specific reasons. 
  • Addressing workers’ compensation, law enforcement, and other government requests and alerting 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 authorization in writing at any time. 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 by 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 that a third party could read your PHI when it’s sent unencrypted in a regular email. Therefore, we will first confirm that you want to get your PHI by unencrypted email before sending it to you. Unless a more stringent state requirement applies, we will usually provide a copy of your PHI within 30 days of your request. If we need more time, we will let you know.  
  • Ask that we correct any 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 them 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 reasonable ways. 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 usually provide you a list within 60 days of your request. If we need more time, we will let you know.  
  • Ask for a restriction of services you pay for out of your pocket. If you pay in full for any medical services out of your pocket, you can ask for a restriction. The restriction would prevent the use or sharing of PHI for treatment, payment, or operational reasons. If a law requires sharing your information, we don’t have to agree to your restriction. 
  • Call Carelon Health Privacy at 562-741-4521 to exercise any of these rights. 

How we protect information

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

We keep your oral, written, and electronic PHI safe using the right procedures through physical and electronic ways. These safety measures follow federal and state laws. Some 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 identification badges to help keep unauthorized people out of areas where your PHI is kept. Also, where law requires, our business partners must protect the privacy of the 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 unless it is 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 provide you with more privacy protections, we must follow that law in addition to HIPAA.

Notice for Carelon Health Colorado patients

Carelon Health endorses, supports, and participates in electronic CORHIO Health Information Exchange (HIE) to improve the quality of your health and healthcare experience. The CORHIO HIE allows us to securely and efficiently share patients’ clinical information electronically with other physicians and healthcare providers participating in the CORHIO HIE network.

Using CORHIO HIE helps your healthcare providers more effectively share information and provide you with better care. The CORHIO HIE also enables emergency medical personnel and other providers treating you to have immediate access to your medical data that may be critical for your care. Making your health information available to your healthcare providers through the CORHIO HIE can also help reduce costs by eliminating unnecessary duplication of tests and procedures. However, you may opt out of participation in the CORHIO HIE or cancel an opt-out choice anytime by visiting www.corhio.org/for-patients/your-choices  or calling 720-285-3200.

Notice for Carelon Health Maryland and Washington, D.C. patients

We have chosen to participate in the Chesapeake Regional Information System for our Patients (CRISP), a regional health information exchange serving Maryland and Washington, D.C. As permitted by law, your health information will be shared with this exchange to provide faster access, better coordination of care, and to assist providers and public health officials in making more informed decisions. You may opt out and disable access to your health information available through CRISP by calling 877-952-7477 or completing and submitting an opt-out form to CRISP by mail, fax, or through their website at www.crisphealth.org/ 

Notice for Carelon Health North Carolina patients

This facility participates in the North Carolina Health Information Exchange Network, called NC HealthConnex, which is operated by the North Carolina Health Information Exchange Authority (NC HIEA). We will share your protected health information, or PHI, with the NC HIEA and may use NC HealthConnex to access your PHI to assist us in providing healthcare to you.

We are required by law to submit clinical and demographic data pertaining to services paid for with funds from North Carolina programs like Medicaid and State Health Plan. We may also share other patient data with NC HealthConnex not paid for with state funds. If you do not want NC HealthConnex to share your PHI with other healthcare providers who are participating in NC HealthConnex, you must opt out by submitting a form directly to the NC HIEA.

Forms and brochures about NC HealthConnex are available in our offices and online at NCHealthConnex.gov . You may also contact our Privacy Office at 562-741-4521. Again, even if you opt out of NC HealthConnex, we will still submit your PHI if your healthcare services are funded by state programs. Your patient data may also be exchanged or used by the NC HIEA for public health or research purposes as permitted or required by law. For more information on NC HealthConnex, please visit hiea.nc.gov/patients .

Learn more

To learn more about how we collect and use your information, your privacy rights, and other state and federal privacy laws, please visit Carelon Health’s Privacy web page at www.carelon.com/privacy .

Calling or texting you

We, including our affiliates and/or vendors, may call or text you 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 Carelon Health Privacy at 562-741-4521 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 Carelon Health Privacy at 562-741-4521. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting 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 Carelon Health Privacy at 562-741-4521 to exercise your rights, file a complaint, or talk to us about privacy issues.

Copies and changes

You have the right to get a new copy of this notice at any time. Even if you agree to obtain this notice electronically, 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 the PHI we already have about you and 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 January 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 primary language isn’t English, we offer free help through interpreters and translators. 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, 12900 Park Plaza Drive, Suite 150, Mailstop 6170, Cerritos, CA 90703-9329. 
  • File a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights at 200 Independence Ave., SW; Room 509F, HHH Building; Washington, D.C. 20201. 
  • Call 800-368-1019 (TDD: 800-537-7697). 
  • Go online at ocrportal.hhs.gov/ocr/smartscreen/main.jsf 

Get help in your language

You have the right to get this information in your language for free. Call your clinic if you’d like extra help understanding this in another language. (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.

Trade name

Carelon Health is the trade name of:

  • Carelon Medical Partners, P.C.  
  • Carelon Medical Partners of Illinois, P.C  
  • Carelon Medical Partners of Kansas, P.A. 
  • Carelon Medical Partners of Texas, P.A. 
  • Carelon Medical Partners of North Carolina, P.C.  
  • Carelon Medical Partners of California, P.C.  
  • Carelon Medical Partners of Arizona, P.C. 
  • Carelon Medical Partners of Colorado, P.C. 
  • Carelon Medical Partners of New York, P.C. 
  • Carelon Medical Partners of Nevada, P.C. 
  • Carelon Medical Partners West, P.C.