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.
Protecting the privacy of information about your medical conditions and health
is a responsibility we take very seriously. We understand that medical information
about you and your health is personal, and it is important to you that we keep
it confidential. We are committed to the practices and procedures we established
to protect the confidential nature of information about your health.
This notice describes the ways in which we may use and disclose information
about your health to carry out treatment, payment and health care operations,
and for other purposes as permitted or required by law. It also describes your
rights and our duties regarding the use and disclosure of health information.
Uses and Disclosures of Information About Your Health Without Your Authorization
The following categories describe different ways that we may use and disclose
information about your health without your written authorization. For each category,
we will explain what we mean and try to give some examples. Not every use or
disclosure in a category will be listed. However, all of the ways we are permitted
to use and disclose information without written authorization fall within one
of the categories.
Treatment: We do not use information about your health to provide
you with medical treatment or related services.
Payment: Generally, we use and disclose information about your
health so we can administer claims, which includes reimbursing incurred expenses
for treatment and services you receive from a health care provider. For example,
we may disclose this information to your health care provider to verify insurance
coverage for medical treatment or service expenses.
Health Care Operations: We use and disclose information about
your health for our insurance operations. These uses and disclosures are necessary
for our business and to make sure our members are receiving quality service.
Some examples of how we may use and disclose information about your health include
underwriting insurance, processing transactions, resolving grievances, and conducting
business planning.
We may also disclose information about your health to our business associates
to enable them to perform services for us or on our behalf relating to our operations.
At the time you apply for insurance, we may disclose information about your
health in encoded form to the Medical Information Bureau (MIB) in an effort
to deter fraud, misrepresentation or criminal activity.
Public Health Risks: As required by law, we may disclose information
about your health to public health authorities that receive information to:
prevent or control disease, injury or disability; report births and deaths;
report child abuse or neglect; and notify a person who may be at risk for contracting
or spreading a disease or condition.
Health Oversight Activities: We may disclose information about
your health to a health oversight agency for activities authorized by law. Examples
of these oversight activities include: audits, investigations and inspections.
These activities are necessary for the government to monitor the health care
system, government programs and entities subject to civil rights laws.
Lawsuits and Disputes: If you are involved in a lawsuit or a dispute,
we may disclose information about your health in response to a court or administrative
order. We may also disclose this information in response to a subpoena, discovery
request, or other lawful process by someone else involved in the dispute. We
will make reasonable efforts to tell you about the request.
Law Enforcement: We may release information about your health
if asked to do so by a law enforcement official in response to a court order,
subpoena, warrant, summons or similar process; and about a death that may be
the result of criminal conduct. We may also release information about your health
to law enforcement or other governmental authorities to protect us against perpetration
of fraud or other illegal activities.
Coroners, Medical Examiners and Funeral Directors: We may release
information about your health to a coroner or medical examiner. We also may
release information about your health to funeral directors as necessary to carry
out their duties.
Research: Under certain circumstances, we may use information
about your health for insurance research purposes. We may also disclose information
about your health to organizations conducting actuarial or insurance research
studies.
To Avert a Serious Threat to Health or Safety: Although it is
not our practice, we may use and disclose information about your health when
necessary to help prevent a serious threat to the health and safety of you or
others. Any disclosure, however, would only be to someone able to help prevent
the threat.
Military and Veterans: If you are a member of the armed forces,
we may release information about your health as required by military command
authorities.
Workers' Compensation: We may release information about your health
to comply with laws relating to workers' compensation or similar programs. These
programs provide benefits for work-related injuries or illness.
Uses and Disclosures of Information About Your Health With Your Authorization
Other uses and disclosures of information about your health that are not described
in this notice or are not otherwise permitted by law will be made only with
your written authorization. You may revoke such authorization as described in
this notice.
Your Rights Regarding Information About Your Health
You have the following rights regarding the health information we maintain about
you, which you may exercise by submitting your request in writing to:
Attention: Privacy Office
Thrivent Financial for Lutherans
4321 North Ballard Road
Appleton, Wisconsin 54919-0001
Right to Revoke Authorization: You may revoke your authorization
that allows us to use or disclose health information that is not otherwise covered
by this notice or applicable law in writing at any time except: when the authorization
was obtained as a condition of obtaining insurance; during the contestable period;
or to the extent that we have taken action in reliance on your written authorization.
You understand we are unable to take back any disclosures we have already made
with your authorization and that we may retain documents that may contain information
about your health.
Right to Request Restrictions: You have a right to request a restriction
on the information about your health that we use or disclose for treatment,
payment or health care operations. You also have the right to request a limit
on the information we disclose about your health to someone who is involved
in your care or the payment for your care, such as a family member.
In your request, you must tell us: the information you want to limit; whether
you want to limit our use, disclosure or both; and to whom you want the limits
to apply (for example, disclosures to your spouse).
We are not required to agree to your requested restriction or limitation.
Right to Request Confidential Communications: If you could be
endangered by our normal communication channels, you have the right to request
that we communicate information about your health to you by alternative means
or at an alternative location. We will ask you the reason for your request,
and we will accommodate all reasonable requests. Your request must specify how
or where you wish to be contacted.
Right to Inspect and Copy: You have a right to inspect and copy
information about your health that we maintain. Usually, this includes medical
and billing records. Under Federal law, this right does not include psychotherapy
notes or information about your health compiled in reasonable anticipation of
litigation, administrative action, or administrative proceeding. If you request
a copy of this information, we may charge a standard fee for the costs of copying,
mailing or other supplies associated with your request.
We may deny your request to inspect and copy in certain limited circumstances,
such as where disclosure would reasonably endanger the life or physical safety
of you or another person. If you are denied access to information about your
health, you may request that the denial be reviewed.
Right to Amend: If you believe the information we have about your
health is incorrect or incomplete, you may ask us to amend the information.
You must provide a reason that supports your request. You have the right to
request an amendment for as long as the information is kept by or for us.
We may deny your request for an amendment if it is not in writing or does not
include a reason to support the request. In addition, we may deny your request
if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information
is no longer available to make the amendment;
- Is not part of the information about your health kept by or for us;
- Is not part of the information about your health that you would be permitted
to inspect and copy;
- Is accurate and complete.
Right to Request an Accounting: You have the right to receive
an accounting of certain disclosures of information about your health that we
made, if any. This right applies to disclosures for purposes other than treatment,
payment, health care operations or as otherwise permitted or required by law.
You have a right to receive specific information about these disclosures that
occur after November 1, 2002. The right to receive this information is subject
to certain exceptions, restrictions and limitations.
Right to a Copy of This Notice: You have the right to obtain a
copy of this notice at any time.
Our Duties Regarding Information about Your Health
We are required by law to:
- Maintain the privacy of information about your health;
- Provide you with this notice of our legal duties and health information
privacy practices; and
- Abide by the terms of this notice.
Changes to This Notice
We reserve our right to change the terms of this notice. We reserve the right
to make the revised or changed notice effective for health information we already
have about you as well as any information we receive in the future. If we make
a material change to the terms of this notice, we will mail a revised notice
to you.
For More Information or to File a Complaint
If you have questions or would like additional information, you may contact
us at 800-847-4836.
If you believe your privacy rights have been violated, you may file a written
complaint with our privacy office and with the Secretary of the Department of
Health and Human Services. You will not be retaliated against for filing a complaint.
This notice was published and became effective on November 1, 2002.