We at WorkPartners have pledged to keep your personal information private and confidential—and we take this pledge seriously. Whether you are a prospective, current, or former member, living or deceased, we respect and safeguard the privacy and confidentiality of the information we have about you. Privacy is one of your rights as a consumer as well as a WorkPartners member. You retain this right even when you are no longer a member of WorkPartners.
But what does "private and confidential" really mean?
When you fill out your enrollment or renewal application form and sign it, you are doing two important things:
- Verifying the correctness and truthfulness of the information that you have provided to us
- Acknowledging that WorkPartners can only use the information we collect or receive about you and your family for very well-defined routine purposes:
- Arranging for the provision of health care treatment and services to you and your family members whom you are enrolling as dependents on your application.
- Making payment to doctors, hospitals, and other health care professionals for the treatment and services you and your family receive.
- Performing certain health care operations that WorkPartners uses to monitor the quality of the health care coverage and services that you have purchased for yourself and your family. These operations include measurement and review of all our data to see how many of our members receive certain services, such as childhood immunizations, mammograms, and other preventive health services. We use all these measurements so that we can assess how well we are doing in providing quality health care to our members.
Your personal information covers a number of elements that all have one thing in common: they are unique to you, and can be used to identify you. This means that any files containing information that includes such details as your name, address, Social Security number, and birth date are considered "protected health information." It is our responsibility to ensure the privacy of the protected health information of all our members—prospective, current, or former.
A managed care organization does not
collect or maintain files such as medical charts or records. Rather, files include the claims we have received and paid for the services provided to you, and the health care premiums that you or your company have paid. Whether the protected health information we have is considered health information or nonpublic personal financial information, we only use the information in our files within our company and with our contracted providers, vendors, and agents for the purposes of your health care insurance.
Other than for the well-defined, routine purposes described above, or as required by law, you are the only person who has access to your personal information and records.
WorkPartners does not share your protected health information with anyone else—including employers—unless you give us permission to do so. Any reports to employers about the services provided to their employees are based only on employee group percentages and totals—and not
on individual member data or information.
All physicians and providers in our network know that your information is private and confidential, and so do all of our WorkPartners employees. In fact, we have training programs for our employees to ensure that they know the procedures they need to follow to make sure that your information—whether in oral, written or electronic format
—is secure. We will not disclose information for any purpose beyond the provision of your health care coverage, unless authorized by you in writing or required by law.
If we have any additional programs that we feel would be beneficial to you and that would require us to use your specific personal information in order to let you participate in the program, we may contact you and let you know the details. We would request your permission and signed authorization before using your personal information for anything other than the routine purposes described above. If you decline such a request, your information will not be part of the special program enrollment.
You may have heard a great deal about privacy in the news—especially concerning federal legislation about privacy of health information. In addition to any new legislation, all health insurance carriers and health care providers must follow the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and several important sets of regulations that government agencies have issued for HIPAA implementation and compliance. Because HIPAA privacy regulations require doctors, hospitals, and health care insurers as well as employee benefit plans involved in your health care to have a "Notice of Privacy Practices
," you will probably be receiving several of these notices.
In addition to this Privacy Statement, WorkPartners’ Notice of Privacy Practices will give you even more specific information and details about how we ensure the privacy of your protected health information. The Notice will also explain all the rights you have concerning the privacy of your health information, and how you can exercise those rights.
WorkPartners, through its Compliance Committee and Quality Improvement Committee, monitors all applicable laws and government regulations. We continually review our policies and procedures to ensure that we are following privacy laws and honoring our commitment to our members. As new laws are passed and new regulations are issued or clarified, we will provide you with revised information that explains any changes or updates.
If you have questions about your right to the privacy and confidentiality of your personal information and data that have been entrusted to WorkPartners, contact our Member Services Department at the phone number on the back of your member ID card.
If you have specific questions about this statement or HIPAA readiness and compliance, contact:
UPMC Health Plan Privacy Officer
U.S. Steel Tower
600 Grant Street
Pittsburgh, PA 15219
Click here for general inquires about UPMC Health Plan.