BlueChoice HealthPlan

Authorization to Disclose Protected Health Information

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BlueChoice HealthPlan has always had a commitment to protecting our members' confidential health information. The Health Insurance Portability and Accountability Act (HIPAA) is a new federal law that changes the way we use and release information about our members.

As of April 13, 2003, we are not allowed to give protected health information to another person unless we have legal permission. What does this mean? If a member wants to let an agent, employer or plan sponsor contact us for claims or payment information, we can't release it to them unless we have the member's permission. We must have the permission in writing.

For your convenience, we have created a HIPAA Authorization to Disclose Protected Health Information to a Third Party Form. Members can use this form to give us permission to release information to a third party. They don't have to complete and return this form unless they want someone other than themselves to receive their protected health information.

If you'd like to complete the form, here it is!

Authorization To Disclose Protected Health Information To A Third Party

If you'd like to learn more about how we protect health information, please review our Privacy Practices.