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Your Rights as a Member
Your
Rights | You
Can File a Complaint or Grievance
You Can
Accept or Refuse Treatment | Confidentiality
and Disclosure of Medical Information
Confidentiality and Disclosure of Medical
Information
Protection of Privacy in All Settings
Keystone has taken numerous steps to see that your personal
information is kept confidential and to prevent the unauthorized
release of, or access to, your personal information.
Inclusion in Routine Consent
As more fully described in this section, by enrolling in
this program, you give consent to Keystone to maintain and
release your medical records, claims-related information,
and health and related information for the purposes identified
below. All of your records and information can be maintained
and released, even if the records or information is about
drug or alcohol abuse or addiction, mental health treatment,
HIV, an HIV-related illness, or AIDS. Any of your diagnoses,
any of your prognoses, any services you receive, the cost
of any of your services, and any insurance claims you file
can be maintained and released (these are just some examples).
The records and information can be maintained and released
for the direct or indirect purposes of: providing or paying
for health care or services related to your health insurance;
performing Keystone’s obligations under your health insurance
or assisting Keystone in doing so; granting requests made
pursuant to law, legal proceeding, or court order; granting
requests or meeting requirements of government, regulatory,
peer review, oversight, or accrediting bodies or any of
their representatives; complying with law; or for purposes
connected thereto. The records and information can be
released orally, by letter, by facsimile, electronically,
or in any other way possible, and can be maintained on
paper, electronically, or in any other way possible. The
records and information can be released: to persons connected
with providing health care or services related to your
health insurance; to persons providing stop-loss insurance
or reinsurance; to persons under subcontract with Keystone
or to subsidiaries or affiliates of Keystone; to persons
requesting the records or information pursuant to law,
legal proceeding, or court order; or to government, regulatory,
peer review, oversight, or accrediting bodies or any of
their representatives.
Use of Measurement Data
At times Keystone may utilize membership data to develop
or enhance health benefits. Patient identity will be kept
anonymous whenever possible.
The records and information can be maintained and released
as soon as you are enrolled in adultBasic. Records and
information can be maintained and released in the future,
too, as long as the maintenance and release is for one
or more of the above-stated purposes.
Access to Medical Records
Upon your request, Keystone will provide you with a summary
of any of your personally identifiable information maintained
by Keystone. At any time, you may request that Keystone
modify, correct, change or update your personally identifiable
information that Keystone maintains by contacting Keystone
by postal mail, e-mail, or telephone.
Right to Approve Release of Information
In certain circumstances, where required by law to release
unique member health information, Keystone will first ask
for your consent before releasing your information. If you
give consent for us to release your information, you have
the right—at any time—to revoke your consent (except to
the extent we relied on the consent while it was in effect).
When the plan needs to obtain consent for the release
of personal health information, authorization of care
and treatment, or access to information from an adultBasic
member, the plan will obtain consent from the member or
other individual with appropriate legal authority to make
decisions on behalf of the member.
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| NOTE: |
This is a
comprehensive consent related to Keystone
maintenance and release of your records and
information. There are state and federal laws
that apply to the maintenance and disclosure
of certain medical records, claims-related
information, and health and related information. |
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