MEMBER HANDBOOK - Community Care Behavioral Health

22
Privacy
We will not let anyone else see information about the care you receive
if you don’t want us to.
Community Care defines privacy as the protection of your personal
health information, which is sometimes called Protected Health
Information, or PHI. Your personal information is private and
confidential. Community Care wants to take this opportunity to remind
you that this is the trust that we establish with you. It is a pledge that
we take seriously. Whether you are a current member or a former
member, we respect and safeguard the privacy and confidentiality of
the information that we have about you.
Privacy is one of your rights as either a person receiving services or
simply as a member of Community Care. It also is a right that you keep
even when you are no longer a member of Community Care.
Community Care only uses the information we collect or receive about
you to make sure that you are getting the best possible care that
meets your behavioral health care needs. This means that we do the
following:
• We have developed a network of behavioral health care providers
from whom you receive behavioral health care treatment.
• We pay the claims submitted by the doctors, hospitals, and other
health care professionals for the treatment and services you receive.
• We perform certain health care operations to monitor the quality of
the healthcare coverage and services that you receive. Examples of
these activities include:
1. Checking with your providers to help coordinate your care and
avoid any gaps or problems.
2. Providing the reports that the Department of Welfare requires us
to make.
3. Undergoing quality surveys by agencies that rate health care
plans.
4. Investigating any complaints and grievances that we receive from
members.
Customer Services 1-866-622-4228