How We Use Your Information Without Authorization


For Treatment

Information obtained will be recorded in your file in order to get you the care you need. For example, a doctor or nurse may need to consult with another specialist, clinic, lab, etc. for the best treatment.

For Payment

Limited information is shared with doctors, clinics and others who bill for your care. We may forward bills to other health plans for payment.

For Health Care Operations

In addition to general administration, we may share information with other organizations to accomplish certain tasks, such as quality improvement, audits, investigations, testing and planning. Those organizations must safeguard your information.

  1. Additional Ways
  2. Public Health Activities

Additional ways that we may share your information:

  • Appointments/Other Notifications: We may need to contact you (your family, friend or personal representative if involved in your care or payment for your care) in an emergency, or to tell you about an appointment or available health benefits, refills, exams or programs.
  • Coroners, Medical Examiners and Funeral Directors: Some laws require health information to be shared with funeral directors, coroners or medical examiners in order for them to carry out their duties.
  • Correctional Institutions: If you are an inmate, protected health information may be legally shared as necessary.
  • For Specialized Governmental Functions: Health information may be provided for reasons of national security, intelligence or to public assistance programs.
  • Judicial/Administrative Proceedings: We may share health information for judicial and administrative purposes as required by law, such as in lawsuits or court-ordered Workers’ Compensation actions.
  • Law Enforcement: We may share health information for certain law enforcement purposes, including laws that require reporting of certain types of wounds or other physical injury or abuse, or crimes against program employees or on program premises. Sharing is also allowed to identify a suspect, fugitive, witness or missing person.
  • Organ Procurement Organizations: Health information may be shared with organizations that obtain, store or transplant organs or tissue according to law.
  • Oversight Agencies: Certain agencies that oversee health care systems may receive health care information as part of their audits, civil, administrative or criminal investigations, inspections, licensures or disciplinary actions, and for similar reasons.
  • Research: We may disclose information to specific approved researchers who are also required to protect your health information.
  • Threat to Health and Safety: Health information may be shared in the case of a threat to the health or safety of a person or the public, such as a terrorist attack, medical emergencies, serious risk of disease, injury or disability, or emergency disaster relief.
  • Victims of Abuse, Neglect, or Domestic Violence: If health providers believe disclosure of information is necessary to prevent or discontinue serious harm to someone, that information may be shared with certain governmental agencies.