Privacy Notices

Notice of Privacy Practice

This notice describes how VyStream may use and disclose Protected Health Information or PHI. It also describes our legal obligations concerning PHI and your rights to access and control your PHI.                 
 
This notice is in effect in accordance with the privacy regulations issued under the federal Health Insurance Portability and Accountability Act (HIPAA Privacy Regulations) of 1996. Please review it carefully.             
 
This notice was last updated: 5/5/2014
 
Personal Health Information (PHI)
PHI is individually identifiable health information that includes modifiers such as name, address, phone number, identification number, or other identifiers collected from the member or created and/or received by a healthcare provider, health plan, or employer that relates to:              
  • A past, present or future physical or mental health or condition;
  • The provision of healthcare; or
  • The past, present, or future payment for healthcare.
We are required by law to maintain the privacy of PHI. We are obligated to provide a copy of this notice and we must abide by the terms of this notice. We reserve the right to change this notice at any time. If we make a material change to this notice, it will be placed on this Web site and notification sent to the appropriate parties.                 
 
When a member joins a health insurance plan, they give their employer and the insurance plan permission to use and share medical information so that they, a provider, insurance company, or third party administrator can pay the medical bills. VyStream may also use and share medical information to an employer to initiate payment; to a provider regarding specified medical services; and/or to an administrator for claims payment.                
 
VyStream understands that following these regulations could seem confusing and at times frustrating, but they have been put into place to protect all parties involved and to keep personal health information from falling into the wrong hands.                 
 
Authorizations
VyStream is committed to assisting you in every way to resolve your claim questions. It is important to note, however, effective April 13, 2003, the federal government issued HIPAA Privacy Regulations that place limits on the amount of information we can release. We can no longer discuss Protect Health Information (PHI) with anyone other than the member or his or her designated representative, unless we have written authorization to do so. A permission form has been created and posted to this Web site. To access the form, click here. The form should be mailed or faxed to:             
 
VyStream
Attention: Call Center
2700 N Central Ave Ste 810
Phoenix, Arizona 85004-1162
 
Fax: 602-256-7816
 
Note: You must have Adobe Acrobat to download and print the form. If you do not have Adobe Reader installed on your computer, please download from here for free: http://www.adobe.com/products/acrobat/readstep2.html   
 
Please note, the form must be filled out entirely and must be specific about the issue to be discussed. In addition, an expiration date or an event that triggers the expiration of the release must also be included on this form. This form must be updated annually. VyStream only keeps forms for one year.    
 
It is not acceptable to release a "blanket" authorization for all claims. If PHI needs to be discussed on multiple claim issues, a separate form must be completed for each issue.                 
 
Medical information may be used or shared without permission for reasons like:                 
  • Speaking to providers (i.e. doctors and hospitals), an employer, insurance company and/or third party administrator about a member's care and giving them medical information that will help them provide access to care and/or treat a condition.
  • A review of our own programs and/or operations.
  • Reviewing information from providers for grievances, appeals, fraud and abuse.
  • Medical case management, disease management, maternity care management, chiropractic care management and/or workers' compensation entities.
  • Working with other companies and/or agencies that provide healthcare services.
  • Sharing information with companies that perform functions for us.
It is important to know that we use only the health information that we need to do our job. Only employees that need to see the information are able to see and use it. When we share health information that the law allows us to, we only share the information that the person need to do their job. We believe that privacy is very important.  
 
Other Uses and Disclosures
Disclosures Required by Law - VyStream will share medical information when federal, state, and/or local law tells us that we have to. 
 
Health Oversight Activities - VyStream may share medical information with (federal) The Centers for Medicare and Medicaid (CMS), state Medicaid (AHCCCS), the Department of Insurance (DOI), or any other governing entity. This could include things like audits, investigations and inspections. These activities are necessary so that the government may review the healthcare system and how members receive healthcare. 
 
Lawsuits and Disputes - If you are involved in a lawsuit or a grievance, we may share medical information to respond to a court order or an order from the Administrative Law Judge. We may also share medical information to respond to a lawful process (for example, a subpoena or discovery request). In this case, we will not share any information unless we know that the person asking for the information has attempted to let you now that they are going to ask for it.  
 
Law Enforcement, Military Activity and/or National Security, Protective Services - VyStream may have to give local or federal law enforcement official and/or military official medical information. In rare cases, we may have to share information because of national security and intelligence activities, and for the protection of the President, other authorized persons, or heads of state. 
 
Written Permission (Authorization) - Other uses and disclosures of medical information that are not mentioned in this notice or not allowed by the law will be made only with written permission and after you tell us what information we may share, where, and to whom the information must be sent. The authorization is good until the date put on the form. The amount of information can be limited or rescinded at any time by letting us know in writing. If permission is rescinded, we will no longer use or share medical information for the reasons covered by the authorization.  
 
Changes to this Notice
VyStream may change this notice. The change may involve medical information already on file, as well as any information we get in the future. If we do change the notice, we will post a new one. You will always know it is current by the effective date of the notice on the top of the page.  
 
Complaints
If you believe privacy rights have been violated and VyStream has not followed what we have said in this notice, you may file a complaint in writing (the address is at the bottom of this notice). If we do not answer all of your questions, you may file a complaint with the Secretary of the Department of Health and Human Services. You will never be penalized or discriminated against for filing a complaint.  
 
Other Privacy Rights
Another law provides additional privacy protections to patients of alcohol and drug treatment programs. For more information, go to the Web site at www.samhsa.gov. 
 
For More Information
This is a brief summary of rights and protections under the federal health information privacy law. You can learn more about health information privacy and an individual's rights in a fact sheet called "Your Health Information Privacy Rights". You can get this free from the Web site at http://www.hhs.gov/ocr/privacy/index.html or call 866-627-7748; the phone call is free. 
 
The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201 
 
Phone: 202-619-0257
Toll free: 877-696-6775  
 
If you have concerns about VyStream' privacy policies or procedures, or our compliance with the HIPAA Privacy Regulation, you may communicate your complaint to:   
 
Tracy Mitchell, Executive Vice President
 
VyStream
2700 N Central Ave Ste 810
Phoenix, Arizona 85004-1162
 
Phone: 844-250-8267
 
You may also submit a written complaint to the Secretary of the U.S. Department of Health and Human Services at the contact information listed above. Complaints filed directly with the Secretary must: (1) be in writing; (2) contain the name of the entity against which the complaint is lodged; (3) describe the relevant problems; and (4) be filed within 180 days of the time you became or should have become aware of the problem.  
 
We support your right to protect the privacy of your PHI. You can be assured there will be no retaliation of any kind if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.  
 
VyStream
2700 N Central Ave Ste 810
Phoenix, Arizona 85004-1162
 
Phone: 844-250-8267
Main Fax: 602-417-2871
Call Center Fax: 602-256-7816