Venture Behavioral Health Information Privacy Practices

PRIVACY NOTICE
For Medicaid and Other Medical Assistance Programs
Effective April 14, 2003

THIS NOTICE DESCRIBES HOW PERSONAL AND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Understanding the Type of Information We Have.

We get information about you when you enroll in a health plan. It includes your date of birth, sex, ID number and other personal information. We also get bills, reports from your doctor, and other data about your medical care.

Our Privacy Commitment To You.

We care about your privacy. The information we collect about you is private. We are required to give you a notice of our privacy practices. Only people who have both the need and the legal right may see your information. Unless you give us permission in writing, we will only discuss your information for purposes of treatment, payment, business operations, or when we are required by law to do so.

Treatment.

We may disclose medical information about you to coordinate your health care. For example, we may notify your doctor about care you get in an emergency room.

Payment.

We may use and disclose information so the care you get can be billed and paid for. For example, we may ask an emergency room for details before we pay the bill for your care.

Business Operations.

We may need to use and disclose information for our business operations. For example, we may use the information to review the quality of care you get.

Exceptions.

For certain kinds of records, your permission may be needed even for release of treatment, payment, and business operations.

As Required By Law.

We will release information when we are required by law to do so. Examples of such releases would be for law enforcement or national security purposes, subpoenas or other court orders, communicable disease reporting, disaster relief, review of our activities by government agencies, to avert a serious threat to health or safety or in other kinds of emergencies.

With Your Permission.

If you give us permission in writing, we may use and disclose your personal information. If you give us permission, you have the right to change your mind and revoke it. This must be in writing too. We cannot take back any uses or disclosures already made with your permission.

Your Privacy Rights

You have the following rights regarding the health information that we have about you. Your requests must be made in writing to Venture Behavioral Health at the address below.

Your Right To Inspect and Copy.

In most cases, you have the right to look at or get copies of your records. You may be charged a fee for the cost of copying your records.

The Right To Amend.

You may ask us to change your records if you feel that there is a mistake. We can deny your request for certain reasons, but we must give you a written reason for our denial.

Your Right To a List Of Disclosures.

You have a right to ask for a list of disclosures made after April 14, 2003. This list will not include the times that information was disclosed for treatment, payment, or health care operations. The list will not include information provided directly to you or your family, or information that was sent with your authorization.

Your Right to Request Restrictions on Our Use or Disclosure of Information.

You have the right to ask for limits on how your information is used or disclosed. We are not required to agree to such requests.

Your Right to Request Confidential Communications.

You have the right to ask that we share information with you in a certain way or a certain place. For example, you may ask us to send information to your work address instead of your home address. You do not have to explain the basis for your request.

Changes To This Notice

We reserve the right to revise this notice. A revised notice will be effective for medical information we already have about you as well as any information we may receive in the future. We are required by law to comply with whatever notice is currently in effect. Any changes to our notice will be published in our next handbook. If the changes are material, a new notice will be mailed to you before it takes effect.

How To Use Your Rights Under This Notice

If you want to use your rights under this notice, you may call us or write us. If your request to us must be in writing, we will help you prepare your written request, if you wish.

Complaints to the Federal Government

If you believe that your privacy rights have been violated, you have the right to file a complaint with the federal government. Please contact Venture’s Corporate Compliance Officer for the address and phone number.

Complaints and Communications to Us.

If you want to exercise your rights under this notice or if you wish to communicate with us about privacy issues, or if you wish to file a complaint, you can contact:

You will not be penalized for filing a complaint.

Copies of This Notice

You have the right to receive an additional copy of this notice at anytime, even if you have agreed to receive this notice electronically. You are still entitled to a paper copy of this notice. Please call our write us to request a copy. This notice is available in other languages and alternate formats that meet the guidelines for the Americans with Disabilities Act (ADA).

Esta notificación esta disponible en otras lenguas y formatos diferentes que satisfacen las normas del Acta de Americans with Disabilities (ADA).

For Further Information call Venture Member Services at 1-888-357-0016

Reporting Suspected Compliance Violations

All employees and providers in the Venture network, board members of Venture, and each County Community Mental Health Service Provider, are responsible for making sure that the agency’s compliance efforts are working. It is required that these people report suspected compliance violations to the Compliance Officer. If you suspect a compliance violation you can also report it by calling the phone number below or sending your complaint in writing to the address below.

Examples of Compliance Violations include, but are not limited to:

• Intentional deception or misrepresentation by a provider
• Practices by providers that result in unnecessary costs or improper payments; improper claims; billing irregularities; waste,
• Member abuse
• Member/member’s family disrespect
• Offering pay for referrals,
• Falsification of claims and records

If you have any questions, want more information about our information practices, or if you suspect that there has been a compliance violation, please call the Venture Compliance Officer at 1-800-897-3035. You can also mail it to:

Recipient Rights

Venture members have rights guaranteed by Michigan’s Mental Health Code and various other laws. These rights are outlined in a booklet entitled “Your Rights” which you receive when you begin getting services at your local CMHSP. If you believe that your rights have been violated during the course of your mental health services, a complaint can be filed at your local office of Recipient Rights. Complaints can be filed in person, through the mail, and by telephone. You can find this form in the “Your Rights” booklet, or you can ask your local Recipient Rights Office.