What is Protected Health Information?
When you see your doctor, there is a record of your visit. This record may have details about your treatment, condition, test results, and more. Your doctor sends claims to AlohaCare to pay for the services you receive. The claims may include some information from your records. We call this information about you and the services that you received your protected health information, or PHI.
What is routine use?
Routine use means using your PHI in the following ways:
- For your treatment with your doctor or other health care providers.
- To pay doctors, hospitals and other health care providers for the care you receive.
- To make sure you receive proper health care.
Is AlohaCare authorized to use information not covered in routine use?
Yes, there are some cases where we must share your PHI without your consent for non-routine use. We may use or share your PHI in any of the following situations:
- We may share your PHI with public health or legal agencies that work to prevent or control disease, injury or disability in Hawaii.
- As required by law, we may need to share PHI if we suspect abuse, neglect or domestic violence.
- We may share PHI with agencies that work to help prevent fraud and abuse and for other government activities that watch over health care.
- We may share your PHI with law enforcement officials because of a court order, warrant, subpoena or other law process.
- We may use or share PHI as required by the federal privacy law.
- We may share PHI with the medical examiner or a funeral director so they can do their job.
- We may share PHI with researchers who are approved to do research projects.
- We may share PHI to protect the health of another person or for the public.
- We may share your PHI with federal officials for national security activities.
- We may share PHI to comply with laws on workers’ compensation or other programs.
- During a medical emergency or disaster, we may share PHI to make sure you get the care or services you need.
Unless for one of the reasons listed here, we have to get your written permission to share your PHI. You do not have to agree and authorize additional use of your PHI. If you do agree and later change your mind, you may cancel your authorization.
How do I request restrictions on use or disclosure of PHI?
Call or write us to request restrictions on use of your PHI. There may be reasons why we cannot agree to this request. Even if we agree, we may still share records with a health care provider if needed for your treatment in an emergency.
How do I amend my PHI? Call or write us to change or add to your PHI. In some cases, we may not be able to comply with your request, such as if we did not create the PHI. If we cannot comply with your request, we will explain why in writing.
How do I request an accounting of disclosures of PHI?
Call or write us to ask for and receive a list of people or organizations outside of AlohaCare that we share your PHI with. We share your PHI only for the reasons described above.
How do I access my PHI?
If you would like a copy of your PHI or need to request access to the PHI that AlohaCare has, please call Member Services at 808-973-0712 (O`ahu) or toll-free at 1-877-973-0712 (Neighbor Islands/O`ahu). AlohaCare does not keep copies of your medical records. To get copies of your medical records, please call your provider’s office and request a copy of your medical record.
You may also make your request in writing by sending a letter to:
AlohaCare
Attention: Compliance Department
1357 Kapi`olani Blvd, Suite G101
Honolulu, HI 96814
AlohaCare has the right to not provide copies of your PHI in certain cases. To understand your rights, and the rights of AlohaCare, please see Notice of Privacy Practices or look at your AlohaCare QUEST Integration Member Handbook. You can also request a copy of the Notice of Privacy Practices by calling us.
How does AlohaCare protect my PHI?
AlohaCare is committed to protecting your sensitive and confidential information. We have privacy policies and procedures that tell staff about how to keep your health information secure. We provide ongoing training to our staff about confidentiality. We make sure staff only see and use the information that is required for them to do their job. Staff are very careful not to talk about confidential information where others may hear or in inappropriate places. We keep paper documents in a secure locked space when not in use. They are never visible when not in use. We have systems in place to protect electronic information throughout the organization. Our building is secure and visitors are not permitted in without authorization. AlohaCare reviews these protections on an annual basis, and looks for ways of improving protections for your PHI.
What is transition of care?
We want to make sure that you maintain your care with minimal disruptions at all times, especially when you are moving from one health plan, doctor or setting to another. This includes:
- Joining AlohaCare for the first time
- Changing your Primary Care Provider (PCP)
- Going into and being discharged from a hospital or moving into a nursing home or other housing arrangement
- Leaving AlohaCare
What if I am new to AlohaCare?
If you are a new member, we want to make sure you still receive the services that you need. We will help you transition into our plan.
- We will assign you to your current Primary Care Provider (PCP) if he/she is a part of the AlohaCare provider network.
- If your PCP is not a part of our provider network, we will invite your PCP to join our network. If your PCP applies to join our network, you can continue to see your PCP.
- If your PCP does not want to join our provider network, we will find you a new PCP as soon as possible.
- If you have Medicare, you don’t have to choose a Primary Care Provider (PCP) in our provider network. We will work with your Medicare PCP to coordinate your care with our plan.
- Prior treatment and services you were receiving will be approved for the same amount that was previously approved
What if I change my PCP?
If you change your PCP, we will help make sure your new PCP gets your information. We share important information that will help your new PCP provide you with better care.
- Your list of medications
- Your treatment and action plans
- Your medical history
What if I go to the hospital or move into a nursing home or other housing arrangement?
We will help make sure that you have support as you move into a different setting of care. This includes helping new caregivers understand your medical and other care needs and that your PCP and other providers are aware of the changes in your condition.
- When you leave the hospital, we will help you for at least the first 30 days with your transition back into your home or other care home setting. If you have a Health Care Worker or Care Coordinator, he or she will continue to assist you as long as you need it.
- Help you understand your medical condition, recognize symptoms and develop a plan to stay healthy
- Help you make follow up appointments and transportation if needed to see your PCP and other providers
- Help you sort out your medications and follow your doctor’s orders
What if I leave AlohaCare?
If you leave AlohaCare, we will help make sure your new health plan gets all your information. We will help you transition your health care information over to your new health plan. We share important information that will help your new health plan continue to provide the medical care and services you already receive.
- Your list of medications
- Your treatment and actions plans
- Schedule of doctor appointments
How will AlohaCare know who to share my information with?
Call us when you have changed to a new health plan or to a new PCP. Let us know where we should send your information.
Also, if you are moving, call us and let us know so that we can help you with this transition. In addition, a copy of our policy on transitions of care is available at AlohaCare.org.
2021 Transition of Care Policy
What is transition of care?
We want to make sure that you maintain your care with minimal disruptions at all times, especially when you are moving from one health plan, doctor or setting to another. This includes:
- Joining AlohaCare for the first time
- Changing your Primary Care Provider (PCP)
- Going into and being discharged from a hospital or moving into a nursing home or other housing arrangement
- Leaving AlohaCare
What if I am new to AlohaCare?
If you are a new member, we want to make sure you still receive the services that you need. We will help you transition into our plan.
- We will assign you to your current Primary Care Provider (PCP) if he/she is a part of the AlohaCare provider network.
- If your PCP is not a part of our provider network, we will invite your PCP to join our network. If your PCP applies to join our network, you can continue to see your PCP.
- If your PCP does not want to join our provider network, we will find you a new PCP as soon as possible.
- If you have Medicare, you don’t have to choose a Primary Care Provider (PCP) in our provider network. We will work with your Medicare PCP to coordinate your care with our plan.
- Prior treatment and services you were receiving will be approved for the same amount that was previously approved
What if I change my PCP?
If you change your PCP, we will help make sure your new PCP gets your information. We share important information that will help your new PCP provide you with better care.
- Your list of medications
- Your treatment and action plans
- Your medical history
What if I go to the hospital or move into a nursing home or other housing arrangement?
We will help make sure that you have support as you move into a different setting of care. This includes helping new caregivers understand your medical and other care needs and that your PCP and other providers are aware of the changes in your condition.
- When you leave the hospital, we will help you for at least the first 30 days with your transition back into your home or other care home setting. If you have a Health Care Worker or Care Coordinator, he or she will continue to assist you as long as you need it.
- Help you understand your medical condition, recognize symptoms and develop a plan to stay healthy
- Help you make follow up appointments and transportation if needed to see your PCP and other providers
- Help you sort out your medications and follow your doctor’s orders
What if I leave AlohaCare?
If you leave AlohaCare, we will help make sure your new health plan gets all your information. We will help you transition your health care information over to your new health plan. We share important information that will help your new health plan continue to provide the medical care and services you already receive.
- Your list of medications
- Your treatment and actions plans
- Schedule of doctor appointments
How will AlohaCare know who to share my information with?
Call us when you have changed to a new health plan or to a new PCP. Let us know where we should send your information.
Also, if you are moving, call us and let us know so that we can help you with this transition. In addition, a copy of our policy on transitions of care is available at AlohaCare.org.
2021 Transition of Care Policy
What is transition of care?
We want to make sure that you maintain your care with minimal disruptions at all times, especially when you are moving from one health plan, doctor or setting to another. This includes:
- Joining AlohaCare for the first time
- Changing your Primary Care Provider (PCP)
- Going into and being discharged from a hospital or moving into a nursing home or other housing arrangement
- Leaving AlohaCare
What if I am new to AlohaCare?
If you are a new member, we want to make sure you still receive the services that you need. We will help you transition into our plan.
- We will assign you to your current Primary Care Provider (PCP) if he/she is a part of the AlohaCare provider network.
- If your PCP is not a part of our provider network, we will invite your PCP to join our network. If your PCP applies to join our network, you can continue to see your PCP.
- If your PCP does not want to join our provider network, we will find you a new PCP as soon as possible.
- If you have Medicare, you don’t have to choose a Primary Care Provider (PCP) in our provider network. We will work with your Medicare PCP to coordinate your care with our plan.
- Prior treatment and services you were receiving will be approved for the same amount that was previously approved
What if I change my PCP?
If you change your PCP, we will help make sure your new PCP gets your information. We share important information that will help your new PCP provide you with better care.
- Your list of medications
- Your treatment and action plans
- Your medical history
What if I go to the hospital or move into a nursing home or other housing arrangement?
We will help make sure that you have support as you move into a different setting of care. This includes helping new caregivers understand your medical and other care needs and that your PCP and other providers are aware of the changes in your condition.
- When you leave the hospital, we will help you for at least the first 30 days with your transition back into your home or other care home setting. If you have a Health Care Worker or Care Coordinator, he or she will continue to assist you as long as you need it.
- Help you understand your medical condition, recognize symptoms and develop a plan to stay healthy
- Help you make follow up appointments and transportation if needed to see your PCP and other providers
- Help you sort out your medications and follow your doctor’s orders
What if I leave AlohaCare?
If you leave AlohaCare, we will help make sure your new health plan gets all your information. We will help you transition your health care information over to your new health plan. We share important information that will help your new health plan continue to provide the medical care and services you already receive.
- Your list of medications
- Your treatment and actions plans
- Schedule of doctor appointments
How will AlohaCare know who to share my information with?
Call us when you have changed to a new health plan or to a new PCP. Let us know where we should send your information.
Also, if you are moving, call us and let us know so that we can help you with this transition. In addition, a copy of our policy on transitions of care is available at AlohaCare.org.
2021 Transition of Care Policy
What is transition of care?
We want to make sure that you maintain your care with minimal disruptions at all times, especially when you are moving from one health plan, doctor or setting to another. This includes:
- Joining AlohaCare for the first time
- Changing your Primary Care Provider (PCP)
- Going into and being discharged from a hospital or moving into a nursing home or other housing arrangement
- Leaving AlohaCare
What if I am new to AlohaCare?
If you are a new member, we want to make sure you still receive the services that you need. We will help you transition into our plan.
- We will assign you to your current Primary Care Provider (PCP) if he/she is a part of the AlohaCare provider network.
- If your PCP is not a part of our provider network, we will invite your PCP to join our network. If your PCP applies to join our network, you can continue to see your PCP.
- If your PCP does not want to join our provider network, we will find you a new PCP as soon as possible.
- If you have Medicare, you don’t have to choose a Primary Care Provider (PCP) in our provider network. We will work with your Medicare PCP to coordinate your care with our plan.
- Prior treatment and services you were receiving will be approved for the same amount that was previously approved
What if I change my PCP?
If you change your PCP, we will help make sure your new PCP gets your information. We share important information that will help your new PCP provide you with better care.
- Your list of medications
- Your treatment and action plans
- Your medical history
What if I go to the hospital or move into a nursing home or other housing arrangement?
We will help make sure that you have support as you move into a different setting of care. This includes helping new caregivers understand your medical and other care needs and that your PCP and other providers are aware of the changes in your condition.
- When you leave the hospital, we will help you for at least the first 30 days with your transition back into your home or other care home setting. If you have a Health Care Worker or Care Coordinator, he or she will continue to assist you as long as you need it.
- Help you understand your medical condition, recognize symptoms and develop a plan to stay healthy
- Help you make follow up appointments and transportation if needed to see your PCP and other providers
- Help you sort out your medications and follow your doctor’s orders
What if I leave AlohaCare?
If you leave AlohaCare, we will help make sure your new health plan gets all your information. We will help you transition your health care information over to your new health plan. We share important information that will help your new health plan continue to provide the medical care and services you already receive.
- Your list of medications
- Your treatment and actions plans
- Schedule of doctor appointments
How will AlohaCare know who to share my information with?
Call us when you have changed to a new health plan or to a new PCP. Let us know where we should send your information.
Also, if you are moving, call us and let us know so that we can help you with this transition. In addition, a copy of our policy on transitions of care is available at AlohaCare.org.
2021 Transition of Care Policy
We want to make sure that you maintain your care with minimal disruptions at all times, especially when you are moving from one health plan, doctor or setting to another. This includes: