Privacy & Code of Conduct

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

West Virginia Family Health Notice of Privacy Practices (pdf)

West Virginia Family Health Notice of Online Privacy Practices (pdf)

West Virginia Family Health Code of Conduct (pdf)

West Virginia Family Health ("WVFH") is required to protect the privacy of your personal medical and non-public personal information.  Also, WVFH is required to give you this notice about how WVFH uses or gives out ("discloses") medical and personal ("non-public") information held by WVFH.  This protection extends to all forms of communication (oral, written, and electronic) of this information.

WVFH will use and give your medical information:

  • To you or someone who acts for you (your personal representative)

  • To the Secretary of the Department of Health and Human Services, if necessary, to make sure your privacy is protected

  • When required by law

  • To meet your medical needs, to pay for your healthcare and to operate the WVFH benefit program

  • To give information to help the doctors or other healthcare providers who care for you

  • To make sure you and other WVFH members get quality healthcare, to provide member services to you, or to resolve any complaints you have

  • To pay or deny your claims or to share payments and payment information with your other insurer(s)

WVFH may also use or give your medical information:

  • To state and federal agencies that have the legal right to receive such data

  • For public health activities (such as reporting disease outbreaks)

  • For government healthcare oversight activities (such as fraud investigations)

  • For judicial and administrative proceedings (such as in response to a court order)

  • For law enforcement purposes (such as providing limited information to locate a missing person)

  • For research studies that meet all privacy law requirements (such as research related to the prevention of disease or disability)

  • To avoid a serious and likely threat to health or safety

  • To contact you about new or changed benefits

  • To contact you for appointment reminders or for disease management programs and alternative treatments that may interest you

  • To create a collection of information that can no longer be traced back to you

WVFH must have your written permission (an "authorization") to use or give out your medical information for any purpose that is not listed in this notice.  You may take back ("revoke") your written permission at any time, except if WVFH already took action based on your permission.

What is the non-public information that WVFH collects about you?

  • It is personal information but is non-medical, for example, the information you completed on your enrollment application that identifies who you are and how you can be contacted.

  • It is information collected for a request for services by you or your doctor.

  • It is information collected to answer a question or concern from you.

Can anyone receive your non-public information?

  • WVFH does not give out your non-public information, except if required or permitted by law.

  • WVFH does not give out your non-public information to anyone unrelated to providing your care under the health plan unless you, or your representative, give permission.

How does WVFH protect your non-public information?

  • WVFH does not make your non-public information available to anyone other than those necessary to provide medical or health plan services to you.

  • You have the right to give or withhold permission for other uses or disclosures of this information, except as required by law.

If you believe WVFH has violated your privacy rights as stated in this notice, you may file a complaint at the following address:

Privacy Officer
West Virginia Family Health
614 Market St.
Parkersburg, WV 26101

Filing a complaint will not affect your benefits.  You may also file a complaint with the Secretary of the Department of Health and Human Services.  For more information on filing a complaint or your rights stated in this notice, you may call Member Services at 1-855-412-8001 (TTY/TDD: 711 or 1-800-982-8771).

WVFH is required to follow the terms in this privacy notice.  WVFH has the right to change the way your medical information is used and given out.  If WVFH makes any changes, you will get a new notice by mail within sixty (60) days of the change.

These privacy practices will be effective July 1, 2013.

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