PHI is a special term created by the government. It is defined as “any information that is created or maintained by the Plan that relates to the past, present or future physical or mental health or condition of an individual or the provision of and/or payment for the provision of health care to an individual and which identifies the individual, or with which there is a reasonable basis to believe the information can be used to identify the individual.” PHI includes information received or maintained in any form, including oral statements. Examples of PHI are your name, address, Social Security number, and birth date, dates of service, telephone number, fax number, account number, diagnosis code, and procedure code.

The Plan may receive PHI about you from various sources, such as from enrollment or other forms, which include your name, address, Social Security number, birth date, telephone number, health care provider, other health insurance coverage, and information about others in your household. The Plan may also receive PHI about you from outside sources, such as employers, health care providers, federal and state agencies, or third-party vendors.

Except as described below, unless you specifically authorize the Plan to do so, the Plan will provide access to your PHI only to you, your authorized representative, and those persons who need the information to aid the Plan in the conduct of their business (“our Business Associates”). You have the right to revoke an authorization, and we have described how to do so in this notice.

When using or disclosing PHI, the Plan will make every reasonable effort to limit the use or disclosure of that information to the minimum extent necessary to accomplish the intended purpose. The Plan maintains physical, technical and procedural safeguards that comply with federal law and our Business Associates are limited by contract to using or disclosing PHI that we provide to them to only those purposes for which the information was disclosed.