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Blue Cross NC Home Policies and best practices Notification of shared information with other payers Notification of shared information with other payers

Review our policies about your shared information with Blue Cross NC and other payers.

What you need to know when you ask us to share your personal information Sharing your personal information with Blue Cross and Blue Shield of North Carolina (Blue Cross NC)

At your request, Blue Cross NC is required to accept from another health plan (that provided your health coverage within the preceding five years) detailed information about your health history. The information includes data another payer collected about you while you were enrolled in their health plan since at least January 1, 2016. The data may include clinical data that was collected in the process of providing case management, care coordination or other services to you.

The information another payer shares with Blue Cross NC may include information about treatment for Substance Use Disorders (SUDs), mental health treatment, HIV status or other sensitive information. It is important for you to understand that Blue Cross NC will have access to all the information provided by the other payer.

You should review our privacy policy to ensure you understand how information will be used and disclosed.

Sharing your personal information with another payer

At your request, Blue Cross NC is required to provide another health plan (also known as a payer) with access to detailed information about your health history. The information available to the payer includes information we collect about you while you have been enrolled in certain lines of business since January 1, 2016. The information available to the payer includes the data listed below for as long as Blue Cross NC maintains such data. You may request your information be shared with another payer for up to five years after disenrollment:   

  • Clinical data that we collect in the process of providing case management, care coordination or other services to you.    

The information we will disclose may include information about treatment for Substance Use Disorders, mental health treatment, HIV status or other sensitive information.  

It is important for you to understand that the payer you select will have access to all of your information. If you decide to request your personal information be shared with another payer, you should carefully review their privacy policy to ensure you understand how they will use and disclose your personal information. 

Please note, if you have been enrolled in multiple plans with Blue Cross NC over the last five years, you will need to complete the authorization process separately for each plan in order to have all applicable data sent to the requested payer.

Covered entities and HIPAA enforcement

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) enforces the HIPAA Privacy, Security and Breach Notification Rules. Blue Cross NC and other payers are subject to HIPAA, as are most health care providers, such as hospitals, doctors, clinics and dentists. You can find more information about your rights under HIPAA and who is obligated to comply with HIPAA at the U.S. Department of Health and Human Services (HHS). To learn more about filing a complaint with OCR related to HIPAA requirements, visit the HHS page on filing a claim.

You may also file a complaint with Blue Cross NC by calling the Customer Service phone number on the back of your Member ID card. If your physical card is unavailable, you can find your card online through Blue Connect for 18 months after the coverage end date. Alternatively, if you have a Medicare Advantage plan through Blue Cross NC, you can call Customer Service at 888-310-4110 (TTY: 711), seven days a week, 8 a.m. to 8 p.m., Eastern Standard Time. Individual Members can call Customer Service at 888-206-4697 (TTY 800-442-7028) Monday-Friday, 8 a.m. to 7 p.m., Eastern Standard Time.

Frequently asked questions

Below are some frequently asked questions about asking another payer to share your data with Blue Cross NC.

 

To see if your desired payer is eligible to share data with Blue Cross NC, please log in to your Blue Connect account and visit “Connect to Previous Insurance Companies” in the Profile section.

You may file a request with Blue Cross NC by calling the Customer Service phone number on the back of your Member ID card. Alternatively, if you have a Medicare Advantage plan through Blue Cross NC, you can call Customer Service at 888-310-4110 (TTY: 711), seven days a week, 8 a.m. to 8 p.m., Eastern Time. Individual Members can call Customer Service at 888-206-4697 (TTY 800-442-7028) Monday-Friday, 8 a.m. to 7 p.m., Eastern Time.

You can log in to your Blue Connect account to determine the status of your data sharing request.

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