THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY. THE PRIVACY OF YOUR MEDICAL INFORMATION IS IMPORTANT TO US.
Our Legal Duties
Triple S is firm in its commitment to protect the privacy of your medical information. This notice informs you on our privacy practices and your rights regarding your medical information. We will follow the privacy practices described in this notice while it is in effect.
This notice contains some examples of the types of information we collect and describe the types of uses and disclosures we execute. The examples provided are for illustrative purposes and shall not be construed as a complete listing of such uses and disclosures.
We reserve the right to change our privacy practices and the terms of this notice. Before we make a significant change in our privacy practices, we will change this notice and send an updated notice to our active subscribers.
Organizations Covered by this Notice
This notice applies to the following entities:
TRIPLE-S SALUD, INC.,
INTERACTIVE SYSTEMS
TRIPLE-C INC.
Summary of Privacy Practices
Our pledge is to limit to the minimum necessary the information we collect in order to administer your insurance products or benefits. As part of our administrative functions, we may collect your personal, financial or health information from sources such as:
- applications and other documents you have provided to obtain a product or insurance service;
- transactions you make with us or our affiliates;
- consumer credit reporting agencies;
- healthcare providers;
- Government health programs
Uses and Disclosures of Information
We may use and disclose your personal information to our business associates, who provide services on our behalf and contribute in the administration or coordination of your services. We only share the minimum necessary information and require from each of our business associates to sign a written agreement in which they provide satisfactory assurances of compliance with the security and privacy of your health information.
As part of our administrative functions, we may use or disclose your information for treatment, payment and healthcare operations, and when authorized or permitted by law. For example:
Treatment: To a physician or other health care provider who provides medical services to you.
Payment: To pay your medical claims, to determine your eligibility for benefits, to coordinate your benefits with other payers, or to collect premiums, and the like.
Health Care Operations: For audits, legal services, including fraud and abuse detection, business planning and general administration.
We may disclose your medical information to another health plan or to a health care provider subject to federal or local privacy protection laws, as long as the plan or provider has or had a relationship with you.
Your Authorization: You may give us a written authorization to disclose your medical information to anyone for any purpose. The authorization must be signed and dated, mention the entity authorized to receive the information, a brief description of the data to be disclosed and the expiration date, which will not exceed 2 years from the date of signage. You may revoke the authorization in writing at any time. Your revocation will not affect any use or disclosure permitted by your authorization while it was in effect. Unless you give us a written authorization, we will not use or disclose your medical information for any purpose other than those described in this notice.
Family and Friends Involved in Your Care or Payment for Care: To a family member or friend you involve in your health care or payment for your health care, unless you request a restriction. We will disclose only the medical information that is relevant to the person’s involvement.
Before we make such a disclosure, we will provide you with an opportunity to object. If you are not present or disabled or in case of emergency we will use our professional judgment to determine whether disclosing your medical information is in your best interest.
Your Employer, union or other employee organization: To your employer on whether you are enrolled or disenrolled in the health plan your employer sponsors, and summary health information (aggregated claims history, claims expenses or types of claims experienced by the enrollees in your group health plan) to be used for the administration of the group health plan.
Disaster relief or emergency situations
Government Sponsored Benefits Programs
Public Health and Benefit Activities: We may use and disclose your medical information when required or permitted by law for the following activities:
- public health, including to report disease and vital statistics;
- to report child and/or adult abuse or domestic violence;
- healthcare oversight, fraud prevention and compliance;
- in response to court and administrative orders;
- to law enforcement officials or matters of national security;
- to avert a serious and imminent threat to health or safety;
- scientific research
- as authorized by state worker’s compensation laws; and
- as otherwise required by applicable laws and regulations
Health-Related Products and Services: We may use your medical information to inform you about health-related products, benefits and services we provide or include in our benefits plan, or treatment alternatives that may be of interest to you.
Terminated accounts: We will not share the data of persons who are no longer our customers or who do not maintain a service relationship with us, except as required or permitted by law.
Security safeguards: We have implemented physical, technical and administrative safeguards to limit access to your personal information. Our employees and business associates are trained and know their duty to protect and maintain the privacy of your medical information, and are committed to comply with the highest security and privacy standards to handle your information in a responsible manner.
Individual Rights
Access: You have the right to examine and receive a copy of your protected health information on enrollment and claims within the limits and exceptions provided by law. You must make a written request.
The first report will be free of charge, but we may charge you reasonable, cost-based fees for subsequent reports. If you request the report in a special format, you may have to pay an additional charge.
Disclosure Accounting: You have the right to a list of instances after April 14, 2003, in which we disclose your protected health information for purposes other than treatment, payment, health care operations, as authorized by you, and for certain other activities.
The report will provide the name of the entity to which we disclosed your information, the date and purpose of the disclosure and a brief description of the data disclosed. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to your additional requests. The report only covers the last six (6) years.
Amendment: You have the right to request that we amend your medical information. Your request must be in writing, and it must explain and justify the amendment requested.
If we deny your request, we will provide you a written explanation. You have the right to request that we include your statement of disagreement with the determination taken by us in future disclosures of the disputed information. If we accept your request, we will make your amendment part of your record and use reasonable efforts to inform our business associates and others who we know may have and rely on the unamended information.
Restriction: You have the right to request that we restrict our use or disclosure of your medical information. We are not required to agree to your request. If we do agree, we will abide by our agreement, except in a medical emergency or as required or authorized by law. Any agreement we may make to a request for restriction must be in writing signed by an authorized officer.
Confidential Communication: You have the right to request that we communicate with you about your medical information in confidence by alternative means or to alternative locations. You must make your request in writing, and your request must represent that the information could endanger you if it is not communicated in confidence as you request.
We will accommodate your request if it is reasonable, specifies the alternative means or location for confidential communication, and continues to permit us to collect premiums and pay claims under your health plan, including issuance of explanations of benefits to the subscriber.
Notice of security breaches in which your health information may be at risk: You are entitled to be notified by any means if the security breach is the result of not having your information secured by technologies or methodologies approved by the Department of Health and Human Services.
Electronic Notice: If you receive this notice on our web site (www.ssspr.com) or by e-mail, you are entitled to receive this notice in written form.
Questions and Complaints
If you want more information about our privacy practices or have questions or concerns, please contact us. All the forms to exercise your rights are available at: www.ssspr.com.
If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your medical information, in response to a request you made to amend, restrict the use or disclosure of, or communicate in confidence about your medical information, you may complain to us using the contact information at the end of this notice.
You also may submit a written complaint to the Office for Civil Rights of the United States Department of Health and Human Services (DHHS) at: Region II, Office of Civil Rights, US Department of Health and Human Services, Jacob Javitz Federal Building, 26 Federal Plaza – Suite 3312, New York, New York, 10278; voice phone: (212) 264-3313; fax (212) 264-3039; TDD (212) 264-2355.
We support your right to the privacy of your medical information. We will not retaliate in any way if you choose to file a complaint with us or with the DHHS.
Contact Office: COMPLIANCE AND PRIVACY OFFICE
Telephone: (787) 277-6686 Fax: (787) 706-4004
E-mail: privacidad@ssspr.com
Address: PO Box 363628, San Juan, PR 00936-3628
