Health Insurance Portability and Accountability Act (HIPAA)

  • The federal government adopted regulations that impose numerous requirements upon the DCIU with respect to the privacy of health information. These requirements ae generally referred to as the HIPAA Privacy Act.  As a result of the HIPAA, the DCIU has adopted a number of practices that will insure compliance.  Moreover, certain companies with whom we work with are also covered by the Act and are not be allowed to provide information that they are required to keep confidential. This notice is to advise you of certain procedures with respect to coverage questions that are being implemented by us due to the HIPAA requirements.  Notices with respect to other topics will be sent by us to you from time to time as necessary.  Please keep this memorandum for your records.

     The following questions can be addressed by the Human Resources (HR) office regarding HIPAA:

     Your eligibility to be covered under a particular plan.

    1. The name of the plan in which you are enrolled or should be enrolled.

     If our insurance carrier or third party administrator (TPA) advises you that you are not covered at all or that your plan is different than what you think it should be, please contact the HR Benefits office.

     The following questions cannot be addressed by the HR office.  You must contact the insurer or TPA:

     If a specific service is covered.

    1. If the insurer or TPA is properly adjusting or administering a particular claim.
    2. The coverage available under any particular plan in which you are enrolled.
    3. Why a particular claim was adjusted or administered.

     

    If you have concerns as to whom you are to contact, please contact the HR Benefits Coordinator.

    If you disagree on how a claim was handled by any insurer or TPA, there are complaint procedures in the applicable plan that must be followed.