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ppoNEXT Privacy Statement
This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

ppoNEXT is sensitive to your concerns about privacy. This privacy notice describes how we use and protect personal information, referred to as "customer information" in this statement. It will help you understand how we treat the customer information that we obtain from you or other sources in the course of providing you with products and services. When you are conducting business with ppoNEXT, you can have confidence that we respect your privacy and that we will protect the information that we may obtain about you. At ppoNEXT:

  • We have established physical, electronic, and procedural safeguards to protect customer information. All personnel within ppoNEXT are trained and reminded of the importance of protecting customer information.
  • We demand any persons or businesses that provide services on our behalf to keep customer information confidential and to use it only to provide the services we've asked them to perform.
  • We do not sell your customer information.
  • We do not share customer information with persons, companies, or organizations outside of ppoNEXT that would use that information to contact you about their own products and services.

YOUR HEALTH INFORMATION RIGHTS:
Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to request a restriction on certain uses and disclosures of your information. You have the right to request to inspect and obtain a copy of your health information, to obtain an accounting of disclosures of your health information, to request communications of your health information by alternative means or at alternative locations, and to revoke your authorization to use or disclose health information except to the extent that action has already been taken. You have the right to obtain a paper copy of this privacy notice upon request.

OUR RESPONSIBILITIES:
ppoNEXT is required to maintain the privacy of your health information and to provide you with this notice of our legal duties and privacy practices with respect to information we collect and maintain about you. We must abide by the terms of this notice, notify you if we are unable to agree to a requested restriction, and accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations. We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our privacy practices change, we will post a notice on the home page of our web site. We will not use or disclose your health information without your written authorization, except as described in this notice. You may revoke your authorization to use or disclose health information except to the extent that action has already been taken.

EXAMPLES OF DISCLOSURES FOR TREATMENT, PAYMENT, AND HEALTH OPERATIONS:
We may use your health information for treatment. For example: Information obtained by a nurse, physician, or other member of your healthcare team may be recorded in your record and used to determine pre-authorization for service or treatment by a healthcare provider under the terms of your policy. We will use your health information for payment. For example: An Explanation of Benefits (EOB) may be sent to a third-party payer to coordinate payment of claims. The information on or accompanying the EOB may include information that identifies you, as well as your diagnosis, procedures, and supplies used. We will use your health information for regular health operations. For example: Members of the ppoNEXT staff will use health information provided by your physician or other health care provider or facility, to review and determine the payment of benefits under the terms of your policy.

Business associates: There are some services provided in our organization through contracts with business associates. Examples include claims scanning and destruction of old claim documents. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we've asked them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Research: We may disclose information to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved the research.

Marketing: We may contact you to provide information about health insurance benefits and services that may be of interest to you.

Public health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney provided that a ppoNEXT staff member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional standards.

How we obtain customer information:
Some of the customer information that we collect comes directly from you. You may give us information through a Covered Entity such as your name, address, and Social Security number. We collect information from outside sources, primarily health care providers and third party insurance companies. This information includes medical information related to treatment that has been provided to you and billed to us for payment. We may also keep information about your transactions such as the types of products and services you purchase from us, premiums that you have paid, account balances, and payment history. We may also collect information from our Web site such as your activity while using our site and information from online collecting devices known as "cookies" (see below).

What we do with your customer information:
We may use customer information to provide services to you. We may, without authorization but only as permitted or required by law, provide customer information to persons or organizations both inside and outside of ppoNEXT in order to handle and/or investigate claims, fulfill a transaction you have requested, service your policy, detect and/or prevent fraud, participate in insurance support organizations, or comply with lawful requests from regulatory and law enforcement authorities. For example, we may share claim payment information with your physician, other physicians who have provided services (such as a radiologist who interprets your x-rays), your hospital, or a medical lab.

How do we protect your customer information?
Customer information within ppoNEXT is only available to those individuals who need to see it to fulfill and service your needs. All employees and agents of ppoNEXT are instructed on the need to protect customer information. In addition, we've established physical, electronic, and procedural safeguards to protect customer information. We have established legal agreements with companies working on ppoNEXT's behalf that require them to protect customer information and to use that information only to provide the service we have asked them to perform. Should your relationship with ppoNEXT end, your customer information will remain protected in accordance with our privacy practices as outlined in this Privacy Notice.

How can you find out what information we have about you?
You may request to either see, or obtain from us by mail, the customer information about you in our records. If you believe that information is incomplete or inaccurate, you may request that we make any necessary corrections, additions or deletions to the disputed customer information. You may also request a more complete description of the entities to whom we disclose customer information, or the circumstances which might warrant such disclosures. Please send any of the requests listed above in writing to: ppoNEXT, 8625 King George, Suite 300, Dallas, Texas 75235, attn: HIPAA Privacy Officer. If you believe your privacy rights have been violated, you can file a complaint with the ppoNEXT Privacy Officer at the above listed address. You may also file a complaint with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.