Your rights over your PHI under federal privacy law
The notice says that under federal privacy laws you have rights when it comes to your PHI, and lists them. The sections that follow cover asking for communications in a way you choose, asking for limits on uses and sharing, getting a copy of your records, asking for corrections, getting a list of certain disclosures, being notified of a breach, and protections in insurance underwriting.
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Your rights under the law
Under federal privacy laws, you have rights when it comes to your PHI. You have the right to:
Qualifications & exceptions
The rights are listed individually, each with its own conditions, in the following cards.
Account & Service Control · User right or choice
Right to ask for communications in the way or place you choose
You have the right to ask Aetna to communicate with you how or where you choose. For example, if you are covered as an adult dependent, you might ask Aetna to send health information, such as your Explanation of Benefits, to an address other than your subscriber's. If the request is reasonable, Aetna says it will make this happen.
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Ask us to communicate with you how or where you choose.
For example, if you’re covered as an adult dependent, you might want us to send health information, like your Explanation of Benefits, to another address than that of your subscriber.
If it’s a reasonable request, we will make this happen.
Qualifications & exceptions
Aetna commits to honor only reasonable requests; the notice does not define "reasonable".
Not stated here
The notice does not say what makes a request unreasonable or whether it must be in writing.
You have the right to ask Aetna to limit how it uses or shares your information for health care operations, payment and treatment. Aetna says it will consider, but may not agree to, such requests. You also have the right to ask Aetna to restrict sharing with people involved in your health care.
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Ask us to limit the way we use or share your information when it comes to health care operations, payment and treatment.
We will consider, but may not agree to, such requests.
You also have the right to ask us to restrict sharing with people involved in your health care.
Qualifications & exceptions
The "may not agree" sentence follows the request to limit operations, payment and treatment; the notice does not say whether it also applies to the request to restrict sharing with people involved in your care.
Not stated here
The notice does not say how Aetna decides these requests.
Account & Service Control · User right or choice
Right to a copy of PHI in your designated record set
You have the right to ask Aetna for a copy of PHI that is part of a "designated record set". This may include medical records and other records Aetna keeps and uses for enrollment, payment, claims processing, medical management and other decisions. Aetna may ask you to request this in writing and may charge a reasonable fee for making and mailing the copies. Sometimes Aetna may deny the request.
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Ask us for a copy of PHI that’s part of a “designated record set”.
This may include medical records. It may also include other records we keep and use for: Enrollment
Payment
Claims processing
Medical management
Other decisions
We may ask you to request this in writing. And we may charge a reasonable fee for making and mailing the copies. Sometimes, we may deny the request.
Qualifications & exceptions
The list of record uses is split across source blocks after the words "records we keep and use for: Enrollment".
Aetna may ask for a written request and charge a reasonable fee, and may sometimes deny the request.
Not stated here
The notice does not give the fee amount, the response time, or the reasons a request may be denied.
Account & Service Control · User right or choice
Right to ask Aetna to fix your PHI
You have the right to ask Aetna to fix your PHI. You need to ask in writing and must include the reason for the request. If Aetna denies it, you may write to Aetna to let it know you disagree.
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Ask us to fix your PHI. You need to ask this in writing. And you must include the reason for the request. If we deny it, you may write us, to let us know you disagree.
Qualifications & exceptions
The request must be in writing and include the reason.
Not stated here
The notice does not say how long Aetna has to respond, what happens after you write that you disagree, or whether your statement is kept with the record.
Account & Service Control · User right or choice
Right to a list of certain disclosures (an "accounting")
You have the right to ask Aetna for a list of certain disclosures it has made about you, such as PHI shared with government agencies that license it. The notice calls this an "accounting". You need to ask in writing. If you ask for this kind of list more than once in 12 months, Aetna may charge a reasonable fee.
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Ask us to give you a list of certain disclosures we have made about you, such as PHI we’ve shared with government agencies that license us. (This is called an “accounting.”) You need to ask this in writing. If you ask for this kind of list more than once in 12 months, we may charge a reasonable fee.
Qualifications & exceptions
The list covers "certain" disclosures, not all of them.
A fee may apply to a request after the first in 12 months.
Not stated here
The notice does not say which disclosures appear on the list or how far back it goes.
Account & Service Control · Procedure
How to make requests: call the toll-free number on your member ID card
You may make any of the requests above (if they apply), ask for a paper copy of this notice, or ask questions about this notice by calling the toll-free number on your member ID card.
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You may make any of the above requests (if they apply), ask for a paper copy of this Notice, or ask questions about this Notice. You can do this by calling the toll-free number on your member ID card.
Qualifications & exceptions
The requests are available only "if they apply".
The request to correct PHI, the request for an accounting of disclosures and the withdrawal of an authorization are each described as requiring writing, and a copy of PHI may require a written request.
Not stated here
The notice does not say how a phone call satisfies the written-request requirements described for several rights.
Cross-references
contrast (model-proposed): Right to ask Aetna to fix your PHI — contrast: The notice says rights requests can be made by calling the toll-free number on the member ID card, while the right to ask for corrections is described as one you need to ask for in writing. The notice does not reconcile the two.
Account & Service Control · Procedure
Stop the paper mailing of EOBs by registering on Aetna.com
You may stop the paper mailing of your EOB and other claim information by visiting Aetna.com, choosing "Log In/Register", and completing the one-time registration. You can then log in at any time to view your EOBs and other claim information.
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You may stop the paper mailing of your EOB and other claim information by visiting Aetna.com.
Choose “Log In/Register.” Follow the prompts to complete the one-time registration. Then you can log in anytime to view your EOBs and other claim information.
Qualifications & exceptions
Stopping paper mail requires creating an Aetna.com account through the one-time registration.
Not stated here
The notice does not say whether stopping paper mail also changes where other claim information is sent.