2013 XGS Office SPD.pdf - US Xpress

For treatment: So that you receive appropriate treatment and care, the Plan may disclose your
Protected Health Information to coordinate or manage your health care services. For example,
the Plan might disclose information about your prior prescriptions to a pharmacist to determine if
prior prescriptions would cause a problem with a new prescription.
For payment: To make sure that claims are paid accurately and you receive the correct benefits,
the Plan may use and disclose your Personal Health Information to determine plan eligibility and
responsibility for coverage and benefits. For example, the Plan may use your information to
confer with other health plans to resolve a coordination of benefits issue. The Plan may also use
your Personal Health Information for utilization review activities.
For health care operations: To ensure quality and efficient plan operations, the Plan may use
your Personal Health Information in several ways, including plan administration, quality
assessment and improvement, and vendor review. Your information could be used, for example,
to assist in the evaluation of a vendor who supports the Plan. The Plan may contact you to
provide information about treatment alternatives or other health-related benefits and services
available under the Plan.
To Business Associates: The Plan may contract with individuals or entities known as Business
Associates to perform various functions involving Protected Health Information on the Plan’s
behalf or to provide certain types of services for the Plan.
As Required by Law: The Plan may disclose your Protected Health Information when required
to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety: The Plan may use and disclose your Protected
Health Information when necessary to prevent a serious threat to your health and safety, or the
health and safety of the public or another person.
Organ and Tissue Donation: If you are an organ donor, the Plan may release your Protected
Health Information to organizations that handle organ procurement or organ, eye, or tissue
transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation
and transplantation.
Military and Veterans: If you are a member of the armed forces, the Plan may release your
Protected Health Information as required by military command authorities.
Workers' Compensation: The Plan may release your Protected Health Information for workers'
compensation or similar programs.
Public Health Risks: The Plan may disclose your Protected Health Information for public health
actions, such as to prevent or control disease or to report abuse, neglect or domestic violence.
Health Oversight Activities: The Plan may disclose your Protected Health Information to a
health oversight agency for activities authorized by law (for example, audits, investigations,
inspections, and licensure).
Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, the Plan may disclose your
Protected Health Information in response to a court or administrative order, or in response to a
subpoena, discovery request, or other lawful process by someone else involved in the dispute,
but only if efforts have been made to tell you about the request or to obtain an order protecting
the information requested.
Law Enforcement: The Plan may disclose your Protected Health Information if asked to do so by
a law enforcement official (for example, to identify a suspect or missing person).
Coroners, Medical Examiners and Funeral Directors: The Plan may release your Protected
Health Information to a coroner or medical examiner.
National Security and Intelligence Activities: The Plan may release your Protected Health
Information to authorized federal officials for intelligence, counterintelligence, and other national
security activities authorized by law.
Inmates: If you are an inmate of a correctional institution or are in the custody of a law
enforcement official, the Plan may disclose your Protected Health Information to the correctional
institution or law enforcement official if necessary for the institution to provide you with health
care, to protect your health and safety or the health and safety of others, for the safety and
security of the correctional institution.
Research: The Plan may disclose your Protected Health Information to researchers when the
individual identifiers have been removed or when an institutional review board or privacy board
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