CITY OF MEMPHIS
HEALTH BENEFITS PRIVACY NOTICE
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.
This Notice describes how the City of Memphis’s medical/surgical and mental
health/substance abuse programs and prescription drug programs (collectively referred to as
the “Plans”) may use and disclose Protected Health Information (“PHI” or “health
information”). PHI is individually identifiable information about your past, present or future
health or condition, health care services provided to you, or the payment for health services,
whether that information is written, electronic or oral. This notice also describes your rights
under federal law relating to that information. It does not address medical information
relating to disability, workers’ compensation or life insurance programs, or any other health
information not created or received by the Plans.
How The Plans May Use or Disclose Your Health Information
For Treatment. While the Plans generally do not use or disclose your PHI for treatment,
the Plans are permitted to do so if necessary. For example, the Plans may disclose to a
treating orthodontist the name of your treating dentist so that the orthodontist may ask for
your dental X-rays from the treating dentist.
For Payment. The Plans may use and disclose your health information for payment of
claims. Such purposes include, but are not limited to, eligibility, claims management, pre-
certification or pre-authorization, medical review, utilization review, adjustment of
payments, billing, and subrogation. For example, a detailed bill or an “Explanation of
Benefits” may be sent to you or to the primary insured or “subscriber” by a third-party payor
that may typically include information that identifies you, your diagnosis, and the procedures
For Health Care Operations. The Plans may use and disclose health information abo