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Effective Date April 14, 2003
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.
If you have any questions about this notice, please contact Member Services at (702) 242-7300 or 1-800-
777-1840. Senior Dimensions members may contact us at (702) 242-7301 or 1-800-650-6232.
(TDD/TTY (702) 242-9214 or (800) 349-3538) Monday through Friday, 8 a.m. to 5 p.m.
Who Will Follow This Notice
This notice describes the privacy practices of Health Plan of Nevada, Inc. and of any third parties that
assist it in the performance of its duties involving the use of your Protected Health Information (PHI).
Our Pledge Regarding your Protected Health Information
When we say “Protected Health Information” or “PHI” we mean: information created or received by a
health care provider, health plan, or employer that relates to your past, present, or future physical or
mental health or condition, the provision of health care to you; or the past, present, or future payment for
your health care. The information must also identify you or be the type that could reasonably be used to
identify you.
We understand that your PHI is personal. We are committed to protecting that information. This notice
applies to all of the PHI we maintain. Your personal doctor or health care provider may have different
policies or notices regarding his or her use and disclosure of your PHI created in his or her office or
clinic.
This notice tells you about the ways we may use and disclose your PHI. It also describes our obligations
and your rights regarding use and disclosure of your PHI.
We are required by law to:
•
make sure that your PHI is kept private;
•
give you this notice of our legal duties and privacy practices with respect to your PHI; and
•
follow the terms of this notice for as long as it remains in effect.
How We may Use and Disclose Your Protected Health Information
The following categories describe different ways that we use and di