Interoperability and Patient Access
Connecting Your Healthcare
NEW OPTIONS FOR MANAGING YOUR DIGITAL MEDICAL RECORDS
Starting in 2021, a new federal rule made it easier for Community Health Plan of Imperial Valley members to manage their digital medical records.
The Interoperability and Patient Access rule (CMS-9115-F) makes it easier for members and their personal representatives to get their health records when they need it most. You now have full access to your health records on your mobile device, at no charge. This allows you to manage your health better and know what resources are available to you.
Provider Directory information is available through a standards-based API. This is in a machine-readable format that allows access through a third-party application.
Starting in 2022, the Payer-to-Payer Data Exchange portion of the rule allows former and current members to request that their health records go with them as they switch health plans. For more information about this rule, visit the Payer-to-Payer Data Exchange section found on this web page.
Imagine:
- You go to a new healthcare provider because you don’t feel well and you can show that provider your health history from the past five years
- The provider uses that information to diagnose you and you quickly find the right specialist by checking an up-to-date provider directory
- You have a question about a claim, so you go to your computer or mobile device and, in minutes, you see if it’s paid, denied, or still being processed
- You can take your health history with you as you switch health plans
The new rule makes it so you can easily find information on:
- claims (paid and denied)
- healthcare providers
- pharmacy directory data
- specific parts of your clinical information
Frequently Asked Questions
HOW DOES PAYER-TO-PAYER DATA EXCHANGE WORK FOR BOTH CURRENT AND FORMER MEMBERS?
Starting in 2022, members may request that Community Health Plan of Imperial Valley send health records to other health plans. They can also request that Community Health Plan of Imperial Valley receive health records from other health plans. If a member switches health plans, Community Health Plan of Imperial Valley will send their clinical records (included in the USCDI v1) to another health plan. This is in order to build a complete health record. A complete health record will help a member make decisions that improve their quality of care and health outcomes.
Former members of Community Health Plan of Imperial Valley should start the request through their new health plan. Based on this request, Community Health Plan of Imperial Valley will send the clinical records to their new health plan.
Current members of Community Health Plan of Imperial Valley may start the request by clicking on this link: Payer-to-Payer Data Exchange and logging in using their username and password. On the login screen, if their health plan does not have a member portal or they have never before created a username and password, use the “Create New Account” to do so. After this, they can request and receive the clinical records from their previous health plan.
What health information will be sent?
The full USCDI version 1 data set can be found here. Additional data elements may be included in the future.
If I am a former member, can I request my records?
Former members may request data exchange up to five years after disenrollment.
You will have access to health information with a date of service of January 1, 2016 or later.
Read our Frequently Asked Questions or call us at 1-833-236-4141.
To learn more, call Community Health Plan of Imperial Valley at 1-833-236-4141.
Yes. You will be able to access your health information no matter what health plan or provider you go to.
Yes. You can use an app to see what shots you’ve had with a date of service January 1, 2016 or later.
No. The app does not have to be affiliated with Community Health Plan of Imperial Valley. Visit the Currently Connected Applications link for a list of applications available to connect with your health records. This includes apps that promise to meet the CARIN Code of Conduct. Follow the instructions on the app to connect it with your health records.
Not every app has agreed to meet the CARIN Code of Conduct or any other set of guidelines. We will let you know which apps have agreed to follow our privacy guidelines. You will have a chance to select another app if you selected the app before they shared their privacy practices with us.
We suggest that you request a Notice of Privacy Practices from the app. Read it carefully before using that app. If the app does not provide you with a Notice of Privacy Practices, we suggest that you choose another app.
You will be able to access your health plan information in the apps starting on July 1, 2021.
No. You do not have to use an app to access your health information. You can contact your provider or health plan for information.
It depends on the app you choose. Some apps will collect your health data. This includes (but is not limited to):
- claims
- medications
- diagnoses
- procedures
- doctor visits
You give the app permission to collect your health information when you sign up for it. The app’s Notice of Privacy Practices should tell you what information it collects.
The app’s Notice of Privacy Practices should tell you what information it collects. Apps do have the ability to collect non-health data, such as your location. Some apps give you the option to provide that information. We suggest that you ask your app provider.
If a family member is linked to your health account, there is a chance that their health information will be shared.
You will need to contact your provider or health plan. The app only makes data available from healthcare sources. The app does not create this data.
We suggest that you ask the app provider for their Notice of Privacy Practices.
Most apps will not be covered by HIPAA. They will instead be covered by the Federal Trade Commission (FTC) and the protections provided by the FTC Act. The FTC Act protects against deceptive acts. For example, if an app shares personal data without permission. This is even though the privacy policy says it will not do so.
For more information:
- The FTC has information about mobile app privacy and security for consumers on their websites
- For apps subject to HIPAA, the HHS.gov web site has information about HIPAA patient rights and who is obligated to follow HIPAA
- The HHS.gov web site also has HIPAA FAQs for Individuals.
We suggest that you request a Notice of Privacy Practices from the app provider to understand your rights.
We suggest that you request a Notice of Privacy Practices from the app provider. This is so that you can understand how they respond to a privacy and security incident. You have the right to file a complaint with enforcement agencies including the Office for Civil Rights (OCR) and the Federal Trade Commission (FTC).
Most apps will not be covered by HIPAA. They will instead be covered by the Federal Trade Commission (FTC) and the protections provided by the FTC Act. The FTC Act protects against deceptive acts. For example, if an app shares personal data without permission. This is even though the privacy policy says it will not do so.
For more information:
- To learn more about filing a complaint with OCR under HIPAA, visit the HHS.gov web site
- Individuals can file a complaint with OCR using the OCR complaint portal
- Individuals can file a complaint with the FTC using the FTC complaint assistant
The purpose of the app is for you to see your health data in one place. We suggest that you request a Notice of Privacy Practices to understand how the app will use your data.
We suggest that you request a Notice of Privacy Practices from the app provider to understand if the app will share your data with third parties.
We suggest that you request a Notice of Privacy Practices from the app provider. This is so you can understand what happens to your data after you stop using the app.
We suggest that you request a Notice of Privacy Practices from the app provider. This is so you can understand what happens to your data after you stop using the app.
The best way to stop sharing data is through the app or by contacting the app’s support. If this doesn’t work, call Community Health Plan of Imperial Valley member services.
We suggest that you request a Notice of Privacy Practices from the app provider. This is so you can understand if the app will share your data with third parties for advertising or research.
App providers may respond to complaints in different ways. We suggest that you ask your app provider this question.
We suggest that you request a Notice of Privacy Practices and additional information on security practices from the app provider. This is so you can understand how they handle a security incident.
We suggest that you request a Notice of Privacy Practices from the app provider. This is so you can understand how to limit the use and release of your data.