Member Rights and Privacy

Your Rights and Health Information

Our Medicaid Notice of Privacy Practices tells you how we use and share your health information. It also includes your health privacy rights. We suggest you review your Member Rights and Responsibilities, which help ensure you get the best care.

Protected Health Information

Protected Health Information (PHI) means health information including your name, member number, or other identifying information. PHI is protected by federal law.

You have the legal right to:

  • Ask us for access to your PHI
  • Ask us to correct your PHI
  • Ask for a list of certain people and times we shared your PHI
  • Ask for certain restrictions about how we share your PHI
  • Ask us to change your contact information

To make a request, complete the appropriate form and send it to:

Community Health Plan of Washington
Attn: Compliance, Privacy, and Security Officer
1111 Third Ave., Suite 400
Seattle, WA 98101

Forms for Apple Health (Medicaid) Members

Use, disclosure, and security of protected health information

CHPW is committed to keeping your health information safe.

We use technology to protect your protected health information.
  • We send health information by email in a form that cannot be read if somebody else sees the email.
Our office is physically secure.
  • We control access to our office with security access procedures and all people who enter our facility must wear identification
  • We keep written health information locked in a drawer when not in use.
  • We keep our computers secured at all times.
We teach our staff how to protect your information.
  • CHPW trains staff to protect the privacy and security of protected health information.
  • We limit who may see protected health information. Only staff with a need to know protected health information may use it.
  • We limit what we discuss on the phone.

If your health information is ever shared with someone who should not see it, or who is not required to protect it under the law, we take steps to correct the mistake by notifying you and the appropriate government agencies.

Ask a Question or Report a Problem

If you have questions about the privacy and security of your PHI, please contact us.

Apple Health members: Call 1-800-440-1561 (TTY Relay: Dial 711), Monday – Friday, 8 am – 5 pm, or email us at customercare@chpw.org.

If you believe your privacy rights have been violated, you may file a complaint with us by phone or mail. We will not penalize you in any way if you file a complaint.

Phone1-800-440-1561 (TTY Relay: Dial 711)

Mail:
Community Health Plan of Washington
Attn: Compliance, Privacy, and Security Officer
1111 Third Ave., Suite 400
Seattle, WA 98101

Stopping fraud, waste, and abuse

Fraud occurs when someone knowingly submits a false claim that results in inappropriate payments. Fraud takes money away from health care programs and makes it more difficult to pay for real, needed care. It be tied to higher overall costs of medical care.

Waste is overuse of services or other practices that, directly or indirectly, results in unnecessary medical costs. It is not generally considered to be a crime, but is a misuse of resources.

Abuse is an action that may result in unnecessary medical costs. It’s when a person or entity has misrepresented facts to obtain payment, but not knowingly and/or purposely.

➔ Learn more about fraud, waste, and abuse
➔ Report fraud

Advance directive

An advance directive puts your choices for health care into writing and tells your doctor and family what kind of care you do or do not want. Having an advance directive means your loved ones or your doctor can make medical choices for you based on your wishes.

➔ Learn how to create an advance directive for your health care preferences.

Grievances and appeals

We take your concerns seriously. You can file a grievance with your health care plan if you are not happy with the way you were treated, the quality of care or services you received, you have problems getting care, treatment or medication you need is denied, or you have billing issues.

➔ Learn how to submit a grievance (complaint) or an appeal.

DID YOU KNOW...?

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