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Connecting Your Healthcare: New Options for Managing Your Digital Medical Records

Starting in 2021, a new federal rule made it easier for Superior STAR+PLUS MMP members* to manage their digital medical records.  

The Interoperability and Patient Access rule (CMS-9115-F) makes it easier for members to get their health records when they need it most. You now have full access to your health records on your mobile device.  This allows you manage your health better and know what resources are available to you.

Starting in 2022, the Payer-to-Payer Data Exchange portion of the rule* will allow 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

Patient Demographics

  • first name
  • last name
  • previous name
  • middle name
  • suffix
  • birth sex
  • date of birth
  • race
  • ethnicity
  • preferred language

Allergies & Intolerances

  • substances (medications)
  • substances (drug class)
  • reaction

New Demographics

  • current address
  • previous address
  • phone number
  • phone number type
  • email address

Health Concerns

Immunizations

Procedures

Medications

Laboratory Tests & Results

Assessment & Treatment Plan

Care Team Members

Having your information in one place can help you:

  • Understand your health better
  • Make better decisions
  • Improve your health outcomes
  • Reduce healthcare costs
  • Carry information to new providers or health plans

Your privacy and the security of your PHI is a top concern of ours. The new rule allows you to use an app from a third-party application developer (a company with no connection to Superior STAR+PLUS MMP). You can use this app to look up your health information.  When choosing an app, it is important to consider how your data can be used and the app’s security and privacy practices.

The CARIN alliance is working to advance the exchange of health information. We will require third-party application developers to agree to follow certain privacy standards outlined in the CARIN Code of Conduct. The CARIN Code of Conduct is a set of practices that these applications have voluntarily adopted to protect and secure your health information. Visit the My Health Application website to see a list of apps that have agreed to the CARIN Code of Conduct. We will give you information on federal agencies you can contact if you feel your rights to patient privacy have not been protected. Learn more about the CARIN Alliance.

Before sharing your data with a third party application, we will ask you to agree to an Access Your Data statement. This is an added security step to protect your data.

  1. Find an app. Visit the My Health Application website for a list of apps that meet the CARIN Code of Conduct. By agreeing to the CARIN Code of Conduct, the app developer attests it meets certain standard security practices. These practices include, but are not limited to:
    • Protection of a user’s personal data against:
      • loss or unauthorized access
      • use
      • alteration
      • destruction
      • unauthorized annotation
      • disclosure
    • Protect personal data through a combination of mechanisms including:
      • secure storage
      • encryption of digital records both in transit and at rest
      • data-use agreements and contractual obligations
      • accountability measures (e.g., access controls, logs and independent audits)
    • Comply with applicable breach notification laws
    • Provide meaningful remedies to address security breaches or other violations due to a misuse of the user’s personal data
    • Adopt internal policies and secure contractual commitments with third parties to prohibit the re-identification of de-identified or anonymized data
  2. Download the app. Smartphone apps are available through the Google Play Store (Android) and the App Store (iOS).  Web apps are also available for computers.
  3. Create your account. Use the app to do so.
    • To link your health information, choose your health plan
    • On the login screen, enter your member portal username and password
    • Read the Access your Health Data statement. If you agree to the terms, click “Allow Access”
  4. Use your information to manage your healthcare.

FREQUENTLY ASKED QUESTIONS

IMAGINE:

You go to a new healthcare provider because you don’t feel well and that provider can pull up your health history from the past five years:

  • The provider uses that information to diagnose you and quickly finds the right specialist by checking an up-to-date provider directory
  • You have a question about a claim, so you go to your computer and, in minutes, you see if it’s paid or denied or still being processed

Starting in 2021, a new federal rule will make it easier for members* to do all of this and more.

The Interoperability and Patient Access rule CMS-9115-F puts patients first. It gives you control. Get easy access to your health information when you need it most. Having complete access to your health information allows you to manage your health better. You can know what healthcare resources are available to you.

THE NEW RULE MAKES IT SO YOU CAN EASILY FIND INFORMATION** ON:

  • claims (paid and denied)
  • provider appointments
  • past test results
  • health status
  • your cost of care
  • specific parts of your clinical information
  • healthcare providers
  • pharmacy directory data***

Patient Demographics                                  

  • first name                            
  • last name
  • previous name
  • middle name
  • suffix
  • birth sex
  • date of birth
  • race
  • ethnicity
  • preferred language

 

New Demographics

  • current address
  • previous address
  • phone number
  • phone number type
  • email address

 

Clinical Notes

  • consultation note
  • discharge summary note
  • history & physical
  • imaging narrative
  • laboratory report narrative
  • pathology report narrative
  • procedure note
  • progress note

 

Allergies & Intolerances

  • substances (medications)
  • substances (drug class)
  • reaction

 

Vital Signs

  • body height
  • body weight
  • BMI percentile (2-20 years)
  • blood pressure
  • heart rate
  • respiratory rate
  • body temperature

 

Health Concerns

Immunizations

Procedures

Medications

Laboratory Tests & Results

Assessment & Treatment Plan

Care Team Members

Having your medical information in one place helps you and your providers understand your health better so you can make better decisions and improve your health outcomes. This often reduces healthcare costs. This information will follow you to any provider or health plan in the future.

At Superior STAR+PLUS MMP, your privacy and the security of your PHI is a top concern. The new rule allows you to look up your information using an app from a third-party application developer (a company with no connection to Superior STAR+PLUS MMP).  We promise to give you information on what to consider when selecting an app, the ways your data can be used by the third party, and the importance of understanding the security and privacy practices of the app.

We will ask, but not require, third-party application developers to prove they will follow certain privacy standards, including whether they will use a patient’s health data for reasons other than the patient’s health. We will tell you which third-party application developers agree to these privacy standards. We will give you information on federal agencies you can contact if you feel your rights to patient privacy have not been protected. Learn more about third-party application privacy standards at CARIN Alliance.

  1. Find a trusted app. Visit myhealthapplication.com for a list of trusted apps that meet the strictest privacy and security guidelines.
  2. Download the app. Smartphone apps are available through the Google Play Store (Android) and the App Store (iOS), and web apps are available for computers.
  3. Create your account. Follow the instructions in the app of your choice to sign up and link your health information.
  4. Use your information to manage your healthcare. Now you have the information you need to make the best healthcare decisions for yourself.

Contact Us.

For more information on CMS Policies and Technology for Interoperability and Burden Reduction visit https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index.

Any health information from Superior STAR+PLUS MMP with a date of service of January 1, 2016 or later will be made available.

You always have access to your health information. The health plan or provider you visit will not affect that.

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 you use will not be affiliated with Superior STAR+PLUS MMP.  You may also visit myhealthapplication.com/health-apps/connections/Carin for a list of apps that have attested to the CARIN Code of Conduct. Follow the instructions on the app to connect it with your health record.

There may be some apps that don’t follow all the privacy provisions. We will let you know which apps have agreed to follow our privacy guidelines. Have you already selected an app prior to us receiving a response from the app provider on their privacy policies? If so, you will have a chance to select another app within a certain timeframe. We recommend that you request a Notice of Privacy Practices from the app. If the app does not provide you with a Notice of Privacy Practices, we recommend that you choose another app. You may also visit myhealthapplication.com for a list of trusted apps.

You can access your information starting July 1, 2021. You will be able to access your Superior STAR+PLUS MMP plan information through the apps.

No. You do not have to use an app to access your healthcare info. You can contact your provider or health plan for needed information.

You give the app your permission when you enroll. The app will collect your health data such as:

  • your claims
  • medications
  • diagnosis
  • procedures
  • doctor visits

Apps do have the ability to collect non-health data. Some apps let you have the option to provide that information. We recommend that you ask your app provider.

The health data of family members may be connected to your health account. If so, that data may be included with a request of your own data via the app.

You will need to contact your provider or health insurance company. The health app only makes data available from healthcare sources. The app does not create this data.  Is the app showing incorrect information that was not sent to the app? If so, the app must correct this problem.

Ask the app provider for their notice of privacy and security practices.

Most apps will not be covered by HIPAA. Most apps will instead fall under:

  • The Federal Trade Commission (FTC)
  • The FTC Act.

The FTC Act protects against deceptive acts (e.g., if an app shares personal data without permission, despite having a privacy policy that says it will not do so).

The FTC provides information about mobile app privacy and security for consumers here: www.consumer.ftc.gov/articles/0018-understanding-mobile-apps

You can find more information about patient rights under HIPAA and who is obligated to follow HIPAA here:  www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html

You can also see the HIPAA FAQs for Individuals: www.hhs.gov/hipaa/for-individuals/faq/index.html

We recommend that you request a Notice of Privacy Practices from the app provider to understand your rights.

We recommend that you request a Notice of Privacy Practices from the app provider. This will help you understand how they respond to an 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 under HIPAA. Most apps will fall under:

  • The Federal Trade Commission (FTC)
  • The FTC Act

The FTC Act protects against deceptive acts (e.g., if an app shares personal data without permission, despite having a privacy policy that says it will not do so).

To learn more about filing a complaint with OCR under HIPAA, visit:  www.hhs.gov/hipaa/filing-a-complaint/index.html

Individuals can file a complaint with OCR using the OCR complaint portal:  ocrportal.hhs.gov/ocr/smartscreen/main.jsf

Individuals can file a complaint with the FTC using the FTC complaint assistant: reportfraud.ftc.gov

The app is meant for you to be able to see your data in one place. However, we recommend that you request a Notice of Privacy Practices. This will help you understand how the app will use your data.

We recommend that you request a Notice of Privacy Practices from the app provider. It will help you understand if the app will share your data with third parties.

We recommend that you request a Notice of Privacy Practices from the app provider. It will help you understand what happens to your data after you stop using the app.

We recommend that you request a Notice of Privacy Practices from the app provider. It will help you understand what happens to your data after you stop using the app.

The best way to stop sharing data is through the Third Party Application. You can also contact the Third Party Application support.  Are you unable to successfully stop sharing data through the Third Party Application or by using the Third Party Application Support? You may call <Plan Name> member services for assistance.

We recommend that you request a Notice of Privacy Practices from the app provider. This will help you understand if the app will share your data with third parties.

App providers may respond to user complaints in different ways. We recommend that you ask your app provider.

We recommend that you request a Notice of Privacy Practices from the app provider. It will help you understand how the app stores your data.

We recommend that you request a Notice of Privacy Practices. You can also request additional information on security practices. They will help you understand how they handle an incident.

We recommend that you request a Notice of Privacy Practices from the app provider. It will help you understand how you can limit the use and release of your data.

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