Privacy Policy

1. INTRODUCTION

1.1 PURPOSE OF POLICY. AmericasHealth Plan, Inc., ("us," "we," or "Company") is committed to respecting the privacy rights of its customers, visitors, and other users of the Company Website (the "Site"). We created this Website Privacy Policy (this "Policy") to give you confidence as you visit and use the Site, and to demonstrate our commitment to fair information practices and the protection of privacy. This Policy is only applicable to the Site, and not to any other websites that you may be able to access from the Site, each of which may have data collection and use practices and policies that differ materially from this Policy. Additionally, this Policy is for purposes of your visit and use of the Site only and is not intended to address all of the policies the Company has and implements for purposes of privacy of third parties, compliance with HIPAA or Medicare, etc., which are covered by other Company policies.

1.2 NOTICE CONCERNING CHILDREN.
PLEASE NOTE: We are a general audience site, and do not direct any of our content specifically at children under 13 years of age. We understand and are committed to respecting the sensitive nature of children's privacy online. If we learn or have reason to suspect that a Site user is under age 13, we will delete any personal information in that user's account.

2. Information Collection Practices

2.1 WHAT PERSONAL INFORMATION DOES THE COMPANY COLLECT?
In order for you to access or utilize certain services on the Site we require you to provide us with certain information that personally identifies you ("Personal Information"). Personal Information includes the following categories of information: (1) Contact Data (such as your name, telephone number, mailing address, or e-mail address); (2) Financial Data (such as your account or credit card number); (3) Demographic Data (such as your zip code, you age, or age of your children); and (4) Medical Insurance and Claims Information (such as insurance policy numbers, physician ID numbers, tax ID number, claims information, or services rendered or provided). If you communicate with us by e-mail, post messages to any of our bulletin boards or forums, or otherwise complete online forms, surveys, or contest entries, any information provided in such communication may be collected as Personal Information.

2.2 WHAT ADDITIONAL INFORMATION DOES COMPANY COLLECT?
(a) AUTOMATIC COLLECTION. Our servers automatically recognize visitors' domain names and IP addresses (the number assigned to computers on the Internet). No Personal Information about you is revealed in this process. The Site may also gather anonymous "traffic data" that does not personally identify you, but that may be helpful for marketing purposes or for improving the services we offer.

(b) COOKIES. From time to time, we may use the standard "cookies" feature of major browser applications that allows us to store a small piece of data on your computer about your visit to our Site. We do not set any personally identifiable information in cookies, nor do we employ any data capture mechanisms on our Site other than cookies. Cookies help us learn which areas of our Site are useful and which areas need improvement. You can choose whether to accept cookies by changing the settings on your browser. However, if you choose to disable this function, your experience at our Site may be diminished and some features may not work as they were intended.

(c) USER CHOICE REGARDING COLLECTION OF PERSONAL INFORMATION. You may choose not to provide us with any Personal Information. In such an event, you can still access and use much of the Site; however you will not be able to access and use those portions of the Site that require your Personal Information.

3. Use and Sharing of Information

3.1 WHAT DOES COMPANY DO WITH COLLECTED INFORMATION?
(a) PERSONAL INFORMATION. We will not share your Personal Information with any third parties without your consent, except as necessary to provide you with the services offered by us or to comply with the law. We may use your Personal Information to verify your identity, to check your qualifications, or to follow up with transactions initiated on the Site. We may also use your Contact Data to inform you of any changes to the Site, or to send you information about our Company including promotional materials regarding the products and services we provide or programs we support.

(b) ANONYMOUS INFORMATION. We use anonymous information to analyze our Site traffic, but we do not examine this information for inpidually identifying information. In addition, we may use anonymous IP addresses to help diagnose problems with our server, to administer our Site, or to display the content according to your preferences. Traffic and transaction information may also be shared with business partners and advertisers on an aggregate and anonymous basis.

(c) USE OF COOKIES. We may use cookies to deliver content specific to your interests, to save your password so you don't have to re-enter it each time you visit our Site, or for other purposes. Promotions or advertisements displayed on our Site may contain cookies. We do not have access to or control over information collected by outside advertisers on our Site.

(d) DISCLOSURE OF PERSONAL INFORMATION. We may disclose Personal Information if required to do so by law or in the good-faith belief that such action is necessary to (1) conform to the edicts of the law or comply with legal process served on Company or its parent company, subsidiaries or affiliates, (2) protect and defend the rights or property of Company or the users of the Site, or (3) act under exigent circumstances to protect the safety of the public or users of the Site.

(e) SALE OF INFORMATION. In order to accommodate changes in our business, we may sell or buy portions of our Company or other companies or assets, including the information collected through the Site. If Company or substantially all of its assets are acquired, customer information will be one of the assets transferred to the acquirer.

(f) ACCESS TO INFORMATION. Unfortunately, we do not maintain any procedures for you to review or request changes to the information that we collect about you, except that you may request that we remove all information about you from our database by contacting us in accordance with Section 6.1 below.

4. Security

The Site has security measures in place to prevent the loss, misuse, and alteration of the information that we obtain from you, but we make no assurances about our ability to prevent any such loss, misuse, or alteration, and we will have no liability to you or to any third party arising out of any such loss, misuse, or alteration.

5. Website Areas Beyond Company's Control

5.1 PUBLIC FORUMS.
The Site may include interactive forums such as message boards and chat rooms. Please remember that any information that is disclosed in these areas becomes public information and you should exercise caution when deciding to disclose your personal information.

5.2 THIRD PARTY WEBSITES.
The Site may contain links to other websites. If you choose to visit other websites, we are not responsible for the privacy practices or content of those other websites, and it is your responsibility to review the privacy policies at those websites to confirm that you understand and agree with their policies.

6. Contact Information and Policy Updates

6.1 CONTACTING US
If you have any questions about this Policy, our practices related to the Site, or if you would like to have us remove your information from our database please feel contact us at the following:

By email: privacy@ahp.org

By mail: AmericasHealth Plan, Inc.
200 So. Wells Road, Suite 200
Ventura, CA 93004
Attn: Administration

6.2 UPDATES AND CHANGES.
We reserve the right, at any time, to add to, change, update, or modify this Policy, simply by posting such change, update, or modification on the Site and without any other notice to you. Any such change, update, or modification will be effective immediately upon posting on the Site. It is your responsibility to review this Policy from time to time to ensure that you continue to agree with all of its terms.

HIPAA Privacy Statement

“Confidentiality, it’s everyone’s job, not everyone’s business” AmericasHealth Plan, Inc., understands the importance of providing patients with the highest levels of privacy and security for their confidential health information. This level of protection is attributed to this organization’s firm commitment to sound business practices including: mandatory safety and security policies; regular audits; effective employee training and management oversight.

HIPAA, the Health Insurance Portability and Accountability Act (hereinafter the ‘ACT’), was enacted into law on August 21, 1996. The Act, among other things, contains requirements to issue regulations related to the privacy of patients’ health information. These requirements take two forms – Privacy Rules and Security Rules. The Privacy Rules became effective on January 1, 2013. AmericasHealth Plan, Inc. is a covered entities and has many “business associates” for purposes of the Act.

AmericasHealth Plan, Inc., (AHP) takes seriously its role as a covered entity under the Act, and as such, is obligated under the Act to implement policies and procedures over and above those already in existence.

AHP recognizes the importance of this Act and has worked diligently to comply with HIPAA rules and regulations. AHP has established an employee training program, developed privacy and security policies and procedures, and worked with business associates and business partners to achieve compliance. AHP will continue to strive to meet its compliance obligations, and to assist our business associates in meeting the compliance requirements mandated under the Privacy and Security rules.

Compliance

AmericasHealth Plan has various methods in place in which Providers, Members, vendors and employees can report suspected fraud, waste or abuse. Reports can be made anonymously.

Please provide as much information as possible such as:

Fraud

An intentional deception or misrepresentation made with the knowledge that the deception could result in some unauthorized benefit to himself or some other person. It includes any act that constitutes fraud under applicable federal or state law. (Title 42 CFR 455.2; Welfare and Institutions Code 14043.1(i))

Waste

Overutilization of services and/or misuse of resources not caused by a violation of law.

Abuse

Provider practices that are inconsistent with sound fiscal, business or medical practices, and result in an unnecessary cost to the Medicaid program or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for healthcare. It also includes recipient practices that result in unnecessary cost to the Medicaid program. (Title 42 CFR 455.2; Welfare and Institutions Code 14043.1(a))

Attention Providers: You are required to report incidents of fraud to AmericasHealth Plan within 10 days from the date you became aware of such activity.

    • Toll-free hotline available 24/7: 800.633.3313
    • Via internet: compliance@ahp.org
    • Written report: Attention: Compliance Officer–Fraud Investigation
      200 So. Wells Road, Suite 200 
      Ventura, CA 93004
    • Name of person(s), facility, vendor, etc., suspected of fraud, waste or abuse.
    • Identifying information, such as: Member/Provider/Facility name, address or telephone number.
    • Description and details of the suspected fraud, waste or abuse: who, what, where, when, and date and time of incident or incident(s).
    • Documentation (any) that is related to the report.
    • Person filing the report: name and telephone number if you do not wish to remain anonymous.
  • General Claim Form

    A general claim form must be completed and submitted to the Clerk of the Commission for persons wishing to file a non Medicare claim against AmericasHealth Plan, Inc., (AHP) at compliance@ahp.org.

    Health Education 
    At AmericasHealth Plan, Inc. a primary care physician driven health plan with the goal of keeping you healthy and decreasing your chance of illness or injury. Our Primary Care Provider driven health education programs are specifically designed to keep our patients better informed on preventative measures they can take to ensure their well-being.

    From regular health screenings and classes, to one-on-one counseling, we help our patients achieve healthier, happier and more productive lives.

    • Diabetes/Hypertension Education
    • Family Planning Education
    • Blood Pressure Screenings
    • Diabetes Screenings
    • HIV/AIDS Education
    • Pre and Postnatal Care
    • Nutritional Counseling
    • Infant Care
    • Weight Control

    Patients are usually referred to Health Educators by providers. If anyone wants to see a health educator and was not referred, appointments can be scheduled by calling the health center number.

    Pregnant women are treated with extensive pre and postnatal programs that include services for newborns and family planning. Our physician providers offer prenatal classes through out Ventura County in Spanish and English. At Maravilla, Oxnard, and El Rio, they are also available in Mixteco for our Mixteco patients.

    For our patients, we also offer inpidual classes at their convenience.

    We also provide OB Maternity Tours at St. John’s and Community Memorial Hospital for our OB patients who will be delivering there. To sign up for classes or a tour, speak to a health educator at any of our health centers.

    AmericasHealth Plan Provider Network Health Education locations: