Privacy Policy

Notice of Privacy Practices and Protection

This Privacy Notice will describe the type of information we collect, how that information is used and what measures are taken to assure confidentiality of that information.

3PAdministrators strives to provide exceptional customer service to both the employer whose group plan we administer and to the individuals covered under the plan. As part of our dedication to service, we are committed to protecting the privacy of those individuals and the confidentiality of personal health information we receive.

What Information We Receive and How it is Obtained

General personal information is collected from the enrollment application or other necessary administrative forms completed by the individual. This includes but is not limited to:

  • Name
  • Address
  • Telephone number
  • Social Security number
  • Date of birth
  • Maritalstatus
  • Employment/Position
  • Previous and current health conditions

In the processing of health claims through the plan, we are provided specific information on the treatment received. The patient’s consent to submit the minimum necessary claim information is secured by the healthcare provider for payment to be issued. Claims are either sent in paper form by mail or sent electronically and include the following patient information:

  • Name
  • Address
  • Diagnosis
  • Service provided (i.e.: office visit and exam, labs, x-rays, surgery, etc.)

Occasionally, issuing payment requires more information than what is provided on a standard claim form. 3PAdministrators will request only the minimum necessary information to make a benefit determination. Some situations which may require obtaining additional information include but are not limited to investigating for pre-existing conditions, pre-authorization of a proposed treatment, or conducting a review on an appeal. The patient may be required to provide authorization for release of this information.

How Information is Protected

Access to personal information is restricted to those employees responsible for receiving, distributing and processing claims for payment. We maintain physical, electronic and procedural safeguards such as physically secured areas and computer access controls that comply with all legislated regulations. Information is accessed only as necessary to conduct our business. All employees of 3PAdministrators sign statements requiring them to maintain privacy and to follow the policies we establish to secure confidentiality. Any third parties named below to whom we disclose personal information, or who receive or handle information on our behalf, are also required to adhere to our privacy policies.

Disclosure

We do not disclose any personal information except as permitted by law or unless authorized by the individual. We may be required to disclose information to our affiliates which include but are not limited to:

  • Plan sponsor Utilization review
  • Electronic clearinghouse
  • Other Insurance carriers
  • Policy holder’s broker
  • Reinsurance carrier
  • Subrogation affiliate
  • Flex administrator

Any disclosures are made for the purpose of conducting normal business, for performing administrative services on our behalf, helping us to administer or review a claim where we feel it is necessary to protect our interests, or as requested by a governmental agency. An accounting of any disclosures will be maintained and can be viewed by the individual upon request.

About this Privacy Notice

This notice serves as a summary of 3PAdministrators’ privacy policies and procedures and is not intended to be a comprehensive accounting of the rights provided by applicable laws. These procedures of privacy protection will remain in effect for as long as the information is retained regardless of whether coverage is effective or not. Written notice will be given of any changes or additions to the procedures set forth in this notice.

Please direct any questions to:

3PAdministrators
ATTN: Privacy Officer
1113RidersClubRoad
Onalaska, WI 54650

Phone: 608-779-3000
Toll Free: 888-540-0094