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Legal Policies

Evergreen Health, Inc.
Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Effective January 1, 2017

Evergreen Health Inc. (Evergreen Health) is required by law to protect the privacy of your health information. We are also required to send you this notice, which explains how we may use information about you and when we can give out or “disclose” that information to others. You also have rights regarding your health information that are described in this notice. We are required by law to abide by the terms of this notice.

The terms “information” or “health information” in this notice include any information we maintain that reasonably can be used to identify you and that relates to your physical or mental health condition, the provision of health care to you, or the payment for such health care. We will comply with the requirements of applicable privacy laws related to notifying you in the event of a breach of your health information.

We have the right to change our privacy practices and the terms of this notice. If we make a material change to our privacy practices, we will provide to you, in our next annual distribution, either a revised notice or information about the material change and how to obtain a revised notice. We will provide you with this information either by direct mail or electronically, in accordance with applicable law. In all cases, we will post the revised notice on your health plan website, such as to make any revised or changed notice effective for information we already have and for information that we receive in the future.

Evergreen Health collects and maintains oral, written and electronic information to administer our business and to provide products, services and information of importance to our enrollees. We maintain physical, electronic and procedural security safeguards in the handling and maintenance of our enrollees, information, in accordance with applicable state and federal standards, to protect against risks such as loss, destruction or misuse.

How We Use or Disclose Information

We must use and disclose your health information to provide that information:

  • To you or someone who has the legal right to act for you (your personal representative) in order to administer your rights as described in this notice; and
  • To the Secretary of the Department of Health and Human Services, if necessary, to make sure your privacy is protected.

We have the right to use and disclose health information for your treatment, to pay for your health care and to operate our business. For example, we may use or disclose your health information:

  • For Payment of premiums due us, to determine your coverage, and to process claims for health care services you receive, including for subrogation or coordination of other benefits you may have. For example, we may tell a doctor whether you are eligible for coverage and what percentage of the bill may be covered.
  • For Treatment. We may use or disclose health information to aid in your treatment or the coordination of your care. For example, we may disclose information to your physicians or hospitals to help them provide medical care to you.
  • For Health Care Operations. We may use or disclose health information as necessary to operate and manage our business activities related to providing and managing your health care coverage. For example, we might talk to your physician to suggest a disease management or well ness program that could help improve your health or we may analyze data to determine how we can improve our services.
  • To Provide You Information on Health Related Programs or Products such as alternative medical treatments and programs or about health-related products and services, subject to limits imposed by law.
  • For Plan Sponsors. If your coverage is through an employer sponsored group health plan, we may share summary health information and enrollment and disenrollment information with the plan sponsor. In addition, we may share other health information with the plan sponsor for plan administration purposes if the plan sponsor agrees to special restrictions on its use and disclosure of the information in accordance with federal law.
  • For Underwriting Purposes. We may use or disclose your health information for underwriting purposes; however, we will not use or disclose your genetic information for such purposes.
  • For Reminders. We may use or disclose health information to send you reminders about your benefits or care, such as appointment reminders with providers who provide medical care to you.

We may use or disclose your health information for the following purposes under limited circumstances:

  • As Required by Law. We may disclose information when required to do so by law.
  • To Persons Involved With Your Care. We may use or disclose your health information to a person involved in your care or who helps pay for your care, such as a family member, when you are incapacitated or in an emergency, or when you agree or fail to object when given the opportunity. If you are unavailable or unable to object, we will use our best judgment to decide if the disclosure is in your best interests. Special rules apply regarding when we may disclose health information to family members and others involved in a deceased individual’s care. We may disclose health information to any persons involved, prior to the death, in the care or payment for care of a deceased individual, unless we are aware that doing so would be inconsistent with a preference previously expressed by the deceased.
  • For Public Health Activities such as reporting or preventing disease outbreaks to a public health authority.
  • For Reporting Victims of Abuse, Neglect or Domestic Violence to government authorities that are authorized by law to receive such information, including a social service or protective service agency.
  • For Health Oversight Activities to a health oversight agency for activities authorized by law, such as licensure, governmental audits and fraud and abuse investigations.
  • For judicial or Administrative Proceedings such as in response to a court order, search warrant or subpoena.
  • For Law Enforcement Purposes. We may disclose your health information to a law enforcement official for purposes such as providing limited information to locate a missing person or report a crime.
  • To Avoid a Serious Threat to Health or Safety to you, another person, or the public, by, for example, disclosing information to public health agencies or law enforcement authorities, or in the event of an emergency or natural disaster.
  • For Specialized Government Functions such as military and veteran activities, national security and intelligence activities, and the protective services for the President and others.
  • For Workers’ Compensation as authorized by, or to the extent necessary to comply with, state workers compensation laws that govern job-related injuries or illness.
  • For Research Purposes such as research related to the evaluation of certain treatments or the prevention of disease or disability, if the research study meets federal privacy Jaw requirements.
  • To Provide Information Regarding Decedents. We may disclose information to a coroner or medical examiner to identify a deceased person, determine a cause of death, or as authorized by law. We may also disclose information to funeral directors as necessary to carry out their duties.
  • For Organ Procurement Purposes. We may use or disclose information to entities that handle procurement, banking or transplantation of organs, eyes or tissue to facilitate donation and transplantation.
  • To Correctional Institutions or Law Enforcement Officials if you are an inmate of a correctional institution or under the custody of a law enforcement official, but only if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
  • To Business Associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. Our business associates are required, under contract with us and pursuant to federal law, to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract and as permitted by federal law.
  • Additional Restrictions on Use and Disclosure. Certain federal and state laws may require special privacy protections that restrict the use and disclosure of certain health information, including highly confidential information about you. “Highly confidential information” may include confidential information under Federal laws governing alcohol and drug abuse information and genetic information as well as state laws that often protect the following types of information:
  1. HIV/AIDS;
  2. Mental health;
  3. Genetic tests;
  4. Alcohol and drug abuse;
  5. Sexually transmitted diseases and reproductive health information; and
  6. Child or adult abuse or neglect, including sexual assault.

If a use or disclosure of health information described above in this notice is prohibited or materially limited by other laws that apply to us, it is our intent to meet the requirements of the more stringent law.

Except for uses and disclosures described and limited as set forth in this notice, we will use and disclose your health information only with a written authorization from you. This includes, except for limited circumstances allowed by federal privacy law, not using or disclosing psychotherapy notes about you, selling your health information to others, or using or disclosing your health information for certain promotional communications that are prohibited marketing communications under federal law, without your written authorization. Once you give us authorization to release your health information, we cannot guarantee that the recipient to whom the information is provided will not disclose the information. You may take back or “revoke” your written authorization at any time in writing, except if we have already acted based on your authorization. To find out where to mail your written authorization and how to revoke an authorization, contact the phone number listed on the back of your ID card.

What Are Your Rights

The following are your rights with respect to your health information:

  • You have the right to ask to restrict uses or disclosures of your information for treatment, payment, or health care operations. You also have the right to ask to restrict disclosures to family members or to others who are involved in your health care or payment for your health care. We may also have policies on dependent access that authorize your dependents to request certain restrictions. Please note that while we will try to honor your request and will permit requests consistent with our policies, we are not required to agree to any restriction.
  • You have the right to ask to receive confidential communications of information in a different manner or at a different place (for example, by sending information to a P.O. Box instead of your home address). We will accommodate reasonable requests where a disclosure of all or part of your health information otherwise could endanger you. In certain circumstances, we will accept your verbal request to receive confidential communications, however, we may also require you confirm your request in writing. In addition, any requests to modify or cancel a previous confidential communication request must be made in writing. Mail your request to the address listed below.
  • You have the right to see and obtain a copy of certain health information we maintain about you such as claims and case or medical management records. If we maintain your health information electronically, you will have the right to request that we send a copy of your health information in an electronic format to you. You can also request that we provide a copy of your information to a third party that you identify. In some cases you may receive a summary of this health information. You must make a written request to inspect and copy your health information or have your information sent to a third party. Mail your request to the address listed below. In certain limited circumstances, we may deny your request to inspect and copy your health information. If we deny your request, you may have the right to have the denial reviewed. We may charge a reasonable fee for any copies.
  • You have the right to ask to amend certain health information we maintain about you such as claims and case or medical management records, if you believe the health information about you is wrong or incomplete. Your request must be in writing and provide the reasons for the requested amendment. Mail your request to the address listed below. If we deny your request, you may have a statement of your disagreement added to your health information. You have the right to receive an accounting of certain disclosures of your information made by us during the six years prior to your request. This accounting will not include disclosures of information made: (i) for treatment, payment, and health care operations purposes; (ii) to you or pursuant to your authorization; and (iii) to correctional institutions or law enforcement officials; and (iv) other disclosures for which federal law does not require us to provide an accounting.
  • You have the right to a paper copy of this notice. You may ask for a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You also may also obtain a copy of this notice on your health plan website, such as Exercising Your Rights
  • Contacting Evergreen Health. If you have any questions about this notice or want information about exercising your rights, please call the toll free member phone number on the front of your health plan ID card or you may contact an Evergreen Member Services Representative at (855) 978-3282.
  • Submitting a Written Request. Mail to us your written requests to exercise any of your rights, including modifying or canceling a confidential communication, requesting copies of your records, or requesting amendments to your record, at the following address:

Evergreen Health, Inc,
Chief Compliance Officer
3000 Falls Road, Suite 1
Baltimore, Maryland 21211

  • Filing a Complaint. If you believe your privacy rights have been violated, you may file a complaint with us at the address listed above.

You may also notify the Secretary of the US Department of Health and Human Services of your complaint. We will not take any action against you for filing a complaint.

FINANCIAL INFORMATION PRIVACY NOTICE

THIS NOTICE DESCRIBES HOW FINANCIAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Effective January 1, 2015

Evergreen Health is committed to maintaining the confidentiality of your personal financial information. For the purposes of this notice, “personal financial information” means information about an enrollee or an applicant for health care coverage that identifies the individual, is not generally publicly available, and is collected from the individual or is obtained in connection with providing health care coverage to the individual.

Information We Collect

We collect personal financial information about you from the following sources:

  • Information we receive from you on applications or other forms, such as name, address, age, medical information and Social Security number;
  • Information about your transactions with us, our affiliates or others, such as premium payment and claims history; and
  • Information from consumer reports.

Disclosure of Information

We do not disclose personal financial information about our enrollees or former enrollees to any third party, except as required or permitted by law. For example, in the course of our general business practices, we may, as permitted by law, disclose any of the personal financial information that we collect about you, without your authorization, to the following types of institutions:

  • To our corporate affiliates, which include financial service providers, such as other insurers, and non-financial companies, such as data processors;
  • To non-affiliated companies for our everyday business purposes, such as to process your transactions, maintain your account(s), or respond to court orders and legal investigations; and
  • To non-affiliated companies that perform services for us, including sending promotional communications on our behalf.

Confidentiality and Security

We maintain physical, electronic and procedural safeguards, in accordance with applicable state and federal standards, to protect your personal financial information against risks such as loss, destruction or misuse. These measures include computer safeguards, secured files and buildings, and restrictions on who may access your personal financial information.

Questions About this Notice

If you have any questions about this notice, please login to the Member Portal.

This HIPAA compliant privacy policy was adopted by Evergreen Health on January 1, 2015 and is valid until any revisions are made, of which notice shall be given.

Online/Cookie Policy

1. Introduction

1.1 Evergreen health uses cookies on our website. Cookies allow a web server to transfer data to a computer or device for digital experience record keeping and other purposes. Cookies are text files containing small amounts of information, which your computer or mobile device downloads when you visit a website. When you return to websites — or visit other websites that use the same cookies — they recognize these cookies and therefore, your browsing device.

We use cookies to help us understand how our website is being used, letting you navigate between pages efficiently, remembering your preferences, and generally improving your browsing experience. Cookies can also help ensure marketing you see online is more relevant to you and your interests.

We use a cookie to remember your browsing and site preferences.

If you delete all of your cookies you will have to update your preferences with us again; and
If you use a different device, computer or browser you will have to establish your preferences again
If you do not want information collected through the use of cookies, there is a simple procedure in most browsers that allows you to decline the use of cookies. To learn more about cookies, please visit http://www.allaboutcookies.org.

1.2 By using our website and agreeing to this policy, you consent to our use of cookies in accordance with the terms of this policy.

2. Credit

2.1 This document was created using a template from SEQ Legal (http://www.seqlegal.com).

3. About cookies

3.1 A cookie is a file containing an identifier (a string of letters and numbers) that is sent by a web server to a web browser and is stored by the browser. The identifier is then sent back to the server each time the browser requests a page from the server.

3.2 Cookies may be either “persistent” cookies or “session” cookies: a persistent cookie will be stored by a web browser and will remain valid until its set expiry date, unless deleted by the user before the expiry date; a session cookie, on the other hand, will expire at the end of the user session, when the web browser is closed.

3.3 Cookies do not typically contain any information that personally identifies a user, but personal information that we store about you may be linked to the information stored in and obtained from cookies.

3.4 Cookies can be used by web servers to identity and track users as they navigate different pages on a website and identify users returning to a website.

4. Our cookies

4.1 We use both session and persistent cookies on our website.

4.2 The names of the cookies that we use on our website, and the purposes for which they are used, are set out below:

(a) we use Google Analytics and Double Click Manager (DCM) on our website to recognize a computer when a user visits the website, track users as they navigate the website, improve the website’s usability, analyze the use of the website, administer the website, prevent fraud and improve the security of the website, personalize the website for each user, target advertisements which may be of particular interest to specific users.

5. Analytics cookies

5.1 We use Google Analytics to analyze the use of our website.

5.2 Our analytics service provider generates statistical and other information about website use by means of cookies.

5.3 The analytics cookies used by our website have the following names: utm, _utmb, _utmc and _utmz

5.4 The information generated relating to our website is used to create reports about the use of our website and advertising strategy.

5.5 Our analytics service provider’s privacy policy is available at: http://www.google.com/policies/privacy/.

6. Third-party cookies

6.1 Our website also uses third-party cookies.

6.2 Google tracks your behavior on our website and on other websites across the web using the DoubleClick cookie. This behavior tracking allows Google to tailor the advertisements you see on other websites to reflect your interests (we do not publish interest-based advertisements on this website). You can view, delete or add interest categories associated with your browser by visiting: http://www.google.com/settings/ads/. You can also opt out of the AdSense/Adswerve partner network cookie using those settings or using the NAI’s (Network Advertising Initiative’s) multi-cookie opt-out mechanism at: http://www.networkadvertising.org/choices/. However, these opt-out mechanisms themselves use cookies, and if you clear the cookies from your browser your opt-out will not be maintained. To ensure that an opt-out is maintained in respect to a particular browser, you may wish to consider using the Google browser plug-in available at: https://www.google.com/settings/ads/plugin.

7. Blocking cookies

7.1 Most browsers allow you to refuse to accept cookies; for example:

(a) in Internet Explorer (version 11) you can block cookies using the cookie handling override settings available by clicking “Tools”, “Internet Options”, “Privacy” and then “Advanced”;

(b) in Firefox (version 47) you can block all cookies by clicking “Tools”, “Options”, “Privacy”, selecting “Use custom settings for history” from the drop-down menu, and unchecking “Accept cookies from sites”; and

(c) in Chrome (version 52), you can block all cookies by accessing the “Customize and control” menu, and clicking “Settings”, “Show advanced settings” and “Content settings”, and then selecting “Block sites from setting any data” under the “Cookies” heading.

7.2 Blocking all cookies will negatively impact the usability of many websites.

7.3 If you block cookies, you will not be able to use all of the features on our website.

8. Deleting cookies

8.1 You can delete cookies already stored on your computer; for example:

(a) in Internet Explorer (version 11), you must manually delete cookie files (you can find instructions for doing so at http://support.microsoft.com/kb/278835);

(b) in Firefox (version 47), you can delete cookies by clicking “Tools”, “Options” and “Privacy”, then selecting “Use custom settings for history”, clicking “Show Cookies”, and then clicking “Remove All Cookies”; and

(c) in Chrome (version 52), you can delete all cookies by accessing the “Customize and control” menu, and clicking “Settings”, “Show advanced settings” and “Clear browsing data”, and then selecting “Delete cookies and other site and plug-in data” before clicking “Clear browsing data”.

8.2 Deleting cookies will have a negative impact on the usability of many websites.

9. Our details

9.1 This website is owned and operated by Evergreen Health.

9.2 Our principal place of business is at 3000 Falls Road, Suite 1, Baltimore MD, 21211.

9.3 You can contact us by writing to Evergreen Health Inc. 3000 Falls Road, Suite 1, Baltimore, MD 21211, by using our website contact form, by email to fraud@evergreenmd.org.

The following Terms & Conditions (“Terms”) describe the rules for using the Evergreen Health Inc. (“Evergreen Health”) website. These Terms establish a legally binding agreement between you and Evergreen Health. If you are helping another person use this website, these Terms establish a legally binding agreement between you, the person that you are helping and Evergreen Health.

By accessing, using or viewing this website, you agree to the most recent Terms and the most recent version of Evergreen Health’s Privacy Policy. Evergreen Health may change these Terms at any time, and as such, it is your responsibility to review these Terms each time you use this website. By continuing to use this website, you consent to any changes in these Terms.

Restrictions

By using this website, you agree:

  • not to use this website or content in any way not explicitly permitted by these Terms or the text of the website itself;
  • not to copy, modify or create derivative works involving the content of this website, except you may print a reasonable number of copies for your personal, non-commercial use;
  • not to misrepresent your identity or provide Evergreen Health with any false information in any information-collection portion of this website, such as a registration or enrollment application page;
  • not to take any action intended to interfere with the operation of this website;
  • not to access or attempt to access any portion of this website to which you have not been explicitly granted access;
  • not to share a password assigned to you with any third parties or use any password granted to a third party;
  • not to directly or indirectly authorize anyone else to take actions prohibited in this section;
  • to comply with all applicable laws and regulations while using this website or the content in this website. You represent and warrant that you are at least 18 years of age.

Copyrights

Except as otherwise indicated, all the content on this website, including text, graphics, logos, button icons, photos, images, forms, audio, video, questionnaires, and software, is the property of Evergreen Health or its licensors, and is protected by United States and international copyright laws. Evergreen Health allows you to view or download a copy of the material on the website solely for your personal, noncommercial use.

The compilation of all content on this website is the exclusive property of Evergreen Health and is protected by United States and international copyright laws. Unless specifically authorized in writing by Evergreen Health, any use of these materials or of any materials contributed to this website by entities other than Evergreen Health on any other website or networked computer environment for any purpose is prohibited.

Any rights not expressly granted by these Terms or any applicable end-user license agreements are reserved by Evergreen Health. Content and features of this website are subject to change or termination without notice in the sole editorial discretion of Evergreen Health.

Communication with Evergreen Health

Evergreen Health welcomes your suggestions and feedback on how to improve its services, products and this website. In the event you decide to provide Evergreen Health with any feedback, suggestions, or similar communications (collectively “Comments”), all such Comments will be considered non-personal, non-confidential and nonproprietary. You hereby grant Evergreen Health a perpetual, sub-licensable, assignable, unrestricted, worldwide, royalty free, irrevocable license to use, reproduce, display, perform, practice, modify, adapt, publish, create derivative or collective works, transmit and distribute your Comments, in whole, in part, in like or in kind, and including all intellectual property rights therein.

No Medical Advice

The information provided on this website is neither a substitute nor intended to substitute the advice of a personal physician or other qualified healthcare professional. Evergreen Health advises you to seek the advice of a physician or other qualified healthcare professional with any questions regarding medical symptoms or a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

No Legal Advice

Nothing contained, expressed or implied on this website constitutes legal advice, guidance or interpretation and should not be relied on as such. The information in this website is for informational purposes only. If you have any questions concerning any law, regulation, requirement, or legal issue referenced in this website, you should contact your attorney.

Website Content

Evergreen Health may change, add or remove some or all of the content on this website at any time. Evergreen Health may also make changes over time to features of any plan described in this website as permitted by law, including benefit levels, items included in any formulary, pricing or lists of participating providers or other associated vendors. Although it is Evergreen Health’s intention to provide accurate information on this website, certain features that may be offered through this website, such as participating providers, pricing information or other content, may not be accurate or up to date. Consequently, Evergreen Health makes no guarantees as to correctness, completeness or accuracy of the content on the website. Also, unauthorized additions, deletions, or alterations may be made to the website by third parties without Evergreen Health’s knowledge. If you believe that information found on the website is inaccurate or unauthorized, please email info@evergreenmd.org.

Website Security

Evergreen Health maintains reasonable administrative, technical and physical safeguards designed to protect the information that you provide on this website. Despite these efforts, no security system is impenetrable and Evergreen Health cannot guarantee the security of this website or that the information you supply will not be intercepted while being transmitted over the Internet to Evergreen Health, and as such, Evergreen Health is not liable for the illegal acts of third parties such as hackers.

Privacy Policy

Evergreen Health has a Privacy Policy concerning your use of this website and the information it uses and collects. Please see the Privacy Policy for more information concerning privacy of your information.

Links

Evergreen Health’s website provides links to other websites that are not owned or controlled by Evergreen Health. Evergreen Health is not responsible for the content, security or the privacy practices of third party websites or for any of your dealings with such third party websites. Please review the privacy statement and any terms of use of each third party website you visit. Unless we specifically advise you otherwise, links to third party websites do not constitute or imply endorsement by Evergreen Health of those sites, the information they contain or any products or services they describe. Evergreen Health does not receive payment or other remuneration in exchange for you linking to or using any third party website.

Social Media

Evergreen Health utilizes social media and encourages you to read, share, follow and provide commentary on Facebook, Twitter and other social media sites. Before you post, please read the following:

  • Evergreen Health is under no obligation to screen or monitor your posts or any other user content, however, Evergreen Health will make a reasonable effort to monitor participation to ensure that you stay on topic, are courteous and avoid making offensive comments. Your posts and user content must adhere to the following requirements and cannot:
  • contain any third party material, including logos, drawings, tattoos, photographs, pictures, sculptures, paintings and other images or works of art, phrases, trademarks, trade secrets or other items, without explicit prior written permission to use such materials;
  • contain sexually explicit, graphic, gratuitous or unnecessarily violent content or defamatory or derogatory content against any ethnic, racial, gender, religious, sexual orientation, professional or age group or contain any pornographic or nude material;
  • contain any private information about yourself or any other individual, including without limitation, information related to the health of the individual, financial information about the individual or any identification or account numbers related to the individual, with or without their permission or consent;
  • contain any software viruses or any other computer code, files or programs designed to interrupt, destroy or limit the functionality of any computer software, hardware or telecommunications equipment;
  • contain any advertising, promotional materials, “junk mail”, “spam”, “chain letters”, “pyramid schemes”, or promote illegal activity and/or illegal contests, sweepstakes, gambling, including any online casino, sports books, bingo, poker or any other form of solicitation.

Evergreen Health reserves the right to edit comments for content, remove off-topic comments, delete offensive comments or remarks, block offensive contributors and delete actual or suspected spam content from any social media site. Please be mindful that once you post something online, there is the potential for numerous individuals to read and view your post indefinitely. Evergreen Health encourages you to use caution when posting on any social media sites and that you avoid disclosing personally identifiable information like your location, medical record number, personal medical information, financial information, or other sensitive information. Evergreen Health is not responsible for the content of any comments or responses posted by others to any website or social media site managed or monitored by Evergreen Health. Evergreen Health does not control the placement of any marketing or advertising displayed on its pages by social media or third party organizations.

The information posted on any of Evergreen Health’s social media platforms is for general, informational purposes only and should not be considered medical or legal advice that replaces a consultation with your healthcare professional or attorney. Always consultant an appropriate healthcare professional for your medical needs. Some treatments mentioned on social media platforms may not be covered by your Evergreen Health plan. Please refer to your Evergreen Health plan documents for information about coverage. For questions regarding your Evergreen Health plan, benefits or coverage, Evergreen Health encourages you to contact the appropriate department listed on this website under the “Contact” link.

Information Evergreen Health Collects Automatically

If you visit this website, you consent to Evergreen Health’s use of Google Analytics, which uses cookies to collect non-personally identifiable information. Google Analytics uses cookies to track visitors who use Evergreen Health’s website. Evergreen Health uses this information to compile reports to improve the website. Evergreen Health does not send this information to third parties. Google Analytics collects the information anonymously, and reports website trends without identifying individual visitors. Please refer to Evergreen Health’s Privacy Policy for detailed information on its use of cookies. You can opt out of Google Analytics without impacting how you visit this website. For more information on opting out of being tracked by Google Analytics, please visit this Google page: https://tools.google.com/dlpage/gaoptout

Disclaimer

ALL CONTENT ON THIS WEBSITE IS PROVIDED TO YOU ON AN “AS IS”, “AS AVAILABLE” BASIS. THE COMPANY, ALL THIRD PARTIES, IF ANY, PROVIDING CONTENT FOR THIS WEBSITE, AND ALL THIRD PARTIES PROVIDING SUPPORT OR INFORMATION FOR THIS WEBSITE (COLLECTIVELY, “WEBSITE PARTIES”) HEREBY DISCLAIM ALL WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND NON-INFRINGEMENT.

THE WEBSITE PARTIES MAKE NO WARRANTY AS TO THE ACCURACY, COMPLETENESS, CURRENCY, OR RELIABILITY OF ANY CONTENT AVAILABLE THROUGH THIS WEBSITE. WITHOUT LIMITING THE FOREGOING, THE WEBSITE PARTIES SPECIFICALLY DO NOT REPRESENT OR WARRANT THAT ANY INFORMATION REGARDING PARTICULAR PLAN BENEFITS OR SCOPE OF COVERAGE IS ACCURATE OR COMPLETE. NO ORAL OR WRITTEN INFORMATION OR ADVICE GIVEN BY THE WEBSITE PARTIES SHALL CREATE A WARRANTY OF ANY KIND. ANY REFERENCES TO SPECIFIC PRODUCTS OR SERVICES ON THIS WEBSITE DO NOT CONSTITUTE OR IMPLY A RECOMMENDATION OR ENDORSEMENT BY THE WEBSITE PARTIES. THE WEBSITE PARTIES MAKE NO REPRESENTATIONS OR WARRANTIES THAT USE OF THIS WEBSITE WILL BE UNINTERRUPTED OR ERROR-FREE. YOU ARE RESPONSIBLE FOR TAKING ALL PRECAUTIONS NECESSARY TO ENSURE THAT ANY CONTENT YOU MAY OBTAIN FROM THIS WEBSITE IS FREE OF VIRUSES AND ANY OTHER POTENTIALLY DESCTRUCTIVE COMPUTER CODE.

Limitation of Liability

YOU AGREE THAT NONE OF THE WEBSITE PARTIES SHALL BE LIABLE FOR ANY DAMAGE RESULTING FROM YOUR USE OR INABILITY TO USE THIS WESBITE OR THE CONTENT. THIS PROTECTION COVERS CLAIMS BASED ON WARRANTY, CONTRACT, TORT, STRICT LIABILITY, AND OTHER LEGAL THEORY. THIS PROTECTION COVERS THE WEBSITE PARTIES, INCLUDING ALL AFFILIATES, AND THEIR OFFICERS, DIRECTORS, EMPLOYEES, AND AGENTS. THIS PROTECTION COVERS ALL LOSSES INCLUDING, WITHOUT LIMITATION, DIRECT OR INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL, EXEMPLARY, AND PUNITIVE DAMAGES, LOST PROFITS, OR DAMAGES RESULTING FROM LOST DATA OR BUSINESS INTERRUPTION. YOU AGREE THAT YOU USE THIS WEBSITE AT YOUR OWN RISK. IF YOU ARE DISSATISFIED WITH THIS WEBSITE OR THE CONTENT, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE USING THIS WEBSITE.

Governing Law

The laws of the State of Maryland govern these Terms and any cause of action arising under or relating to your use of this website, without reference to its conflicts of law principles. You agree that the only proper jurisdiction and venue for any dispute with Evergreen Health, or in any way relating to your use of this website, is in the state and federal courts in the State of Maryland. You further agree and consent to the exercise of personal jurisdiction in these courts in connection with any dispute involving Evergreen Health or its employees, officers, directors, and agents. If any provision of the Terms is rendered invalid or unenforceable by any state or federal statute or regulations or declared null and void by any court of competent jurisdiction, the remaining provisions of the Terms will remain in full force and effect.

Contact Us

You can contact us by writing to Evergreen Health Inc. 3000 Falls Road, Suite 1, Baltimore, MD 21211, by using our website contact form, by email to info@evergreenmd.org or by telephone on 855.475.0990.

Effective Date

The effective date of these Terms is January 1, 2015.

Help Evergreen Health Combat Insurance Fraud, Waste & Abuse

At Evergreen Health, we believe that preventing insurance fraud, waste and abuse is part of our goal to provide high quality health care to our members. Nationwide, insurance fraud, waste and abuse costs are estimated to be over $80 billion dollars per year and that increases the costs of health insurance and health care services for all of us. Insurance fraud is not only expensive, it is a crime.

What is insurance fraud?

In Maryland, insurance fraud includes fraud committed by members, providers, brokers or employees. Fraud can be committed by completing an enrollment application with false information, by submitting a falsified claim, or by enrolling as a member when you are not eligible for health insurance coverage. To prevent insurance fraud, Evergreen Health asks that everyone—employees, providers, brokers , and members—be vigilant in reporting suspected insurance fraud. Below are examples of insurance fraud – remember it can occur in many forms. You can help us identify and stop insurance fraud, waste and abuse by reporting any situation you are aware of that might be unlawful, such as:

  • Someone using a health insurance ID Card that is not theirs
  • Someone lying about personal information on a health insurance application
  • An Explanation of Benefits (EOB) showing services you did not receive or visits to a health care provider when you did not visit the health care provider
  • Not removing someone from a policy when they are no longer eligible, for example former spouses or children who are over the qualifying age limits for health insurance eligibility
  • Billing for services that were more complex than the services actually performed
  • Insurance brokers misleading or coercing people into purchasing coverage
  • Insurance brokers attempting to receive inappropriate payments on behalf of Evergreen Health
  • Insurance brokers who have inappropriately revised an insurance application
  • A member visiting multiple doctors to receive multiple prescriptions (“pill seeking” or “doctor shopping”)
  • Providers billing for services provided to their own family members
  • Providers waiving co-pays, co-insurance, or deductibles

Evergreen Health asks its members, providers, vendors and others to help us to identify any situation that may be unlawful and that may be an instance of fraud, waste and abuse so that we can investigate and take action.

Reporting Fraud, Waste or Abuse

You can report suspected insurance fraud, waste or abuse by phone, email or regular mail. You can file a report anonymously by phone or by mail if you wish, however if you do not provide us with contact information we will not be able to contact you if we need additional information to investigate your complaint.

To send a report by phone: Call the Evergreen Health Reporting Hotline at (855) 490-1549.
By mail: Send a letter with a description of the suspected fraudulent activity and all available details to:

Chief Compliance Officer
Evergreen Health, Inc.
3000 Falls Road, Suite 1
Baltimore, MD 21211

By email: Complete and submit our fraud report form. Please note that a report filed by email cannot be guaranteed anonymity as the address of the sender will appear on the message transmitted to Evergreen Health.

Under Section 1557 of the Affordable Care Act (ACA), Evergreen Health is required to post a notice of nondiscrimination and inform individuals with limited English proficiency of the availability of foreign language assistance services. The notice is available by clicking on the link below.

Notice of Nondiscrimination