Member Confidentiality

A reminder about the confidentiality of member information and access to medical records:

Health New England is committed to protecting the privacy of our members at all times and in all settings. As part of that commitment, we require all of our providers to protect the confidentiality of member information and medical records in accordance with state and federal law.

When a member joins HNE, they agree that HNE and its affiliated providers may obtain and use their personal health information, which consists of medical, claims, benefit or other information that can identify an individual member, and disclose this information to necessary persons and entities, in accordance with the law, for the following purposes:

• For general plan administration purposes, including processing and paying claims, verification of enrollment and eligibility, coordination of benefits with other benefit plans, subrogation, reinsurance, financial auditing, and member satisfaction processes.
• For quality management.
• For utilization management.
• For disease management activities.
• To furnish information to providers who are treating HNE members.
• When required by law, such as to respond to a court order or subpoena.

Other than the instances noted above, HNE will not disclose a member’s personal health information unless a specific consent is received from the member.

In addition, under Massachusetts law, a member has a right to obtain a copy of his or her medical records.

If you would like a copy of HNE’s formal confidentiality policy, you may request a copy from HNE’s Customer Service Department.