Employee Handbook

14.13 Privacy Complaint Procedure

14.13.1 Policy Statement

Individuals, family members, employees, the general public, or business associates have the right to file complaints regarding Health Plan policies, procedures, or practices relative to the access, use, or disclosure of protected health information (PHI).

14.13.2 Policy Interpretation and Implementation

Designation of Person to Receive Complaints

The HIPAA Privacy Officer has been designated as the individual responsible for receiving, processing, and investigating all privacy related complaints. The Privacy Officer may in turn designate employees in particular areas to assist.



Filing of Privacy Complaints

Any individual, representative, family member, employee, business associate, visitor, or the general public may file a grievance or complaint regarding Health Plan privacy practices (e.g., denial of access to PHI, amendment of health records, problems with business associates, privacy act/ policy violations, etc.) without fear or reprisal or retaliation in any form.



Submitted Complaints

Complaints should be submitted to the HIPAA Privacy Officer in writing.



Investigation Process

The HIPAA Privacy Officer or his/her designee will begin an investigation into allegations within five (5) working days of the receipt of the complaint.



Results of Investigation

A written report of the findings of the investigation will be provided to the individual filing the complaint within thirty (30) days of receiving such complaint unless an extension is necessary to complete the investigation. Such extension may not exceed thirty (30) days.



Dissatisfaction of Investigation/Resolution

Should the individual not be satisfied with the result of the investigation, or the recommended resolution(s), he/she may file a complaint with the Secretary of Health and Human Services (HHS).



Filing Complaints with the Secretary of HHS

Complaints may be filed directly with the Secretary of HHS. Such complaints must be in writing, identify the Health Plan, and must describe the violation. Complaints must be filed within one-hundred eighty (180) days of the complainant learning of the alleged violation or should have been aware of the alleged violation.



Address of Secretary of HHS

The address of the Secretary of HHS is located in the Notice of Privacy Practices (NPP) and/or made available to individuals. Persons may also obtain the address from the HIPAA Privacy Officer.



Retention of Complaints Log

The HIPAA Privacy Officer or his/her designee will maintain a log of all complaints received. Copies of all complaints, their disposition and resolutions, and our complaint log will be maintained for a period of at least six (6) years from the date such complaint was received.



Record Retention

A copy of all HIPAA covered information and any revisions shall be maintained for a period of at least six (6) years. Such retention may be in printed or electronic format, or both.



Privacy Officer

The Privacy Officer is responsible for the development and implementation of the HIPAA policies and procedures. The Privacy Officer is also the contact person for any questions or complaints regarding HIPAA. Questions or concerns about HIPAA rights should be directed to the Privacy Officer during regular business office hours Monday through Friday, except holidays, at (651) 696-6280.




Violations of this policy will be subject to discipline.