Home Contact Site Map Search
Regence Blue Shield (in Washington) logo
Washington State For Members Need Coverage About Us
For Members
Need Coverage?
About Regence
Health plan information for employers, groups and group administrators.
Information for health care providers
For Brokers and Agents
Uniform Glossary of Terms
[an error occurred while processing this directive]

TERMS OF USE

BY USING THIS WEB SITE, YOU SIGNIFY YOUR AGREEMENT WITH THE FOLLOWING TERMS OF USE, SO PLEASE READ THEM CAREFULLY.

Acceptance of Terms. This Regence web site (this "Site") is provided subject to the terms and conditions set forth below (the "Terms"), in addition to, and not in limitation of, the provisions of any other agreement you may enter into with Regence.

Regence may modify these Terms from time to time and without notice, effective immediately upon posting on this Site. Your continued access or use of this Site shall constitute acceptance of such modifications of the Terms. Regence has the right to terminate your access or use of this Site at any time without notice.

Benefit Information. No content on this Site is intended to replace or amend language for coverage that you may have with Regence. You should always consult your benefit brochure and contract for details about what your health plan covers.

No Medical Advice. This Site does not provide medical advice and neither the information available on this Site nor any e-mail responses to your questions shall create a physician-patient relationship or constitute the practice of medicine. The information available on this Site and from any linked sites should not be used as a substitute or supplement for professional medical advice. If you have medical or health related questions, contact your physician.

User Obligations. You may not use this Site in any manner that may: adversely affect this Site's resources or the availability of this Site to others; violate any local, state, national or international law; delete or revise any content on this Site; or, use this Site to harass any other person or to collect or store personal information about other visitors. If you have a unique user identifier and/or password to access secure areas, you are responsible for protecting the identifier and/or password and for any unauthorized use by others, with or without your permission.

Some parts of this Site may allow you to post, or to e-mail to Regence, materials or information ("Visitor Content"); or to access or use Visitor Content posted or e-mailed by other visitors to this Site. You grant Regence the unrestricted right to use or distribute, free of charge, any Visitor Content posted on this Site by you. You may not submit or post any material or information which is illegal, obscene, threatening, defamatory, invasive of privacy, or infringing of proprietary rights of any person or entity, or which contains software viruses, corrupted data, cancel bots, commercial solicitations, or mass mailings or any form of "spam." You may not use a false e-mail address to impersonate any person or otherwise mislead as to the origin of any material or information you submit or post.

Regence may review, remove or edit any Visitor Content at its discretion. Regence has no responsibility and assumes no liability for Visitor Content posted by you or by any other party.

You are responsible for all software and equipment necessary to access and use this Site, including all related expenses. In addition, you are solely responsible for maintaining the confidentiality of any password or other security measure you use in connection with this Site, and agree to notify Regence immediately of any unauthorized use of your password or other security measure.

Privacy and Security. Regence manages and protects your personal information in accordance with applicable laws and established company security standards and practices. For more information about privacy and security, please visit our Online Privacy and Security Statement; or, for more information about how Regence generally manages your personal information, please visit our Notice of Privacy Practices.

No Warranty. Regence does not warrant that any Regence Content, Visitor Content or any other content posted on this Site is accurate, complete, reliable, current or error-free. Regence does not warrant this Site will meet your requirements, or that your access or use of this Site will be uninterrupted, timely, secure or error-free, nor does Regence make any warranty whatsoever regarding the quality of any products, services, information or any other material you obtain through this Site.

Limitation of Liability. Regence is not responsible for any cost or damage arising directly or indirectly from your use of or inability to use this Site or any content, or the interception of loss of any data transmitted to or from this Site. Regence shall have no liability whatsoever for failure of electronic or mechanical equipment or communication, telephone or other connection problems, computer viruses, unauthorized access or interception of data or this Site, theft, or errors. Your use of this Site, and the submission of any information by you, is at your own risk.

Copyright. All text, graphics, logos, button icons, images, audio clips, digital downloads, data compilations, indexes, desktop tools, software and any other material or information used in connection with this Site (the Regence "Content"); the selection, arrangement, and presentation of all Regence Content (including information in the public domain); and the overall design of this Site are the property of Regence and protected by U.S. and international copyright laws. Regence grants you a personal, non-transferable, non-exclusive limited license to access this Site and to download and print a single copy of Regence Content from this Site solely for: (a) your personal, non-commercial use, and provided that you do not delete or modify any copyright or other proprietary notices therefrom; or (b) as expressly permitted under any Agreement currently in effect between you and Regence. Any other copying, use, distribution or modification of Regence Content or any other property of Regence, whether in electronic or hard copy form, is strictly prohibited without the express prior written permission of Regence.

Trademarks. Regence and any other names of Regence or its web sites, publications, products, content or services referenced on this Site are the exclusive trademarks or service marks of Regence, including without limitation the "look and feel" of this Site and the color combinations, layout and other graphical elements of this Site. You may not use Regence's trademarks in any manner without the express, written permission of Regence. Other product and company names that appear on this Site may be subject to trademark or other rights of other parties.

Linking to Other Web Sites. Regence has no control over other Web sites or other resources accessed through links on this Site. Any such links are provided for your convenience only, and do not constitute an endorsement of the linked site(s) or content by Regence. Regence makes no guarantees and disclaims any implied representations or warranties about the accuracy, relevance, timeliness, completeness, or appropriateness of these sites, the information contained in them or the products or services they provide. Regence shall not be liable, directly or indirectly, for any damage or loss incurred by you in connection with web sites or resources accessed through links on this Site.

Linking to and Framing of this Web Site. You may not frame any Regence Content, or use any trademark, logo or other proprietary information on this Site, without Regence's express written consent. You may not use Regence's name or trademarks in any meta-tags or other hidden text without the express written consent of Regence. You may link to this Site for non-commercial purposes only. Regence reserves the right to demand you remove any such link at any time, for any or no reason, and at Regence's sole discretion.

Compliance with COPPA. This Site is not directed at children under the age of 13. Regence complies with the Children's Online Privacy Protection Act and does not knowingly permit registration or submission of personally identifiable information by anyone under 13 years of age.

Governing Law and Disputes. These Terms, and any dispute that may arise between you and Regence, will be governed by the laws of the State of Oregon without regard to conflict of laws principles. The Terms, as may be amended from time to time, set forth the entire understanding between you and Regence as to the subject matter of the Terms, unless otherwise specifically provided under a written agreement, and supercede any prior agreements between you and Regence, whether oral or written, as to the subject matter of the Terms. Jurisdiction and venue will be in the courts of Multnomah County, Oregon for any disputes arising out of or relating to these Terms.

Miscellaneous. If any provision of the Terms is found to be invalid or unenforceable, the remainder of the Terms shall remain in full force and effect, and all Terms shall be enforced to the fullest extent permitted by law. No waiver or failure to assert any provision of the Terms shall be valid unless in writing and signed by an officer of Regence. Regence may assign its rights and duties under the Terms to any party, at any time, without notice. Regence reserves all rights not expressly granted in these Terms.

The Regence Group is an independent corporation operating under a license from the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans (the "Association"), permitting Regence and its affiliated health plans to use the Blue Cross and/or Blue Shield service marks in their respective service areas. The Regence Group is not an agent of the Association.


ONLINE PRIVACY AND SECURITY

At Regence, protecting your personal information is important to us. Whether you are a current customer or just visiting this Site, we are as committed to protecting the information you provide through this Web site as when you provide it to us over the phone, in person or through the mail. However, we recognize, and want you to recognize, that while electronic communications have many benefits, they are not as secure as other means of communication. Please read the following information carefully to better understand how using this Site affects your privacy.

Security Practices.
Regence attempts to protect online information according to applicable laws and established company security standards and practices. We have security measures in place to protect against the loss, misuse, or alteration of information under our control, and we continually evaluate new technologies for safeguarding your information. However, we cannot guarantee the confidentiality or security of electronic transmissions via the Internet because they may potentially use unsecure computers and links, and data may be lost or intercepted by unauthorized parties during such transmission. If you wish to submit personal or confidential information by a more secure means of communication, please contact us.

Sensitive information you provide to us online is protected by Secure Socket Layer (SSL) technology. SSL is the leading security protocol for data transfer on the Internet. This technology scrambles your account information as it moves between your PC's browser and Regence's computer systems. When information is scrambled, or encrypted in this way, it becomes nearly impossible for anyone other than Regence to read it. This secure session helps protect the safety and confidentiality of your information when you interact with Regence online.

Cookies.
A cookie is a small text file that the Regence system sends to your computer to collect information about your activities on this Site, or to make it possible for you to purchase products or services from this Site and to track such purchases. The cookie transmits this information back to this Site each time your browser requests a page from this Site, and the information is stored to help facilitate your use of this Site the next time you visit. In addition to information you provide, Regence may use cookies or other passive means to collect general information such as: the name of the domain and host from which you access the Internet; the IP address of the computer you are using; the browser and operating system you are using; the date and time you access this Site; and the Internet address of the Web site from which you linked to this Site.

Regence uses cookies so you won't have to reenter information each time you visit this Site. If you do not want to receive cookies from this Site, you can set your browser to not accept cookies.

Use of E-Mail.
Please use your own best judgment when sending information via the Internet to an e-mail address. E-mail sent via the Internet may pass through private and public networks with varying levels of security. Some networks may have taken steps to secure e-mail transmissions while others have not, thereby compromising the privacy and integrity of an e-mail. An e-mail may be copied, altered or destroyed. Regence will respect your request not to be contacted by e-mail.

Once your e-mail is received, Regence preserves the content of your e-mail, your e-mail address and our response so we can efficiently respond to questions you might have. We also do this in an effort to meet legal and regulatory requirements.

Updates to the Statement.
Evolving technology will continue to provide Regence with new and better ways to safeguard your information. We may update this statement in the future to reflect these technological advances, and we encourage you to return to this page from time to time for any updates.


CONSUMER PRIVACY NOTICE

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.

We, at Regence BlueShield, know you value your privacy.  That is why we are committed to the confidentiality and security of your personal information.  We maintain physical, administrative and technical safeguards to protect against unauthorized access, use, or disclosure of your personal information. 

We collect personal information, such as your name, contact information, and health information, from you, your health care providers, and other insurers that provide you coverage.  We are required by law to maintain the privacy of this protected health information and to explain our legal duties and privacy practices.  We provide the protections and apply the practices described in this notice to all personal information that we maintain, including to personal information of former members who are no longer covered by us.  We hope this notice will clarify our responsibilities to you and give you an understanding of your rights.  We abide by the notice that is currently in effect.  This notice is in effect as of April 1, 2006. 

Your Rights

Inspection and Copies.  You have the right to request an inspection or copies of protected health information that we maintain about you in a “designated record set” except psychotherapy notes and information that we compiled in anticipation of, or for use in, a civil, criminal, or administrative proceeding.  A “designated record set” is a group of records that is used to administer your health benefits, including enrollment information and claims.  We may limit the information that you can inspect or copy if we have reason to believe that is necessary to protect you or another person from harm.  If we limit your right to inspect or copy, you can ask for a review of that decision.

Amendment.  If you believe that protected health information we maintain about you in a designated record set is inaccurate or incomplete, you have the right to request an amendment to correct or complete the information.  You must submit your request in writing and explain the reason for the amendment.  If the amendment is made, we will make reasonable efforts to inform others, including people you identify, that the information has been amended and we will use our best efforts to include the amendment with any future disclosure.  We may decline to amend information under certain circumstances.  This is likely to occur if we did not create the original record.  If we decline to amend the information, you have the right to submit a statement of disagreement.  You should know that we are allowed to attach a rebuttal statement in response to your statement of disagreement. 

Notice.  You have the right to receive a paper copy of this notice upon request. 

Accounting.  You have the right to request a list of certain disclosures of protected health information.  The list will not include disclosures made for treatment, payment, or health care operations.  It also will not include disclosures made pursuant to an authorization, made prior to six years before the date of the request, incidental disclosures, disclosures made for national security or intelligence, disclosures made to a correctional facility or disclosures made prior to April 14, 2003.  The list will include the date of any accountable disclosure, to whom that disclosure was made, a brief description of the information disclosed, and the purpose for that disclosure (provided this information is known to us).  We will supply this list free of charge once a year at your request.  If you request an accounting more than once in a 12-month period, we may charge a reasonable fee. 

Special Handling.  You have the right to request restrictions on our use or disclosure of protected health information in addition to the restrictions imposed by law.  We are not required to agree to your request and we may be unable to do so.  If we do agree, we will comply with your request except in the case of emergency.  You also have the right to request that we communicate with you in confidence.  We will make every effort to accommodate your request if it is reasonable and you provide an alternate means to communicate.  You should know that redirecting communication may not prevent others on your policy from discovering that you sought medical care.  Accumulated deductibles and co-payment information may reveal that you obtained services.  In addition, historic claims reports may include services which were obtained during the time communications were redirected.

Complaints.  You have the right to submit a complaint if you believe we have violated your privacy rights.  To submit a complaint, write to: The Regence Group, Privacy Office, P.O. Box 1071, Mailstop E12B, Portland, OR 97207 or call our Customer Service department at the phone number provided at the end of this notice.  You also have the right to submit a complaint to the Secretary of the U.S. Department of Public Health & Human Services.  Be assured that we will not retaliate against you for submitting a complaint.

Permitted Uses and Disclosures

To administer health benefits, we collect, use and disclose protected health information for a variety of purposes: 

Treatment.  We may disclose protected health information to a health care provider in order for the provider to treat you.  We may also use or disclose protected health information in an effort to provide preventive health, early detection, and case management programs.

Payment.  We may use or disclose protected health information for payment purposes, including to adjudicate claims, issue Explanation of Benefits, or coordinate benefits with other entities responsible for paying your claims.

Health Care Operations.  We may use or disclose protected health information to facilitate operations, including underwriting, customer service, and detection or prevention of fraud or abuse.

Business Associates.  Occasionally, we contract with business associates to perform insurance-related functions on our behalf.  We may disclose protected health information to these business associates in order to allow them to perform these functions.  They also may collect, use or disclose protected health information on our behalf.  We contractually obligate our business associates to provide the same privacy protections that we provide.

Plan Sponsors and Group Health Plans.  If you are enrolled in a group health plan, we may disclose protected health information to the group health plan or plan sponsor to facilitate administration of the plan.  For example, we supply enrollment lists so that premiums can be paid appropriately.

As Permitted or Required by Law.  We use or disclose protected health information as permitted or required by law.  For example, some laws require that we disclose protected health information to your personal representatives or to certain government agencies. 

Public Health Activities.  We may disclose protected health information for public health activities.  These activities include prevention and control of disease, activities performed by coroners, activities performed by organ or tissue donation and transplantation services, activities performed by the Food and Drug Administration, medical research, research intended to improve the health care system, activities necessary to avert a serious threat to the health or safety of a person, and activities relating to workers’ compensation benefits. 

Health Oversight.  We may disclose protected health information to health oversight agencies.  These agencies are authorized by law to conduct audits; perform inspections and investigations; license health care providers, insurers and facilities; and to enforce regulatory requirements.  These agencies include: State Commissioner of Insurance, State Board of Medicine, and the U.S. Department of Labor.

Health Related ServicesWe may use protected health information to provide information about treatment alternatives or other health related benefits or services that may be of interest to you.  This may include enhancements to your health plan and health related products or services available only to health plan members that add value to, but are not a part of, your benefit plan. 

Legal Proceedings.  We may disclose protected health information in the course of a judicial or administrative proceeding, and in response to a court order, subpoena, discovery request, or other lawful process.

Law Enforcement.  We may disclose protected health information to law enforcement officials in response to an administrative subpoena, a warrant, or an administrative request intended to identify or locate a suspect, victim, or witness.  We also may disclose protected health information for the purpose of reporting a crime on our premises.

Military and National Security.  We may disclose protected health information to armed forces personnel for military activities and to authorized federal officials for national security and intelligence activities.

Correctional Institution.  If you are an inmate, we may disclose protected health information to your correctional institution for treatment purposes or to ensure the safety of yourself and others.

Marketing.  We do not use or disclose protected health information for marketing purposes without your authorization.  However, we may communicate with you face-to-face about products or services that may interest you or we may send you a promotional gift of nominal value.

Others Involved in Your Health Care.  We may disclose protected health information to personal representatives such as appointed guardians, executors, conservators, and in many cases parents of minor children, as well as to attorneys in fact when a valid power of attorney exists.  In addition, if you give us verbal permission or if your permission can be implied (for example, while you are unconscious during an emergency), we may disclose protected health information to family members or others who call on your behalf.  This permission is valid only for a limited time.  If you want to authorize on-going disclosures to family members or friends, you must submit written authorization.

Authorizations.  You may give us written authorization to use protected health information or disclose protected health information about yourself to anyone for any purpose.  An authorization remains valid for two years unless the authorization states otherwise or you revoke it.  You may revoke an authorization at any time by submitting a written revocation, but a revocation will not affect any use or disclosure permitted by the authorization while it was in effect.  An authorization is required for us to use or disclose your protected health information for purposes other than those described in this notice.

Future Changes

We reserve the right to change our privacy practices and this notice at any time without advance notice.  If we make a material change to our privacy practices, we will send a new, updated notice.  The new notice will apply to all protected health information in our possession, including any information created or received before the revised notice became effective.

Contacting Us

You may reach us during regular business hours by calling our Customer Service department at (800) 458-3523.  For more information about this notice or to file a written privacy-related complaint, you may write to: Privacy Official, The Regence Group, P.O. Box 1071, MS E12B, Portland, OR 97207.

 


SERVICE AREAS

Regence BlueShield provides services to its members and contracts with providers in the following Washington counties: Clallam, Columbia, Cowlitz, Grays Harbor, Island, Jefferson, King, Kitsap, Klickitat, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Skamania, Snohomish, Thurston, Wahkiakum, Walla Walla, Whatcom, Yakima.