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Getting health data from other health insurance companies

Don't leave your records behind! If you’ve had health insurance at other companies, or you currently have additional health insurance coverage, we've made it easy for you to securely request your health records and share them with Florida Blue. This allows you to keep everything in one place. Plus, we’ll share it with your doctors, so they have a better understanding of your healthcare journey.

You can: 
•    Request your own records from up to 5 years ago from any of your past or other current health insurance companies. Records will include dental and vision records if they were covered by your health plan. Any existing pre-approvals (prior authorizations) will also be included, helping to ensure your care or treatment plan can continue more seamlessly with Florida Blue. 
•    Request records for your minor child(ren), or for a Florida Blue member who has authorized you as their personal representative, from up to 5 years ago from any past or other current health insurance companies.
•    Come back any time to request additional health records from these companies.
•    Share this protected health information (PHI) with your treating doctors or the third-party apps of your choice. 

Please note: Individuals 18 years or older have to request their own records unless they have a personal representative who acts on their behalf. 

Parents or guardians of minor children are viewed as personal representatives for their children under the Centers for Medicare and Medicaid data-sharing rules. 

•    Health records from past insurers from the past five years. Some health insurance companies may maintain requested data dating back to Jan. 1, 2016, so those details could also be included. 
•    Health records from other current health insurers, like Freedom Health or UnitedHealthcare of Florida.

These health records may include dental and vision records (if these benefits were covered by your overall health plan and were not part of a separate plan). Your other pre-approvals (prior authorizations) will also be included.

Not every health insurance company may participate in data-sharing using the Payer Data Exchange Application Programming Interface (API). When you authorize us to request your records, only health insurers who use the Payer Data Exchange API will share your health records, and only those regulated by CMS are required to do so. 

Get started by asking Florida Blue to request your records. It’s easy.

Set up a new Florida Blue online member account or log in to your existing Florida Blue member account to request your health data from other current or past health plans.

•    Log in to your account and go into My Account
•    From Sharing my health data, go to Data-Sharing Overview
•    Select the Health Insurance Company tab
•    Search for your past or other current health insurance company by entering the name in the text box. Be sure to have the member ID from the other company on hand.
•    Check the consent box to authorize us to request your data from them. 

We’ll securely request your health records from your previous and any other current health insurance companies for you, keeping them in one place to provide a better picture of your health journey. You can check back at any time to see the status of your request.

You can also call the number on the back of your member ID card and connect with a representative to get started.

•    Continuity of care: If you have a chronic condition or ongoing medical issue, you may want to share your previous insurance company's information with any new healthcare providers to ensure continuity of care.
•    Personal health record: You may want to collect your previous insurance company's information to create a more complete personal health record, which can be useful for tracking your medical history and making informed healthcare decisions. 
•    Medical history: Your previous insurance company's information can provide a comprehensive medical history, including diagnoses, treatments, and test results, which can be useful for new healthcare providers.
•    Pre-existing conditions: If you have a pre-existing condition, you may want to obtain your previous insurance company's information to ensure you get any extra support you need to best manage your health. 
•    Prior authorizations: You can bring any existing pre-approval (prior authorization) approvals and information with you, helping to ensure your care or treatment plan can continue more seamlessly with Florida Blue. 

You're eligible from the first day your Florida Blue coverage starts. You can authorize sharing as soon as you set up your online member account. Or you can call us to get set up. Once we process your authorization to request your health records, your prior or other current health insurance company must reply within one (1) business day. Your authorization will be valid for as long as you have coverage with us. 

The Centers for Medicare and Medicaid Services (CMS) requires us to enable secure consumer-directed data sharing. For health insurance companies, this process happens through our Payer Data Exchange Application Programming Interface (API). This API supports the portability of your health records if or when you change health plans. 

From your member account, if you provide information about your last health insurer (or other current health insurer) and submit your authorization, we'll ask them for your data. Then, you'll continue to have access to those records in the same place as your new records.

Yes. We’ll securely request your health records from your previous and any other current health insurance companies for you, using industry-standard privacy and security measures. Plus, all health insurance companies are bound by the Health Insurance Portability and Accountability Act privacy regulations. 

Yes. You have control over whether to authorize us to receive your data from or share your data with health insurers you have or had coverage with. The Payer Data Exchange Application Programming Interface (API) will only be used to receive data from your previous insurer, exchange data with your other, current insurer, and/or to send data to your future insurer, as appropriate.

You'll have to authorize us to request data from them individually from your member account or by calling us and getting help from a representative.

If you have other, current health insurance (like HealthSun or Humana), you can authorize us to get your health data from that insurer from your member account (using the same steps as you would for a past health insurer) or by contacting us. After we process your authorization, we'll import your health records for current policies about every 90 days to make sure your information is up to date.

This sharing will remain in place for as long as you have a policy with us, unless you stop sharing. You can stop sharing this data at any time. You can also restart sharing if you choose to. 
 

Yes. If you are a parent, you can act as a personal representative for your minor child and request their health records, so their information is in one place. If you’d like to share data for your child, please call the number on the back of your member ID card to get set up with data-sharing permission.

Unless you're a personal representative for the member, you won't be able to request their information on their behalf. Every Florida Blue member age 18 and older needs to request their information through their own member account.

Yes, if you're acting on behalf of a Florida Blue member and are linked to their account as a personal representative, you can request their health records, so their information is in one place.

Remember, you're in control of your health information. Sharing is not automatic. You decide what to share and when.
•    For past health insurers: This means you can ask us to import data from them. Once you authorize us to get the data, you can't stop the request, but you can choose not to ask for any additional records. To request your health records from a past health insurance company:
              o    Go into My Account 
              o    From Sharing my health data, go to Data-Sharing Overview 
              o    Select the Health Insurance Company tab 
              o    Search for your past health insurer by entering the name in the text box Be sure to have the member ID from the other company on hand 
              o    Check the consent to authorize us box to request your data from them  
  
•    For a health insurer you have other current coverage with: You can ask us to request that the company starts sharing or stops sharing your data. You can also restart sharing health records from that health insurer at any time. To request your records from another, current health insurance company:
              o    Go into My Account 
              o    From Sharing my health data, go to Data-Sharing Overview 
              o    Select the Health Insurance Company tab 
              o    Search for your other, current health insurer by entering the name in the text box. Be sure to have the member ID from the other company on hand. 
              o    Check the consent to authorize us box to request your data from them. 

To request health record updates, or to request changes to your records due to errors, you can call the number on the back of your member ID card for help.

The data includes important details about your active and recent prior authorizations which will help your providers better understand and care for your needs. This is especially helpful if you're trying to continue a treatment plan with your new provider.

Pre-approval information includes:
•    Pre-approval status changes
•    Dates of approvals and denials
•    The date or circumstance when the prior authorization ends
•    Items and services that were approved
•    If a prior authorization was denied, the reason(s) for it
•    All related administrative and clinical documentation submitted by the provider

If your personal health information (PHI) contains any denied prior authorizations, seeing this data can help your new providers understand the recommendations made by other healthcare professionals, even if you didn’t end up receiving that care. In this way, your prior authorization history may help your current provider or care team make the most appropriate choices for your current needs.

Sharing your protected health information (PHI) with third-party apps

You can request a copy of your PHI through mobile apps

Make sure you have your information at your fingertips! You can choose the third-party apps you'd like to share your medical records with, as long as they’ve been authorized by Florida Blue. This way, you can find your health information quickly, at home or on the go.

Florida Blue is here to help you understand how it works and to give you tips on how to protect your health information when you use these apps. You’ll learn:
•    The types of PHI you can access using an app
•    What steps you should take to better protect your PHI when using an app
•    How you can file a complaint if you think your PHI has been breached or misused by an app

Currently, Florida Blue Medicare Advantage and Florida Blue members who are enrolled in a Qualified Health Plan (QHP) on the Federally Facilitated Exchange (FFE) can request an electronic copy of their PHI through an app of their choice. Presently Florida Blue does not offer a proprietary third-party app for its members. 

Apps must be registered with Florida Blue to receive member health care data transfers. Members may wish to validate app status prior to initiating a new subscription if the app is not listed with Florida Blue as available for data transfers.

At the moment, Florida Blue has extended this app access feature to its current members who are enrolled in either a Qualified Health Plan (QHP) sold on the Federally Facilitated Exchange (FFE) or a Medicare Advantage (MA) Plan.   

Please note: Individuals 18 years or older have to request their own records unless they have a personal representative who acts on their behalf. 

Parents or guardians of minor children are viewed as personal representatives for their children under the Centers for Medicare and Medicaid data-sharing rules. 

You can request a copy of your PHI in accordance with the Florida Blue Notice of Privacy Practices. If you use an app to request PHI, Florida Blue may electronically provide the following information:

•    Any claims, office visit, and medical information in our records going back to January 1, 2016. Records will include dental and vision records if they were covered by your health plan. Any existing pre-approvals (prior authorizations) will also be included. What we provide to the app depends on what information the app requests and what information we have.
•    All of your medical information in our records going back to January 1, 2016, may be released, depending on what the app requests. This may include sensitive medical information, such as treatment or diagnosis information about mental health, substance use disorders, sexually transmitted diseases and more. At this time, Florida Blue cannot withhold sensitive information when responding to a PHI access request through an app, even at your request.
•    The PHI Florida Blue provides is limited to what is in our records. For a more complete picture of your health records, you may also need to request PHI from your doctors and any previous (or other current) insurers.

Florida Blue is required to disclose all claim, office visit, and clinical information (including sensitive information) that an app requests going back to January 1, 2016. If there is sensitive information you do not want an app to receive, you should not request your PHI through that app.

An app will need to register with Florida Blue before you can use it to request access to your PHI. Under certain circumstances, Florida Blue may deny an app’s registration. If you want to request PHI through an app, make sure the app you choose is registered with Florida Blue before requesting your health information. If the app has not registered with Florida Blue, contact the app’s developer so they can begin the registration process. Florida Blue is not responsible for issues that may occur with an app that delay or prevent the transmission of information. As apps register with Florida Blue and become available for PHI access, we will list them below. 

It’s important to take an active role in protecting your PHI. Look for an easy-to-read privacy policy that clearly explains how the app will use your PHI. If an app does not have a privacy policy, or if you do not understand it, you may want to reconsider using the app. Here are some issues to look for when reviewing an app’s privacy policy:

•    What health data will this app collect? Will this app collect non-health data from my device, such as my location?
•    Will my data be stored in a de-identified or anonymized form?
•    How will this app use my data?
•    Will this app disclose my data to third parties?
              o    Will this app sell my data for any reason, such as advertising or research?
              o    Will this app share my data for any reason? If so, with whom? For what purpose?
•    How can I limit this app’s use and disclosure of my data?
•    What security measures does this app use to protect my data?
•    What impact could sharing my data with this app have on others, such as my family members?
•    How can I access my data and correct inaccuracies in data retrieved by this app?
•    Does this app have a process for collecting and responding to user complaints?
•    If I no longer want to use this app, or if I no longer want this app to have access to my health information, how do I terminate the app’s access to my data?
              o    What is the app’s policy for deleting my data once I terminate access? Do I have to do more than just delete the app from my device?
•    How does this app inform users of changes that could affect its privacy practices?

If the app’s privacy policy does not clearly answer these questions, patients should reconsider using the app to access their health information. Health information is very sensitive information, and patients should be careful to choose apps with strong privacy and security standards to protect it.

Some patients, particularly patients who are covered by Qualified Health Plans (QHPs) on the Federally facilitated Exchanges (FFEs), may be part of an enrollment group where they share the same health plan as multiple members of their tax household. Often, the primary policy holder and other members can access information for all members of an enrollment group unless a specific request is made to restrict access to member data. Patients should be informed about how their data will be accessed and used if they are part of an enrollment group based on the enrollment group policies of their specific health plan in their specific state. Patients who share a tax household but who do not want to share an enrollment group have the option of enrolling individual household members into separate enrollment groups, even while applying for Exchange coverage and financial assistance on the same application; however, this may result in higher premiums for the household and some members, (i.e. dependent minors may not be able to enroll in all QHPs in a service area if enrolling in their own enrollment group) and in higher total out-of-pocket expenses if each member has to meet a separate annual limitation on cost sharing (i.e., Maximum Out-of-Pocket (MOOP).

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) enforces the HIPAA Privacy, Security, and Breach Notification Rules, and the Patient Safety Act and Rule. You can find more information about your rights under HIPAA and who is obligated to follow HIPAA here: Guidance Materials for Consumers.

HHS also has published HIPAA FAQs for Individuals, which contain information on specific topics that may interest you: HIPAA FAQs for Individuals. Here’s another helpful resource to understand your rights under HIPAA: How to get your health record.

If you want more information on how Florida Blue complies with HIPAA for our members and what Florida Blue does to protect your information, view our HIPAA Notice of Privacy Practices.

Most apps are not specifically covered by HIPAA and are not required to be covered by HIPAA. HIPAA does not cover most third-party apps. HIPAA governs health insurance plans (such as Florida Blue), health care providers (such as doctor’s offices and hospitals), and health care clearinghouses (collectively known as “covered entities”) or entities performing services on behalf of Covered Entities that involve PHI. Most third-party apps are not created by, or affiliated with covered entities, so these app developers are not likely bound by HIPAA privacy and security protections. These apps may be regulated by the Federal Trade Commission (FTC) and the protections provided by the FTC Act. The FTC Act, among other things, protects against deceptive acts (for example, if an app shares personal data without permission, despite having a privacy policy that says it will not do so). The FTC also enforces the promises that are made in an app’s privacy policies, which is why it’s important for you to review an app’s privacy policies before using it to request PHI from Florida Blue.

The FTC provides information about mobile app privacy and security for consumers here: Understanding Mobile Apps

If you’re concerned an app has violated your privacy rights or believe that your information has been breached in an app, you should consider filing a complaint with the app using the contact information it provides.
•    You can also file a complaint with the FTC using the FTC Complaint Assistant. Florida Blue has no control over the app you choose. While you may contact us if an app has misused your data or if there was a breach, we may not be able to help you.
•    If you think we violated your privacy rights, you may file a complaint with us in accordance with our Notice of Privacy Practices. Members also may file a complaint with the U.S. Department of Health and Human Services (HHS). We support your right to protect the privacy of your PHI. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
              o    Contact: Business Ethics, Integrity & Compliance
                            Florida Blue 
                            PO Box 44283 
                            Jacksonville, FL 32203-4283
                            Phone: 1-888-574-2583
•    To learn more about filing a complaint with the Office of Civil Rights (the department of HHS that enforces HIPAA), visit Filing a Complaint.

Individuals can file a complaint with OCR using the OCR complaint portal.

Ready to stop sharing data with a third-party app? 

To manage your settings:
•    Log in to your Florida Blue member account and go into My Account
•    From Sharing my health data, go to Data-Sharing Overview
•    Go to Third-Party Apps where you can make changes

You can also call the number on the back of your member ID card for help.

When you stop sharing, any protected health information (PHI), including sensitive information, will stop being sent to the app. Any PHI you've already shared may continue to be stored by the third-party app.

Any history held by Florida Blue for a previous Medicare Advantage or Florida Blue Qualified Health Plan member since January 1, 2016 is part of our database. Your Florida Blue PHI is available through a request to the app to which you subscribe. Contact your app provider and request to connect or select "Florida Blue" from the app's available health insurer connections.

To ensure the transfer, members must also make a request through their app. While the transfer from an insurer (or insurers) will happen automatically after consent on the Florida Blue portal, an app must also have its user's permission, and the app must already be registered with Florida Blue. Florida Blue security measures ensure that only applications with our member's permission can acquire PHI.

Members have the right to obtain personal health information dating to January 1, 2016 from any health insurers regulated by the Centers for Medicare and Medicaid Services (CMS). This includes health insurers offering Medicare, Medicare Advantage, Medicaid, Commercial Medicaid, Children's Health Insurance Plans and Marketplace plans sold on the Federally facilitated Exchanges established under the Affordable Care Act.

Please call the number on the back of your member ID card for help updating your information.

These apps are currently registered with Florida Blue, which means they can be used for sharing your Florida Blue health data. This list will be updated as new businesses register their apps.
•    OneRecord
•    Flexpa

Giving your healthcare providers real-time data

Give your providers a more complete picture! With your data-sharing setting On, your current doctors will have up-to-date information. This means your providers will be able to view health records related to your overall care — including information from other providers — in real-time. This can help them understand your health history and give them better insight for your care and treatment.

•    Health records from Florida Blue for any providers you’ve seen since you’ve enrolled in our plan.
If you’ve asked us to request your records from any of your past or other current health insurance companies, you’ll also be sharing:
•    Health records from past insurers (from the past five years) 
•    Dental and vision records (if these benefits were included in your overall health plan and not part of a separate plan)
•    Pre-approval (prior authorization) history

You don’t need to do anything! All of your health records that we have are securely located and any doctors you see can access your health information. Just leave your data sharing On in your member account to continue to give your doctors the most up to date information about your health. 

Sharing this information helps ensure:
•    Your doctors and other providers understand your full health journey
•    Your care can continue seamlessly if you switch insurers or providers
•    Everyone involved in your care has the same information, reducing potential administrative delays

Yes. Your providers will receive your records through a secure electronic health record. Only doctors you have seen will be able to access your health records.

The data includes important details about your active and recent prior authorizations which will help your providers better understand and care for your needs. This is especially helpful if you're trying to continue a treatment plan with your new provider. 

Pre-approval information includes:
•    Pre-approval status changes
•    Dates of approvals and denials
•    The date or circumstance when the prior authorization ends
•    Items and services that were approved
•    If a prior authorization was denied, the reason(s) for it
•    All related administrative and clinical documentation submitted by the provider

If your personal health information (PHI) contains any denied prior authorizations, seeing this data can help your new providers understand the recommendations made by other healthcare professionals, even if you didn’t end up receiving that care. In this way, your prior authorization history may help your current provider or care team make the most appropriate choices for your current needs.

Yes. If you are a parent, you can act as a personal representative for your minor child and share their health records with their doctor. If you’d like to share data for your child, please call the number on the back of your member ID card to get set up with data-sharing permission.

Unless you are a personal representative for the member, you are unable to manage sharing their health records with their doctor on their behalf. Every Florida Blue member 18 and over will need to manage their information through their own member account.

Yes. If you're acting on behalf of a Florida Blue member and are linked to their account as a personal representative, you can choose to share their health records with their doctors.

Your data sharing is automatically On starting within one week of your policy's start date. This helps your doctors have the most up-to-date information about your health. If you turn off data sharing, you can turn it back on again. 

To manage your settings:
•    Log in to your Florida Blue member account and go into My Account
•    From Sharing my health data, go to Data-Sharing Overview
•    Go to Healthcare Providers where you can see your current sharing status
If you decide to stop sharing your data in this way, other existing laws may still allow your provider to ask for and receive certain information they need to treat you. These requests will be approved to support treatment, payment, and healthcare operations.

You can stop or restart sharing this data at any time. We keep a record of your preferences and any recent changes.