Privacy Legislation

  • Stringent federal privacy regulations have recently been enacted - both through the Gramm-Leach-Bliley Act (GLBA) and the Health Insurance Portability and Accountability Act (HIPAA). The GLBA addresses the privacy of non-public personal financial information while HIPAA pertains to the privacy of an individual's personal health information. LifeWise regards member privacy highly, and employs the strictest safeguards to ensure our members peace of mind.

    Privacy of Claim Information

    In the majority of daily claims and service-related situations, your role as a group benefit administrator will not change. For example, when assisting a member checking claim status, you may contact customer service and provide the following information:

    • Member name
    • Date of service (month and year sufficient if exact date not available)
    • Provider name
    • Procedure, reason for visit (e.g. annual physical) or type of prescription

    This information verifies to us that the member has asked you to assist him or her with the claim. We can then provide you the following:

    • Date claim is received
    • Date claim is adjudicated (review and payment or denial process)
    • Payment amounts
    • Reason for denial

    These procedures will accommodate most of our business. Should you be unable to provide this information, we will not be able to release any information to you unless the member has signed a release. To generate a release, please see How to Use the Release Form.