Health Education Resources


Want to know how we protect your privacy? Wondering what your rights and your responsibilities are as a BlueCross BlueShield of Western New York member? You'll find the answers you need to these questions, as well as a variety of others, below.

At BlueCross BlueShield of Western New York, we're dedicated to ensuring our members are well educated when it comes to issues that impact their health.

In this section, you'll find a variety of information about:

  • Your rights and responsibilities as a member
  • How we protect your personal information
  • How we continuously strive to improve the quality of care and service we provide

You'll also find information about the Joint Commission's award-winning patient safety program, Speak Up, which urges you, as a member-patient, to take an involved and informed role in your healthcare.

Learn More about 2013 Health Care Quality Improvement Overview
Learn More about 2013 Summary of Collaborative and Coalition Activities

We Keep Your Information Confidential

BlueCross BlueShield is committed to maintaining the confidentiality of patient information in all situations, such as in your doctor’s office, the hospital, with our employees and everyone we contract with to provide and manage your health care. We will only release such information in accordance with state and federal law and the guidelines established by BlueCross BlueShield. Here’s a summary of some of the guidelines we follow to keep your personal information confidential: Inclusions in routine notifications of privacy practices:

The Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information.

For example:

  • Uses and Disclosures of Protected Health Information (e.g., treatment, payment, health care operations)
  • Individual Rights (e.g., member access, accounting of disclosures, confidential communications)

A copy of the Notice of Privacy Practices is now included in your initial enrollment package, or may be viewed from this web site by clicking here. You may also request a copy by calling the telephone number on the back of your identification card.

The right to approve release of information (use of authorizations):

An authorization is not required for treatment, payment or health care operations and in other instances as required by law. An authorization is required for the release of information in certain circumstances.

For example:

  • When releasing information to someone other than the individual and as otherwise permitted by law
  • When releasing sensitive information (e.g., HIV/AIDS, Alcohol/Substance Abuse)

Forms authorizing the release of these types of information are available here.

Access to Medical Records:

BlueCross BlueShield does not generate or modify, nor do we maintain complete copies of your medical records. We receive copies of your medical records in order to process claims and perform other routine functions in the normal course of business. If you want to obtain copies of your medical records, you should contact the practitioner or facility considered to be the source of these documents.

Protection of oral, written, and electronic information across the organization:

Corporate information assets in oral, written and electronic form are protected by establishing and enforcing corporate security and privacy policies and procedures, implementing security and privacy awareness training for all workforce members, and deploying the appropriate physical, administrative and technical security mechanisms.

Information for employers:
Protected health information is not released to employers unless you have authorized the release and/or the proper agreements are in place as permitted by law. When information is released to employers, it is released with certain restrictions so confidentiality will be maintained. However, enrollment/dis-enrollment and premium quote information is an allowable disclosure under certain law.


As a member, you have certain rights and responsibilities that will help you make the most of your health benefits.

YOUR MEMBER RIGHTS

You have the right to:

  • Receive information about the health plan, its services, its practitioners and providers, and member's rights and responsibilities.
  • Treatment with respect, consideration, dignity and right to privacy.
  • Information about all services available through your health plan, including how to obtain emergency and after-hours care.
  • Confidentiality of your medical records.
  • Candid discussions concerning appropriate or medically necessary treatment options for your condition(s), regardless of cost or benefit coverage.
  • Voice complaints or appeals about the health plan or the care provided.
  • Request to see your primary doctor instead of another member of his/her office staff for an office visit, if you are willing to wait for an available appointment.
  • Make recommendations regarding the health plan's member right and responsibilities policies.

YOUR PATIENT RIGHTS

As a patient, you have a right to expect the following from your physician or other provider:

  • To participate in decisions concerning your health care.
  • To refuse treatment to the extent permitted by law, and to be informed of the medical consequences of that action.
  • To obtain from your physician or other health care provider complete and current information concerning a diagnosis, treatment, or prognosis, in terms you can reasonably be expected to understand. When it is not advisable to give such information to you, the information shall be made available to an appropriate person on your behalf.
  • To receive information from your physician or other provider necessary to give informed consent prior to the start of any procedure.
  • To know the name and qualifications of all your caregivers. Information can be obtained from the provider or the administrator of any healthcare facility.
  • If you feel that your physician has not given you the kind of service you have the right to expect, you have the right to follow the complaint procedure for Quality of Care Access Review. Please refer to your member handbook or contact Customer Service.

YOUR MEMBER RESPONSIBILITIES

  • Establish yourself as a patient of the primary doctor you have selected by making an appointment with the doctor as soon as possible.
  • Follow the instructions and guidance of healthcare providers.
  • Provide honest and accurate information concerning your health history and status.
  • Participate in understanding your heath problems and developing mutually agreed upon treatment goals.
  • Follow carefully your health plan's policies and procedures as described in your member handbook and your contract(s) and rider(s).
  • Be sure your Primary Care Physician coordinates any health care you receive in order to receive the highest level of benefits, if applicable.
  • Carry your member ID card with you and present it when seeking health services.
  • Advise your health plan of any changes which affect you or your family such as birth, change of address, or marriage.
  • Submit all bills you have received from a non-participating provider within one year from the date of service.
  • Notify your health plan when anyone included in your coverage becomes eligible for Medicare or any other group health insurance.
  • Keep your health plan informed of your concerns about the medical care you receive.
  • Pay appropriate co-payments or coinsurance to providers when services or supplies are received.

 

The Joint Commission's award-winning patient safety program is educational and informative. The topics included are:

  • Help prevent errors in your care
  • Help avoid mistakes in your surgery
  • Information for living organ donors
  • Five Things you can do to Prevent infection
  • Help avoid mistakes with your medicine
  • What you should know about research studies
  • Planning your follow-up care
  • Help prevent medical test mistakes
  • Know your rights
  • Understanding your doctors and other caregivers

More information on The Joint Commission's Speak Up program is available online at: www.jointcommission.org/GeneralPublic/Speak+UP. You can also call 1-877-878-8785 (toll free) and leave a message detailing your request, and a copy of your request will be sent to you.


BlueCross BlueShield is working with you to keep health care affordable.

  • We’ll show you how proactive health care can lower the costs of your benefits plan.
  • We can provide information and tools to help you engage your employees in managing the cost of their health care.

Why Are Health Care Costs Rising?
America is spending more on health care; it’s not a temporary phenomenon. Medical expenditures are rising due to:

  • More technologically-advanced care.
  • Increased use of new, expensive prescription drugs.
  • Increased use of hospital services, equipment and specialty care.

What Can Be Done
Working together, employers, insurers, providers and consumers can help slow growing costs.
We can help your employees make healthier choices and become smarter healthcare consumers through proactive programs and services like:

  • Proactive Health Management Programs
  • BlueLife Health Education and Wellness

We Can Do It Together
There are many ways we can help your employees become better educated about the cost of health care and lead healthier lives. Listed here are just some of the proactive programs BlueCross BlueShield is pleased to offer members as part of their benefits package:

Proactive Health Management Programs
Our programs are designed to help our members manage their health and avoid preventable problems. We offer programs for members with:

  • Asthma
  • Diabetes
  • Depression
  • Pregnancy
  • Congestive heart failure
  • Life limiting illnesses

 We also provide preventive health reminders for:

  • Breast and cervical cancer
  • Flu and pneumonia
  • Child and adolescent well care
  • Osteoporosis Screenings

Health Education and Wellness Seminars
Our wellness programs help members take an active role in getting fit and staying healthy. We have partnered with a number of local community providers to help members:

  • Smoking cessation
  • Manage chronic diseases
  • And more

Depending on your group’s benefits package, some programs can be brought right to your worksite.

Let Us Give Your Company’s Benefits Program A Check-up
We’ll show you how proactive health care can lower the costs of your benefits plan. Call 1-888-249-2583 to meet with a representative today.

Department of Health: Office of Minority Health
Find out about the U.S. Department of Health and Human Services' Office of Minority Health (FOMH). Along with health promotion and risk reduction issues of special concern to minority populations, FOMH also offers workshops to organizations.

Multiple Language Health Brochures
Electronic access to over 200 health education brochures in 24 different languages.

CDC Languages
This web site provides information in the seven most common languages spoken in the United States. There also are links to 15 additional languages with the respective health-information documents in English.

BlueCross BlueShield of Western New York has implemented a formal process for reviewing grievances and appeals from our members. This process offers a uniform approach, along with equal treatment of all grievances and appeals.

Click the link below to learn more about our procedure, how to file a grievance, what happens after you file one, and the appeals process.

Grievance Procedure Information


BlueCross BlueShield is working with you to keep health care affordable.

  • We’ll show you how proactive health care can lower the costs of your benefits plan.
  • We can provide information and tools to help you engage your employees in managing the cost of their health care.

Why Are Health Care Costs Rising?
America is spending more on health care; it’s not a temporary phenomenon. Medical expenditures are rising due to more technologically advanced care; newer, more expensive prescription drugs; and increased use of hospital services, equipment and specialty care.

What Can Be Done
Working together, employers, insurers, providers and consumers can help slow growing costs. We can also help your employees make healthier choices and become smarter healthcare consumers through proactive programs and services, such as:

Proactive Health Management Programs
Our programs are designed to help our members manage their health and avoid preventable problems. We offer programs for members with conditions like asthma and diabetes. We also provide preventive health reminders for well care and cancer screenings.

BlueLife Health Education and Wellness Seminars
Our BlueLife program helps members take an active role in getting fit and staying healthy. Depending on your group’s benefits package, some programs can even be brought right to your worksite.

Let Us Give Your Company’s Benefits Program A Check-up
We’ll show you how proactive health care can lower the costs of your benefits plan. Call 1-888-249-2583 to meet with a representative today.

There are many available resources throughout the Erie County region that offer transportation services for individuals. To learn more, please view the Transportation Services document which provides additional information.


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