Clear Spring Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Clear Spring Health does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Provides free aids and services to people with disabilities to communicate effectively with us, such as:
Provides free language services to people whose primary language is not English, such as:
If you need these services, contact Clear Spring Health. If you believe that Clear Spring Health has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Clear Spring Health, Attn: Grievance Department, P.O. Box 4107, Scranton, PA 18505, (877) 384-1241, TTY number—711, fax # (855) 382-6674. We are available 8:00 am to 8:00 pm Monday – Friday from April 1 – September 30 and 8:00 am to 8:00 pm Monday – Sunday from October 1 – March 31. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Clear Spring Health is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf (redirects to HHS website), or by mail or phone at:
U.S. Department of Health and Human Services,
200 Independence Avenue, SW,
Room 509F, HHH Building
Washington, D.C. 20201 Phone: 1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at https://www.hhs.gov/ocr/office/file/index.html (redirects to HHS website).
Your Information. Your Rights. Our Responsibilities.
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.
When it comes to your health information, you have certain rights.
This section explains your rights and some of our responsibilities to help you.
Get a copy of your health and claims records
You can ask to see or get a copy of your health and claims records and other health information we have about you. We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Request confidential communications
You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will consider all reasonable requests and must say “yes” if you tell us you would be in danger if we do not.
Ask us to limit what we use or share
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
Get a list of those with whom we’ve shared information
You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
You can complain if you feel we have violated your rights by contacting us using the contact information at the bottom of this page. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696- 6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share.
If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to
Share information with your family, close friends, or others involved in payment for your care. Share information in a disaster relief situation.
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission
Marketing purposes or sale of your information.
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
Help manage the health care treatment you receive
We can use your health information and share it with professionals who are treating you. Example: A doctor sends us information about your diagnosis and treatment plan, so we can arrange additional services.
Run our organization
We can use and disclose your information to run our organization and contact you when necessary. We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans. Example: We use health information about you to develop better services for you.
Pay for your health services
We can use and disclose your health information as we pay for your health services. Example: We share information about you with your dental plan to coordinate payment for your dental work.
Administer your plan
We may disclose your health information to your health plan sponsor for plan administration. Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to explain the premiums we charge.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html
Help with public health and safety issues
We can share health information about you for certain situations such as:
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests and work with a medical examiner or funeral director
We can share health information about you with organ procurement organizations. We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers compensation, law enforcement, and other government requests
We can use or share health information about you: for workers compensation claims, for law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law, and for special government functions such as military, national security, and presidential protective services.
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena. We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this notice and give you a copy of it. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our web site, and we will mail a copy to you.
Clear Spring Health Care
PO Box 3206
Scranton, PA 18505
If you have any questions, please call us at (877) 384-1241. TTY users should call 711.
We are open
8:00 am to 8:00 pm Monday – Friday from April 1 – September 30
8:00 am to 8:00 pm Monday – Sunday from October 1 – March 31.
Clear Spring Health is committed to detecting and fighting healthcare fraud. Working with law enforcement when necessary, Clear Spring Health evaluates all allegations of fraud, waste and abuse.
You can help us fight fraud by paying close attention to your medical and prescription drug benefits. Review every Explanation of Benefits (EOB) for accuracy. If you find a suspicious charge on your EOB, call your provider first. It could be a simple error that can be easily corrected. If you still suspect fraud after speaking with them, you can contact Clear Spring Health at 1-877-384-1241 (TTY: 711). We are available 8:00 am to 8:00 pm Monday – Friday from April 1 – September 30 and 8:00 am to 8:00 pm Monday – Sunday from October 1 – March 31. Clear Spring Health employees are trained in detecting fraud, waste and abuse and will evaluate your call and determine the appropriate course of action. To report healthcare fraud, waste, or abuse, call the Clear Spring Health Compliance Hotline at 1-866-467-6958. Reports made through the compliance hotline can be made confidentially or anonymously, 24 hours a day, 7 days a week. To submit a written report, write to: Clear Spring Health, Attn: Compliance Department, 250 South Northwest Highway, Suite 302, Park Ridge, IL 60068.
You can also contact the Office of the Inspector General Hotline (redirects to OIG website); this provides a confidential means to report information.
Clear Spring Health is the brand name used for products provided by one or more of the Clear Spring Health family of companies, including Clear Spring Health of Illinois, Inc and its affliates. The following is the issuing carrier in the markets in which Clear Spring Health offers Medicare Advantage plans.
Clear Spring Health of Illinois, Inc.
Delaware Life Insurance Company
Delaware Life Insurance Company
Delaware Life Insurance Company
EON Health, Inc.
The Code of Conduct and other resources are provided to help guide you through difficult decisions and provide ways to ask questions and report potential concerns.
You can report potential issues anonymously and without fear of reprisal, or retaliation.
You can reach us by phone or through email 24 hours a day / 7 days a week
Clear Spring Health Code of Conduct (last updated 7/11/19)