Requesting Information on Members
Posted on September 2, 2016
As a standard practice, we will need your SAC code if you are requesting information about members. Health New England assigns SAC codes to brokerages once a group has been sold. When you call Member Services, please have your SAC code ready so we can verify your brokerage’s association with the requested group.
Once we verify your SAC number, we can provide you with basic information about a group, such as enrollment/disenrollment confirmations and status, benefit package confirmations and general benefit information.
Detailed information on specific members is considered protected health information (PHI) and you will need to submit an authorization of personal representative form in order for us to be able to release this information to you.
Examples of PHI requests include: member ID numbers, member specific claims information, member specific authorization information (medical or pharmacy), member complaints and/or appeals and member reimbursement requests (fitness, medical, etc.). Requests for replacement of member ID cards are also considered PHI requests.
Thank you for your understanding and please reach out to your sales rep with any questions.
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