This notice describes:
- how health information about you may be used and disclosed
- your rights related to your health information
- how to file a complaint about a violation of the privacy or security of your health information, or of your rights concerning your information
You have the right to a copy of this notice (in paper or electronic form) and to discuss it with our Privacy Officer. For any questions, please call Alliance at 800-510-9132 or email [email protected].
Effective Date of This Notice: February 16, 2026
Alliance Health (“Alliance”) is required by law to keep your health information private and to share this notice of its legal duties and privacy practices. If you have questions about any part of this Notice or if you want more information about the privacy practices at Alliance, please contact the Privacy Officer at 800-510-9132 or in writing to 5200 W. Paramount Parkway Suite 200, Morrisville, NC 27560.
Understanding Your Medical Record/Health Information
Each time you visit a health care provider, a record of your visit is made. This record may cover your symptoms, assessment, diagnosis, treatment plan, and treatment recommendations. These records may also disclose (share) or reveal that you receive public welfare benefits. This protected health information (PHI), often called your medical record, serves as a basis for planning your treatment, a way to communicate between providers involved in your care, a legal document describing your care and services, and documentation for you or a third-party payer to show that the services billed were provided to you. It can also be used as a source of data to make sure Alliance is watching the quality of services and tracking outcomes. Understanding what is in your medical record and how, when and why Alliance uses the information helps you make informed decisions when deciding if your information can be disclosed to others. Your health information will not be disclosed without your consent unless required or allowed by State and Federal laws, rules or regulations.
Our Responsibilities
Alliance must protect and secure health information that Alliance created or received about your past, present, or future health condition, health care provided to you, or payment for your health care. Alliance is only allowed to use and disclose protected health information as described in this Notice. This Notice is posted on the Alliance Health website, and a paper copy of this Notice will be shared with you if you ask.
The laws and regulations that Alliance must follow for how we use and disclose your information include the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), 42 USC 1320d et seq., 45 CFR Parts 160 & 164, as amended by the Health Information Technology for Economic and Clinical Health Act, the Federal Confidentiality of Substance Use Disorder Records 42 USC 290dd-2, 42 CFR Part 2 (“Part 2”), and North Carolina General Statutes 122C.
How Alliance Health May Use or Share Your Health Information
The sections below describe ways that Alliance may use or disclose (share) your health information. Only the information needed will be disclosed. Not every use or disclosure in a category will be listed below but all the ways Alliance can use and disclose information will fall within one of the categories. Once your information has been disclosed, it may lose its protection under HIPAA and be further shared by the recipient unless the information is protected by other State or federal privacy laws.
Alliance can only use or disclose alcohol and drug abuse records with your consent or as allowed under federal law. The ways Alliance can share your substance use information are listed in a separate section below.
Treatment: Alliance is not a treatment provider, but sometimes Alliance will need to disclose your information with professionals to:
- make a referral for an assessment
- help create a treatment plan
- coordinate care, treatment, and services
- set up an appointment with health care providers
- help with emergency treatment services
Alliance may also communicate and disclose information with providers that meet the definition of facility under NCGS Chapter 122C. These include hospitals, licensed facilities, licensed practitioners and community-based service providers. When these services are contracted, Alliance may disclose your health information to its contractors so they can provide you with your services. Alliance and the law require the contractor to protect your information.
Alliance may disclose your PHI with another HIPAA Covered Entity such as your Primary Care Physician or another type of health provider. If you do not want Alliance to share your PHI with these types of providers, you must ask for and sign a form that will be kept on file. Contact Alliance at 800-510-9132 to be sent this form.
Payment Functions: Alliance may use or disclose health information about you to decide if you are eligible for plan benefits, to allow payment for treatment and services, to determine plan responsibility for benefits, and to coordinate benefits. Health information may be disclosed with other government programs such as Medicare, NC Medicaid, and Prepaid Health Plans to manage your medical necessity of health care services, to find out if a treatment is experimental or investigational, or to determine if a treatment is covered under your plan.
Health Care Operations: Alliance may use and disclose health information about you to carry out needed managed care and insurance-related activities, such as:
- activities relating to plan coverage
- quality assessment and improvement activities such as handling, investigating, and looking into complaints
- medical reviews, legal services, audit services, and fraud and abuse detection programs
- business planning, management, and general administration
Required by Law: Alliance may use and disclose your health information as required by law. Some examples where your information may be disclosed are:
- if the law requires it
- to report certain types of wounds or other physical injuries
- to report to the Department of Social Services suspected child abuse or neglect, or suspected abuse or neglect of a disabled adult
- when a member or recipient is examined or committed for inpatient treatment
Public Health: Your health information may be reported to a public health authority or other government authority as allowed by law in order to:
- prevent or control disease, injury or disability
- report problems with products and reactions to medicines to the Food and Drug Administration
- report disease or infection exposure
Health Oversight Activities: Alliance may disclose your health information with health, regulatory, and oversight agencies during audits, investigations, inspections, licensure, and other proceedings related to oversight of the health care system. For example, health information may be reviewed by investigators, auditors, accountants or lawyers who make sure that Alliance follows all required laws and that Alliance does not share your information in a way that violates this Notice.
Judicial and Administrative Proceedings: Alliance may disclose your health information in response to a court order in the course of any administrative or judicial proceeding, in the course of any administrative or judicial proceeding required by law (such as a licensure action), for payment purposes (such as a collection action), or for purposes of litigation (a law suit) Alliance is part of that relates to health care operations where Alliance is a party to the proceeding.
Public Safety/ Law Enforcement: Alliance may disclose your health information to prevent or lessen a serious or imminent danger or threat to the health or safety of a person or the general public or when a felony or violent misdemeanor (offense) is likely.
Specialized Government Functions: Alliance may disclose your health information for certain military and veteran activities, for national security purposes, and for health and safety purposes at correctional institutions.
Worker’s Compensation: Alliance may disclose your health information as needed to comply with worker’s compensation or similar laws.
Research: In some situations, and only after a special approval process, Alliance may use and disclose your health information to help with research.
NC Health Information Exchange Authority (NC HIEA): The NC HIEA operates NC HealthConnex, an electronic system that allows health care providers to share patient health information. Alliance is required by law to send your health information to the NC HIEA. Your information may be seen by your health care providers in NC HealthConnex to help them with your care. If you do not want NC HealthConnex to share your information with your health care providers, you must opt out by sending a form to the NC HIEA. You can learn more and access these forms online at NCHealthConnex.gov. You may also contact our Privacy Office at 800-510-9132. Even if you opt out of NC HealthConnex, Alliance must still send your information to the NC HIEA, but providers will not be able to see it. Your health information may be used by the NC HIEA for public health or research purposes as allowed or required by law. For more information on NC HealthConnex, please visit NCHealthConnex.gov/patients.
Use and Disclosure of Substance Use Disorder Health Information
Federal laws require or allow Alliance to disclose your health information, including alcohol and drug abuse records, with others in certain situations in which you do not have to give consent or have the chance to agree or object. Before disclosing your health information under one of these exceptions, Alliance will consider each request to make sure that only needed information will be disclosed. These situations include:
- to report abuse, neglect or domestic violence to a county Department of Social Services or to law enforcement
- to respond to a court order
- for research, audit, and program evaluation
- to a health care provider for emergency medical services
- to law enforcement if Alliance learns that you might commit a crime on Alliance property or against an Alliance employee
- for internal communications, as outlined above
- to qualified service organization agencies when appropriate (these agencies must agree to follow Federal law)
- to public health authorities (Alliance will remove information that identifies you if your information is shared for public health reasons)
In all other situations, Alliance is required to get your consent before your substance use information can be disclosed. These situations include but are not limited to:
- Treatment: to make a referral for diagnosis, to help create a treatment plan, or to coordinate appropriate and effective care, treatment, and services
- Payment: for the treatment and services you get from health care providers and to manage benefits
- Healthcare Operations: such as population-based activities for improving health care or for disclosures made to fraud and abuse detection programs
If you choose to sign a release of information to allow Alliance to disclose your information for treatment, payment, and healthcare operations, you can sign one release that will allow your information to be disclosed for all future treatment, payment, and healthcare operations purposes. Please be aware that when other Part 2 Programs, other HIPAA covered entities, or business associates receive your substance use information under a single release of information for treatment, payment, or healthcare operations purposes, those records may be further disclosed by those agencies without your consent as allowed under HIPAA.
Alliance will not use or share your substance use information in civil, criminal, administrative, or legislative proceedings unless Alliance has your consent or a court order. Records will only be disclosed under a court order after you have been provided with notice and have an opportunity to be heard. The court order must also be accompanied by a mandate compelling disclosure.
Other types of uses and disclosures of your substance use information that need your consent include sharing with family members, for disability determination purposes, with a county Department of Social Services, or with probation and parole officers.
North Carolina Treatment Outcomes & Program Performance System (NC-TOPPS)
NC‐TOPPS assessments fall under the audit or evaluation exception of federal confidentiality regulations (42 CFR Part 2 and 45 CFR Parts 160 and 164). Your identifying information collected via NC-TOPPS assessments may be disclosed without your consent to the North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS) and to authorized contractors. The DMH/DD/SAS or its authorized contractors may redisclose any member/beneficiary‐identifying information only to the chosen provider facility and to the member/beneficiary’s assigned LME/MCO for which this information has been sent.
When Alliance Health May Not Use or Disclose Your Protected Health Information
Except as described in this Notice, Alliance will not use or disclose your health information without written consent from you. If you do allow us to use or disclose your health information, including substance use information, for other purposes, you may revoke (take back) your consent in writing at any time. If you revoke your consent, Alliance will no longer be able to disclose share health information about you for the reasons covered by your written consent. Alliance will not be able to take back any disclosures already made with your permission.
- Your consent is needed for most uses and disclosures of psychotherapy notes and substance abuse counseling notes.
- Alliance may contact you for appointment reminders, to give you information about treatment choices, or to give you information about health-related benefits and services.
- If Alliance receives payment from a third party to share information about other products or services (other than drug refill reminders or generic drug choices), your consent will be needed before your information is shared with this third party.
- Alliance will not sell your information.
- Federal laws do not allow Alliance to use or disclose (share) genetic information to make decisions about your eligibility for enrollment as a member or approval of benefits and services. However, genetic information can be used or disclosed to decide if a benefit and service you request is medically appropriate for you. Your consent is needed for most uses and disclosures of substance use disorder records (except as listed above).
Statement of Your Health Information Rights
Although your health information is the physical property of Alliance, the information belongs to you. You have the right to request, in writing, certain uses and disclosures of your health information.
Right to Request Restrictions: You have the right to request a restriction (limit) on some uses and disclosures of your health information, including substance use information. Alliance does not have to agree to the restrictions that you ask for unless your request relates to disclosure of your protected health information to a health plan or other payor for purposes of payment or health care operations for health care that you or your representative have paid for in full and out-of-pocket. If you would like to make a request for restrictions, you must send your request in writing to the Privacy Officer at the address listed below. You will be told if Alliance can comply with the restriction or not.
Right to Request Confidential Communications: You have the right to ask that we send your health information to you in a different way than the way we normally send you your health information. You must send your request in writing to the Privacy Officer at the address below with your instructions on how we can send you your health information. Alliance must agree to your request if it is reasonable.
Right to Inspect and Copy: You have the right to inspect (look over) and be sent an electronic or paper copy of your health information that may be used to make decisions about your plan benefits. You must submit your request in writing to the Privacy Officer at the address listed below. If you request a copy of the information, Alliance may charge you a fee to cover expenses related to your request. There are some situations where Alliance will not be able to allow your request to review records.
Right to Request Amendment: You have a right to request that Alliance make changes to your health information if you believe it is incorrect or incomplete. Alliance is not required to change your health information. If your request is denied, you will be sent information about the denial and how you can appeal it. To request an amendment, you must make your request in writing to the Privacy Officer at the address listed below. You must also give a reason for your request.
Right to Accounting of Disclosures: You have the right to be sent a list or accounting (record) of disclosures of your health information made by Alliance in the past six years. Alliance is not required to provide an accounting for disclosures made for purposes of payment functions, health care operations or treatment, or made to you. For your substance use information disclosures, you may ask for an accounting of any disclosures for treatment, payment, and health care operations made through an electronic medical record for the past three years. At this time, Alliance does not share member information through an electronic medical record.
To request this accounting of disclosures, you must send your request in writing to the Privacy Officer at the address listed below. Alliance will send you one accounting per 12-month period free of charge. You may be charged for other accountings. Alliance will tell you the cost and you may choose to cancel or change your request before any fees are charged. There are certain exceptions that apply.
Right to a Copy: You have a right to be sent an electronic copy of this Notice at any time. To get a paper copy of this Notice, send your written request to the Privacy Officer at 5200 W. Paramount Parkway Suite 200, Morrisville, NC 27560. You may also get a copy of this Notice at https://www.AllianceHealthPlan.org or by calling 800-510-9132.
Right to be Notified of a Breach: You have the right to be told if Alliance (or an Alliance Business Associate) discovers a breach of your unsecured protected health information. Notice of any breach will be made as outlined by federal requirements.
If you would like to have a more detailed explanation of these rights or if you would like to act on one or more of these rights, contact the Privacy Officer at 5200 W. Paramount Parkway Suite 200, Morrisville, NC 27560 or by calling 800-510-9132.
Changes to this Notice and Distribution
Alliance reserves the right to amend (edit) this Notice of Privacy Practices at any time in the future and to make the new Notice effective for all health information that it maintains. As your health plan, Alliance will send a copy of our Notice when you enroll in the plan and will remind you at least every three years where to find our Notice and how to get a copy of the Notice if you would like one. If Alliance has more than one Notice of Privacy Practices, the Notice that relates to you will be sent.
The most recent Notice of Privacy Practices is posted on the Alliance Health website. The Notice describes how your health information may be used and disclosed as well as the rights you have to your health information. If the Notice has a material change, information about this change will be posted to the website for you to review. Alliance will also include a description of the change that was made and information on how to get a copy of the edited Notice.
Complaints
Complaints about this Notice of Privacy Practices or about how Alliance handles your health information should be sent to the Privacy Officer at 5200 W. Paramount Parkway Suite 200, Morrisville, NC 27560 or by calling 800-510-9132. You may also file a complaint with the Secretary Department of Health and Human Services at https://www.hhs.gov/civil-rights/filing-a-complaint/index.html or call 800-368-1019. Alliance will not retaliate against you in any way for filing a complaint. All complaints to Alliance must be sent in writing. Violations of your privacy rights may result in criminal or civil penalties.
Si necesita información en español, llámenos al 800-510-9132.
Alliance Health History of Notice of Privacy Practices
Original Approval Date: June 2012
Revised: September 23, 2013 (Removed activities including fundraising, genetic information & underwriting, research; added information to Rights to be Notified of a Breach; changes to NC-TOPPS; added use or disclosure of Substance Abuse with consent or as permitted.)
Revised: August 15, 2017 Added the History of changes to the Notice of Privacy Practices
Revised: May 28, 2020 Changed Alliance Behavioral Healthcare to Alliance Health
Revised May 12, 2022 Payment Functions: removed obtain premiums because Alliance does not obtain premiums, and added sharing with Prepaid Health Plans. Removed Disclosure to Plan Sponsors. Added information to when Alliance May Not Use or Disclose Your Health Information: compensation from a third party for providing you with the information about other products or services, genetic information to determine eligibility or benefits, selling your health information.
Revised February 2026: Added NC HIEA sharing and instructions on how to opt out of NC HealthConnex information sharing; added information regarding 2024 Final Rule modifications to 42 CFR Part 2, including single consent for sharing substance use information for treatment, payment, and health care operations, changes to how covered entities and business associates can further share substance use information, and alignment with certain HIPAA rights.
