Connecting Your Healthcare
New options for managing your Digital Medical Records
Starting in 2021, a new federal rule made it easier for Ambetter from Health Net members* to manage their digital medical records.
The Interoperability and Patient Access rule (CMS-9115-F) makes it easier for members and their personal representatives to get their health records when they need it most. You now have full access to your health records on your mobile device, at no charge. This allows you to manage your health better and know what resources are available to you.
Provider Directory information is available through a standards-based API. This is in a machine-readable format that allows access through a third-party application.
Starting in 2022, the Payer-to-Payer Data Exchange portion of the rule* allows former and current members to request that their health records go with them as they switch health plans. For more information about this rule, visit the Payer-to-Payer Data Exchange section found on this web page.
- You go to a new healthcare provider because you don't feel well and you can show that provider your health history from the past five years
- The provider uses that information to diagnose you and you quickly find the right specialist by checking an up-to-date provider directory
- You have a question about a claim, so you go to your computer or mobile device and, in minutes, you see if it's paid, denied, or still being processed
- You can take your health history with you as you switch health plans
The new rule makes it so you can easily find information** on:
- claims (paid and denied)
- healthcare providers
- pharmacy directory data***
- specific parts of your clinical information
Samples of data we maintain include:
- first name
- last name
- previous name
- middle name
- birth sex
- date of birth
- preferred language
Allergies & Intolerances
- substances (medications)
- substances (drug class)
- current address
- previous address
- phone number
- phone number type
- email address
Laboratory Tests & Results
Assessment & Treatment Plan
Care Team Members
* The Interoperability and Patient Access rule applies to Medicare Advantage, Medicaid and CHIP Managed Care, and Qualified Health Plans (QHPs) on the federally-facilitated ACA exchanges. Access may potentially be extended to members of other plans.
** Data will be available for dates of service on or after Jan. 1, 2016; data for Payer-to-Payer Exchange covers clinical data initially.
*** For Medicare Advantage Prescription Drug (MAPD) plans
Why is this so important?
Having your health information in one place may help you and your providers:
- Understand your health better
- Make better decisions
- Improve your health outcomes
- Reduce healthcare costs
- Carry information to new providers or health plans
Keeping your Protected Health Information (PHI) safe is important to us
Your privacy and the security of your PHI is a top concern of ours. The new rule allows you to use an app from a third-party application developer (a company with no connection to Ambetter from Health Net. You can use this app to look up your health information. When choosing an app, it is important to consider how your data can be used and the app's security and privacy practices.
The CARIN alliance is working to advance the exchange of health information. We will request third-party application developers agree to follow certain privacy standards outlined in the CARIN Code of Conduct. The CARIN Code of Conduct is a set of practices that these applications have voluntarily adopted to protect and secure your health information. Visit the Currently Connected Applications link for a list of applications available to connect with your health records. We will give you information on federal agencies you can contact if you feel your rights to patient privacy have not been protected. Learn more about the CARIN Alliance.
Before sharing your data with a third-party application, we will ask you to agree to a Consent to Request Your Health Data statement. This is an added security step to protect your data.
Current Members: What to do now
- Find an app. Visit the Currently Connected Applications link for a list of applications available to connect with your health records.
By agreeing to the CARIN Code of Conduct, the app developer attests it meets certain standard security practices. These practices include, but are not limited to:
- Protection of a user's personal data against:
- loss or unauthorized access
- unauthorized annotation
- Protect personal data through a combination of mechanisms including:
- secure storage
- encryption of digital records both in transit and at rest
- data-use agreements and contractual obligations
- accountability measures (e.g., access controls, logs and independent audits)
- Comply with applicable breach notification laws
- Provide meaningful remedies to address security breaches or other violations due to a misuse of the user's personal data
- Adopt internal policies and secure contractual commitments with third parties to prohibit the re-identification of de-identified or anonymized data
- Protection of a user's personal data against:
- Download the app. Smartphone apps are available through the Google Play Store (Android) and the App Store (iOS). Web apps are also available for computers.
- Create your account. Use the app to do so.
- To link your health information, choose your health plan
- On the login screen, enter your member portal username and password
- Read the Access your Health Data statement. If you agree to the terms, click "Allow Access"
- Use your information to manage your healthcare.
Frequently Asked Questions
Starting in 2022, members may request that Ambetter from Health Net send health records to other health plans. They can also request that Ambetter from Health Net receive health records from other health plans. If a member switches health plans, Ambetter from Health Net will send their clinical records (included in the USCDI v1) to another health plan. This is in order to build a complete health record. A complete health record will help a member make decisions that improve their quality of care and health outcomes.
Former members of Ambetter from Health Net should start the request through their new health plan. Based on this request, Ambetter from Health Net will send the clinical records to their new health plan.
Current members of Ambetter from Health Net may start the request by logging into the Ambetter from Health Net secure member portal. There they can request and receive the clinical records from their previous health plan.
Former members may request data exchange up to five years after disenrollment.
You will have access to health information with a date of service of January 1, 2016 or later.
Yes. You will be able to access your health information no matter what health plan or provider you go to.
Yes. You can use an app to see what shots you’ve had with a date of service January 1, 2016 or later.
No. The app does not have to be affiliated with Ambetter from Health Net. Visit the Currently Connected Applications link for a list of applications available to connect with your health records. This includes apps that promise to meet the CARIN Code of Conduct. Follow the instructions on the app to connect it with your health records.
Not every app has agreed to meet the CARIN Code of Conduct or any other set of guidelines. We will let you know which apps have agreed to follow our privacy guidelines. You will have a chance to select another app if you selected the app before they shared their privacy practices with us.
We suggest that you request a Notice of Privacy Practices from the app. Read it carefully before using that app. If the app does not provide you with a Notice of Privacy Practices, we suggest that you choose another app.
You will be able to access your health plan information in the apps starting on July 1, 2021.
No. You do not have to use an app to access your health information. You can contact your provider or health plan for information.
It depends on the app you choose. Some apps will collect your health data. This includes (but is not limited to):
- doctor visits
You give the app permission to collect your health information when you sign up for it. The app's Notice of Privacy Practices should tell you what information it collects.
We suggest that you ask the app provider for their Notice of Privacy Practices.
For more information:
We suggest that you request a Notice of Privacy Practices from the app provider. This is so that you can understand how they respond to a privacy and security incident. You have the right to file a complaint with enforcement agencies including the Office for Civil Rights (OCR) and the Federal Trade Commission (FTC).
For more information:
App providers may respond to complaints in different ways. We suggest that you ask your app provider this question.
We suggest that you request a Notice of Privacy Practices from the app provider. This is so you can understand how the app stores your data.
We suggest that you request a Notice of Privacy Practices and additional information on security practices from the app provider. This is so you can understand how they handle a security incident.