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What you will get when you request your health information

As an Exchange member, you can connect your Wellmark health information to an app of your choice. This gives you a better picture of your health history and complete control over your health information in an effort called interoperability.

"Interoperability" is a long word, but its meaning is simple — it means more transparency for your health care. With interoperability, all the health systems that hold your health information — doctors, hospitals or clinics and insurance companies — are able to work together to deliver your whole health history. Knowing your whole health history means any doctor you see has a better picture of your health and can deliver more personalized care, at a lower cost.

Wellmark provides you with detailed information about your health history through a "Patient Access API," which allows you to easily access your health information through a third-party application (App) of your choice. The information available through the Patient Access API includes information we collect about you while you have been enrolled in a Wellmark health plan through the Marketplace since Jan. 1, 2019.

When you request your health information, you'll have access to the following:

  • Claims and "encounter" data1 concerning your interactions with health care providers; and
  • Clinical data we collect in the process of providing case management, care coordination, or other services to you.

Note: The disclosed information may include information about treatment for substance use disorders, mental health treatment, HIV status, or other sensitive information.

1 "Encounter" data is information about office visits and other interactions with providers that are paid for under a monthly (or annual) fee that Wellmark pays a provider for giving care to members. This type of payment arrangement is referred to as a "capitation arrangement."

Appoint or revoke an interoperability personal representative

If you're requesting another person's health information as their power of attorney (POA), conservator, parent, legal guardian or other form of personal representative, you may need to provide materials to establish your relationship to the member. You must be appointed the interoperability personal representative for dependents age 12 and over before requesting health information on their behalf.

Learn more about interoperability personal representatives.

Learn More

How to protect your information

It is important to understand the App you select will have access to your health information. The App is not subject to the HIPAA Privacy Rule External Site and other privacy laws External Site, which generally protect your health information. Instead, the App's privacy policy describes self-imposed limitations on how the App will use, disclose and possibly sell information about you. An App that publishes a privacy notice is required to comply with the terms of its notice, but generally is not subject to other privacy laws.

If you decide to access your information through the Patient Access API, you should carefully review the privacy policy of any App you are considering using to ensure you are comfortable with what the App will do with your information.

Questions to ask when selecting an App:

  • Will this App sell my data for any reason?
  • Will this App disclose my data to third parties for purposes such as research or advertising?
  • How will this App use my data? For what purposes?
  • Will the App allow me to limit how it uses, discloses, or sells my data?
  • If I no longer want to use this App, or if I no longer want this App to have access to my health information, can I terminate the App's access to my data? If so, how difficult will it be to terminate access?
  • What is the App's policy for deleting my data once I terminate access? Do I have to do more than just delete the App from my device?
  • How will this App inform me of changes to its privacy practices?
  • Will the App collect non-health data from my device, such as my location?
  • What security measures does this App use to protect my data?
  • What impact could sharing my data with this App have on other individuals, such as my family members?
  • Will the App permit me to access my data and correct inaccuracies? (Note that correcting inaccuracies in data collected by the App will not affect inaccuracies in the source of the data.)
  • Does the App have a process for collecting and responding to user complaints?

If the App's privacy policy does not answer these questions to your satisfaction, you may want to reconsider using the App to access your health information. Your health information may include very sensitive information. You should therefore be careful to choose an App with strong privacy and security standards to protect it.

See the list of apps you can use to connect to your myWellmark health data.

Report suspicious behavior

The Federal Trade Commission Act protects against deceptive acts, such as an App that discloses personal data in violation of its privacy notice. An App that violates the terms of its privacy notice is subject to the jurisdiction of the Federal Trade Commission (FTC). If you believe an App inappropriately used, disclosed, or sold your information, you should contact the FTC. You may file a complaint with the FTC using the FTC complaint assistant External Site. The FTC provides information about mobile App privacy External Site and security for consumers.

The U.S. Department of Health and Human Services' Office for Civil Rights (OCR) enforces the HIPAA Privacy, Security, and Breach Notification Rules. Along with most health care providers, such as hospitals, doctors, clinics and dentists, Wellmark is subject to HIPAA, so your health information is protected. Find more information about your rights under HIPAA External Site and who is obligated to comply with HIPAA. Learn about filing a complaint External Site with OCR related to HIPAA requirements or file a complaint with Wellmark by contacting Customer Service at the phone number listed on the back of your ID card.