Understanding Your Opt-Out Request

TriCore supports a Provider Portal that allows your health information to be accessed through a secure, electronic network by your doctors, hospitals, and other health care providers. This means that information that could help save your life in a medical emergency is available to your health care providers.

TriCore establishes unsolicited results interfaces when requested by health care providers. When you have laboratory tests ordered by one health care provider, TriCore may securely deliver the results to your other providers if they have requested an unsolicited results interface. Unsolicited results interfaces make it easier for the providers involved in your care to access your information in a single medical record without having to make phone calls, wait on faxes, or ask you to bring in paper copies.

If you do not want your health care providers to have access to your health information through the Provider Portal, unsolicited results interfaces, or both, you may Opt-Out by completing and submitting the Request Form below. If you submit the Opt-Out Request Form, you understand that:

1. TriCore will not allow access to your health information through the Provider Portal and/or unsolicited results interfaces, even in an emergency. As a result, you agree to waive any claims against TriCore for any harm caused by the exclusion of your information from the Provider Portal and/or unsolicited results interfaces.
2. Your Opt-Out Request does not prevent your health care providers from requesting and receiving your health information from TriCore using other methods, such as fax, telephone, email, or mail.

TriCore may contact you by phone if additional information is needed to complete your Opt-Out Request.

Your request to Opt-Out of the Provider Portal and/or unsolicited results interfaces will be effective once TriCore has processed your Request, and in no event later than thirty (30) days from our receipt of your completed Request. Your request to Opt-Out of the Provider Portal and/or unsolicited results interfaces will not apply to any health information accessed or disclosed before your Opt-Out becomes effective. Your Opt-Out Request will remain in effect unless you complete and submit a new Request Form informing TriCore you revoke your previous Opt-Out Request.