89 Section 2: Your Protected Health Information Protected Health Information (PHI) Defined The term “Protected Health Information” (PHI) include s all individually identifiable health information relating to your past, present or future physical or mental health condition or to payment for health care. PHI includes information maintained by the Fund in oral, written, or electronic form. When the Fu nd May Disclose your PHI Under the law, the Fund may disclose your PHI without your consent or authorization, and without providing you an opportunity to agree or object, in the following cases: At your request. If you request it, the Fund is required to g ive you access to certain PHI in order to allow you to inspect and/or copy it. You have additional rights explained in Section 3. As required by HHS. The Secretary of the United States Department of Health and Human Services may require the disclosure of y our PHI to investigate or determine the Fund’s complianc e with the privacy regulations. For treatment, payment or health care operations. The Fund and its business associates will use PHI in order to carry out: • Treatment, • Payment, or • Health care operations. Treatment is the provision, coordination, or management of health care and related services. It also includes but is not limited to consultations and referrals between one or more of your providers. For example, the Fund may disclose to a treat ing orthodontist the name of your treating dentist so that the orthodontist may ask for your dental x - rays from the treating dentist. Payment includes, but is not limited to, actions to make coverage determinations and payment (including billing, claims ma nagement, subrogation, Fund reimbursement, reviews for medical necessity and appropriateness of care, utilizatio n review and preauthorization). For example, the Fund may tell a doctor whether you are eligible for coverage or what percentage of the bill wil l be paid by the Plan. If we contract with third parties to help us with payment operations, such as a physician that reviews medical claims, we will also disclose information to them. These third parties are known as “business associates.” Health care op erations includes, but is not limited to, quality assessment and improvement, reviewing competence or qualifications of health care professionals, underwriting, premium rating and other insurance activities relating to creating or renewing insurance contra cts. It also includes disease management, case management, conducting or arranging for medical review, legal services, and auditing functions including fraud and abuse compliance programs, business planning and development, business management and general administrative activities. For example, the Fund may use information about your claims to refer you into a disease management program, a well - pregnancy program, project future benefit costs or audit the accuracy of its claims processing functions. Disclosu re to the Fund’s Trustees. The Fund will also disclose PHI to the Plan Sponsor, the Board of Trustees of the National IAM Benefit Trust Fund , for purposes related to treatment, payment, and health care operations, and has amended the Trust Agreement to per mit this use and disclosure as required by federal law. For example, we may disclose information to the Board of Trustees to allow them to decide an appeal or re view a subrogation claim.