87 When the Fund May Disclose your PHI Unde r the law, the Fund ma y disclose your PHI without your consent or authorization, and without providing you an opportunity to agree or obje ct, in the following cases: At your request. If you request it, the Fund is required to give 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 your PHI to investigate or determine the Fund’s comp lianc 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 mana gement of health care and related services. It also includes but is not limited to consultations and referrals betwe en one or more of your providers. For example, the Fund may disclose to a treating orthodontist the name of your treating dentist so that th e 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 management, subrogation, Fund reimbursement, reviews for medica l 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 will be paid by the Plan. If we contract with third parties to h elp 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 operations includes, but is not limited to, quality assessment and improvement, reviewing competence or qualifications of health care professionals, underwriting, premium rating a nd other insurance activities relating to creating or renewing insurance contracts. It also includes disease management, case management, co nducting 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 info rmation 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. Disclosure 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 permit this use and disclosure as required by federal law. For e xample, we may disclose information to the Board of Trustees to allow them to decide an appeal or re view a subrogation claim. When the Disclosure of your PHI Requires your Written Authorization Although the Fund does not routinely obtain psychotherapy notes, it must generally obtain your written authorization before the Fund will use or disclose psychotherapy notes about you. However, the Fund may use and disclose such notes when needed by the Fund to defend itself against litigation filed by you.