Terms of Use
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Highmark Terms of Use

 

 

 

By using the Highmark website or any website owned and maintained by Highmark or its subsidiaries (collectively, the “Web Site”), you agree to abide by the following Terms of Use.

 

 

 

Legal

 

All information on this website may not reflect the most recent transactions or account balances.

 

 

 

Use of Material

 

The contents of this Web Site are protected by copyright. The collective work of this Web Site may also include work that is the property of others, which work is also protected by copyright or other intellectual property laws. Unauthorized use may violate copyright, trademark, and other laws. Highmark authorizes you to view and download material on the Web Site solely for your own use. You must keep all copyright and other proprietary notices on any copies you make. You may not sell or modify the material or otherwise use it for any public or commercial purpose.

 

You will not use this Web Site, in violation of any laws including without limitation, those pertaining to the fraud and abuse or anti-kickback provisions of the federal Medicare and Medicaid laws. Any advertisement, links with other web sites, co-hosts or references to third parties are not endorsements of such third parties’ products or services and are not intended to result in any referrals or compensation to you or Highmark Blue Cross Blue Shield of Western New York.

 

 

 

Use of Information and Resources

 

Highmark makes this site available for the sole purposes of providing general educational information on health-related issues and providing access to health-related resources. This site and its health-related information and resources are not intended to be a substitute for professional medical advice or for the care that patients receive from their physicians. Nothing in this site is intended to be used for medical diagnosis or treatment. Always seek the advice of your physician before beginning any new treatment or if you have any questions regarding a medical condition. You should not disregard medical advice, or delay seeking medical advice, because of something you read in this site.

 

This site and its health-related information and resources are not intended, and must not be taken, to be the rendering of medical, nursing, or professional health care advice or services, or the practice of medicine, nursing, or professional health care, in any jurisdiction. Additionally, Highmark is not responsible for information provided by health information content providers, third-party sites linked to or framed by the Web Site, or third-party sites, and does not make any representations regarding the content, accuracy, or timeliness of any of such information.

 

By health-related information, we mean the health-related, medical, and wellness information available through the Web Site that includes, but is not limited to, text, graphics, video, and images; information created by health information content providers, licensors, suppliers, and other third parties; advertisements; and any other material, information or health information content accessible on third-party web sites to which Highmark may have links.

 

 

 

Provider Finder

 

Highmark has made reasonable efforts to validate that its lists of providers displayed are up-to-date and accurate. Please call the provider prior to scheduling an appointment to verify that the provider continues to be part of the network. Highmark shall not be liable for any losses, damages, or noncovered charges as a result of using the provider locator tool or receiving care from a provider listed on our site.

 

 

 

Amerigroup Care Comparison Tool

 

Your health insurance benefits plan may not necessarily cover all of the services, treatments, drugs or tests discussed or recommended in the information provided in the tool. In addition, there may be requirements for precertification, or other criteria to determine your coverage. Further, certain sections of the tool and of this web site present information relating to a broad number of providers who may or may not participate in the independently contracted network applicable to your particular plan. Please check the appropriate online provider directory to determine whether a particular provider participates in your network. If you have any questions about particular coverage issues, simply contact us through Customer Support or call the Member Services toll-free number on the back of your ID card.

 

 

 

Caregiver Access

 

Highmark allows you to authorize a designated individual to view and/or edit your Highmark member information as it appears on the Web Site (“Caregiver Access”). This ability is subject to your acceptance of the specific terms that accompany the Caregiver Access function (contained in the relevant section of this Web Site).

 

 

 

Discount Offers

 

Highmark has arranged with various third-party vendors to make product and service discounts available to our members. Access to these discounts is not part of your health plan, and the products and services offered by these discount vendors are not covered by your health plan. Highmark is not responsible for the products, services or information provided by any discount vendor. Discount offers and vendors are subject to change without notice.

 

 

 

Out-of-Network Reimbursement

 

It is important to understand how in-network providers may be able to help you save money. In-network doctors, health care professionals, dentists and X-ray laboratories have agreed in a contract with us to accept specific amounts for various covered services. Because there is no similar contract with out-of-network providers, absent a regulation or law, they may be able to bill you for the difference between what we pay and what they charge.

 

 

For services provided by doctors, health care professionals, dentists and X-ray laboratories that have not contracted to treat members (“Non-Participating Providers”), the amounts that will be allowed for such services and processed for payment (“Non-Participating Provider Reimbursement Amounts”) are based on the member contracts. These amounts may be determined based on Medicare rates, fee schedules or a database produced by FAIR Health, Inc., as supported by member certificates, and also may be subject to deductibles, copays, and other limitations.

 

 

NOTICE: There are hospitals, health care facilities, physicians or other health care providers who are not included in every plan network. Your financial responsibilities for payment of covered services may differ if you use a network provider or a nonparticipating provider. Please refer to the online Find a Doctor tool to determine if a particular provider is in the network, or contact customer service for assistance.

 

 

 

Passwords and Account

 

Your username and password (collectively, the “Password”) will allow you to access the Web Site and certain information about you or your Plan. Your Password is the exclusive property and confidential information of BlueCross BlueShield and may be used solely for your individual use of and access to the Web Site. You are solely responsible for controlling your Passwords and for authorizing, monitoring and controlling access to your account. You are prohibited from distributing, providing or otherwise making available your Password to any third party and are responsible for all activities that occur under your Password. You agree to notify BlueCross BlueShield immediately of any unauthorized use of your Password or of any need to deactivate the Password(s) associated with your account.

 

 

 

Linking to Other Sites

 

From time to time we will provide links to other web sites, not owned or controlled by Highmark Blue Cross Blue Shield of Western New York. We do this because we think this information might be of interest or use to you or where, as a member, we can provide you with value-added services. While we do our best to ensure your privacy, we cannot be responsible for the privacy practices of other sites. A link to a non-Highmark web site does not constitute or imply endorsement by Highmark Blue Cross Blue Shield of Western New York. Additionally, we cannot guarantee the quality or accuracy of information presented on non-Highmark web sites. We encourage you to review the privacy practices of any web site you visit.

 

 

 

Appropriateness of Content

 

This website is not intended to attract children under the age of 13. We do not collect Personal Information from any person we know is under the age of 13. Some of the content on this web site may not be appropriate for children. Parent or guardians are solely responsible for providing supervision of minors’ use of the Highmark website.

 

 

 

Your Submissions

 

Generally, communications which you post to the Web Site are not confidential. If particular webpages permit the submission of communications which will be treated by Highmark as confidential, that fact will be stated on those pages. You are responsible for your own communications and the consequences of such posting.

 

You may not:

  • Communicate material that is copyrighted, without the permission of the copyright owner
  • Communicate material that reveals trade secrets, unless you have permission of the owner
  • Communicate material that infringes on any other intellectual property rights of others or on the privacy or publicity rights of others
  • Communicate material that is obscene, defamatory, threatening, harassing, abusive, hateful, or embarrassing to any person or entity
  • Communicate a sexually-explicit image
  • Communicate chain letters or pyramid schemes
  • Impersonate another person
  • Violate the Children’s Online Privacy Protection Act

 

Highmark does not represent or guarantee the truthfulness, accuracy, or reliability of any communications posted by other users or endorse any opinions expressed by other users. Any reliance on material posted by others is at your own risk.

 

 

 

Digital Millennium Copyright Act

 

Highmark respects the intellectual property of others and expects users of our services to do the same. If you believe that your copyrighted work has been copied in a way that constitutes copyright infringement and is accessible on this site or through this service, you must provide the following information when providing notice of the claimed infringement to Highmark Blue Cross Blue Shield of Western New York:

  • A physical or electronic signature of a person authorized to act on behalf of the copyright owner and identification of the copyrighted work that is infringed
  • Information reasonably sufficient to permit Highmark to contact you, such as an address, telephone number and/or electronic mail address
  • A statement that you have a good faith belief that the use of the material in the manner complained of is not authorized by the copyright owner, its agent or law
  • A statement that the information in the notification is accurate and under penalty of perjury, that the complaining party is authorized to act on behalf of the owner of an exclusive right that is allegedly infringed

 

The above information must be submitted as a written notification to Highmark through Highmark Customer Service at the toll- free number on the back of your member ID card or by writing us at P.O. Box 62509, Virginia Beach, Virginia 23466-2509, ATTENTION: LEGAL DEPARTMENT/DMCA COMPLAINT. This information should not be construed as legal advice. For further details on the information required for valid DMCA notifications, see 17 U.S.C. 512(c)(3).

 

 

 

Privacy and Security

 

The Highmark Privacy Statement describes the type of information Highmark and its licensors and suppliers collect from you when you visit the Web Site and how Highmark uses that information. You can review the Highmark Privacy Statement by clicking on the Privacy button on the Log In Screen, or by going to the Highmark homepage and selecting the Privacy link at the bottom of the page.

 

 

 

Liability of Blue Cross Blue Shield and its Licensors and Suppliers

 

No Liability. HIGHMARK AND ITS LICENSORS AND SUPPLIERS (INCLUDING, FOR THE PURPOSES OF THIS ENTIRE SECTION, ALL PROVIDERS OF CONTENT FOR THIS WEB SITE) SHALL NOT BE LIABLE TO YOU, UNDER ANY CIRCUMSTANCES OR UNDER ANY THEORY OF LIABILITY OR INDEMNITY, FOR ANY DAMAGES OR PENALTIES WHATSOEVER (INCLUDING, WITHOUT LIMITATION, INCIDENTAL INDIRECT, EXEMPLARY, PUNITIVE AND CONSEQUENTIAL DAMAGES, LOST PROFITS, OR DAMAGES RESULTING FROM LOST DATA OR BUSINESS INTERRUPTION) IN CONNECTION WITH THE USE OR INABILITY TO USE THIS SITE OR THE CONTENT, EVEN IF ANY OF THEM HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. HIGHMARK SHALL BE LIABLE TO YOU ONLY TO THE EXTENT OF ACTUAL DAMAGES INCURRED BY YOU. THE REMEDIES STATED FOR YOU IN THESE TERMS AND CONDITIONS ARE EXCLUSIVE AND ARE LIMITED TO THOSE EXPRESSLY PROVIDED FOR IN THESE TERMS AND CONDITIONS.

 

 

Highmark and its licensors and suppliers are not responsible for any claims you may have against any medical professionals, suppliers of products or other persons, institutions or entities identified in whole or in part through this Web Site.

 

 

No Warranties. THE SITE, SERVICES, CONTENT AND INFORMATION ARE PROVIDED “AS IS.” HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NEW YORK, ITS LICENSORS AND SUPPLIERS DISCLAIM ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF THIRD PARTIES RIGHTS OR FITNESS FOR A PARTICULAR PURPOSE. HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NEW YORK, ITS LICENSORS AND SUPPLIERS MAKE NO REPRESENTATIONS OR WARRANTIES THAT THE INFORMATION IN, OR LINKS OR SEARCHES CONDUCTED THROUGH THIS SITE IS COMPLETE, EXHAUSTIVE, RELIABLE, CURRENT OR ACCURATE. NO CLAIMS OR ENDORSEMENTS ARE MADE FOR ANY DRUG, HERB, SUPPLEMENT, COMPOUND, THERAPY, OR TREATMENT.

 

 

 

Limitations

 

The descriptions of Highmark products and services contained in the Web Site are not offers to sell or solicitations for any product or service. Highmark is not licensed to sell products and services in all states. The descriptions of products and services contained on the Web Site are offered as a convenience and do not contain all of the terms, conditions, limitations and exclusions that may be applicable.

 

 

 

Termination

 

Highmark may terminate any User’s right to use this site at any time. Highmark reserves the right to block, delete or stop the uploading of materials and communications that it in its sole discretion finds unacceptable for any reason. Your right to use this site will end at the close of your Membership in the Highmark plan. If your right to use this site ends, you shall make no further use of this site or any information obtained from this site.

 

 

 

Changes to the Terms of Use Statement

 

Highmark may revise, modify or amend these Terms of Use at any time. Any such revision, modification or amendment shall be effective immediately upon either posting it to the Web Site or otherwise notifying you.

 

 

 

Miscellaneous

 

Highmark is based in Buffalo, New York in the United States of America and makes no claims that the content and information included at this site is appropriate or may be downloaded outside of the United States. Access to the content and information included at this site may not be legal by certain persons or in certain countries. If you access this site from outside the United States, you do so at your own risk and are solely responsible for compliance with the laws of your jurisdiction and any other applicable laws.

 

This User Agreement shall be governed and construed in accordance with the laws of the State of Indiana without regard to the choice of law provisions of any jurisdiction. Highmark may without notice to you assign its rights and duties under this Agreement to any party at any time. Failure to enforce or insist on strict performance of any provision of this Agreement shall not be construed as a waiver of any provision or right. You agree that any legal action or proceeding between Highmark and you in any way related to this Agreement shall be brought exclusively in a court of a competent jurisdiction sitting in Buffalo, New York. Any cause of action or claim you may have against or involving Highmark must be commenced within one year after the claim or cause of action arises. Neither the course of conduct between the parties nor trade practice shall modify the provisions of this Agreement. The invalidity or unenforceability of any provision shall not in any way affect the validity or enforceability of the rest of this Agreement. This agreement constitutes the entire agreement between you and Highmark Blue Cross Blue Shield of Western New York, and it supersedes all prior agreements, representations, proposals and other communications with respect to Highmark Blue Cross Blue Shield of Western New York’s web site and content.

 

 

 

Notices

 

To the extent that the law and/or any applicable regulation allows for the provision of notice electronically, and further provide that any group health plan agreement by which you are covered does not require notice by mail, you hereby agree to receive all such notices electronically, including but not limited to notices required by state or federal privacy laws, and all financial information pertinent to, or required in connection with the operation of, your account at this online health site. By accepting the terms of this Agreement, you are acknowledging receipt of all privacy notices linked to this site as a necessary step to obtaining the services in connection with this plan and health site.

 

 

 

Questions

 

If you have questions and comments, or if you believe that your confidentiality has been breached or that any of your communications have been intercepted, or you wish to notify us regarding a suspected violation of these terms, please call Member Services at Highmark immediately at the toll-free number on the back of your member ID card.