Inter-County is committed to protecting the privacy of our members’ personal health information. Part of that commitment is complying with the Privacy Rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which requires us to take additional measures to protect personal information and to inform our members about those measures.
The following documents (available in pdf format) have been developed for our customers.
HIPAA Privacy Documents
The Notice of Privacy Practices (effective April 14, 2003) describes how Inter-County may use and disclose a member’s personal health information and how a member of an Inter-County health plan can get access to this information.
HIPAA Privacy Forms
For your convenience, Inter-County provides a number of HIPAA forms. Choose the form that best fits your situation. We will begin to process your request on the day it is received. If your request is denied for any reason, you will receive an explanation of the denial.
- Forms must be fully completed
- Forms must be typed or legibly written
- Forms must be signed and dated by the requestor
Mail or Fax forms[s] to:
Inter-County Health Plan
Attn: Privacy Official
720 Blair Mill Road
Horsham, PA 19044
Fax: 215-238-7993
To print or download HIPAA forms, forms, simply click on any of the descriptions below—
General HIPAA Information
HIPAA Privacy Office contact information
Phone: 215-830-2579
Fax: 215-238-7993
Email: ichp-privacy@ichphealth.com
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