Your Privacy Matters: Limited Data Use & Verification Disclosure
The information you provide on this form is collected under the strict protections of the Health Insurance Portability and Accountability Act (HIPAA) and California’s Limited Data Use (LDU) privacy standards. We only request the minimum necessary details to verify insurance benefits and respond to your inquiry.
This data is treated as a HIPAA Limited Data Set—excluding direct identifiers—and used solely for care coordination, insurance verification, and related operational purposes under a signed Data Use Agreement.
In accordance with California law, we do not sell your information or use it beyond the necessary scope of your request. Your submission is encrypted, securely stored, and never shared without your explicit authorization where required.