Participant FAQ Clear answers to common MX questions
Manifest MedEx (feel free to call us “MX”) participant policies are a set of rules and guidelines governing the relationships between MX, participants and others who have or might have access to MX data.
A copy of the full policies is available on the MX website for your review anytime.
The participation policies were developed by MX after carefully considering: (1) policies adopted by established health information exchanges; (2) input from providers and payers participating in MX’s network; and (3) privacy, security and other relevant laws.
You can exit anytime, for any reason, with just 30-days’ notice.
To protect participants in the network, MX may make changes to the policies to reflect emerging security concerns, evolving services and practical considerations.
Yes, MX is a nonprofit 501(c)(3) and is tax exempt. We work to keep fees as low as possible and do not charge physicians for participation. We need to be financially sustainable, however, and may need to adjust our fees to better respond to the emerging needs of our participants. Any fee changes are approached with caution and participant input. We will always provide 90-day notice of any fee changes.
Although the primary use of MX data is to provide relevant information to health care providers and health plans, others may from time to time access the data as necessary for MX operations, to fulfill MX’s nonprofit mission, and/or as allowed by law. For example, MX vendors that have entered into a Business Associate Agreement with MX might access data as necessary for MX to provide its services to participants. Patients or public health agencies could access certain data, including access to de-identified data to examine health trends in California. MX could make de-identified data available to health researchers but will not sell de-identified data for a profit.
Health plan participants may access certain clinical data of their own members for treatment, payment or healthcare operations, as allowed today under state and federal law. They may only access the minimum amount of data necessary to accomplish their payment or healthcare operations goals under HIPAA limitations. Patient data for treatment that was paid for out-of-pocket is excluded under the self-pay provision.
No. Participants are prohibited from using the data for their payer contract negotiations. Any misuse of the data would constitute a breach of the participation agreement.
“Insurance panel” refers to the insurance information provided in patient panel whereas “Insurance ADT” is the insurance provided in the ADT message received from the sending facility.
Participants can use the data received from MX for clinical treatment purposes. Other uses are permitted, but many of them have restrictions under law or as set forth in the policies. Contact your own legal counsel or reach out to MX for more details.
Data that has been provided to MX is intermingled with all other data provided by all other participants. That data remains protected as required by the policies, the participation agreements and privacy and security laws. Specific data cannot be removed from MX once it is contributed, but all contributed data continues to be fully protected in accordance with current law and policies.
Yes, patients can choose to opt out of MX.
California is an “opted-out” state, meaning all patients are automatically opted-in by default but they are given the opportunity to opt out. Patients can choose to opt out of the network in two ways. Patients can request to change their consent status in person with their healthcare provider or by submitting this form on the MX website.
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