Member Notice

Essence Healthcare (Essence) is using an Artificial Intelligence (AI) tool to assist with managing your care. Essence is partnering with a healthcare technology company (Lumeris) to provide the AI Healthcare Assistant (the "AI Tool"). The AI Tool assists Essence and your provider, and it does not replace professional medical advice, diagnosis, or treatment. Please contact your healthcare provider directly with any urgent health concerns or if you need specific medical advice. All information processed by the AI Tool is protected according to applicable privacy laws (such as HIPAA) and our own privacy policies. Only authorized individuals will have access to the personal health information you share with the AI Tool and Essence may share your personal information with your provider. You have the right to opt out of AI-assisted communications at any time. If you prefer to communicate only with human staff, please let us know using the opt-out instructions included in this notice.

AI-supported technology, like all other software, is subject to the same limitations and risks as other software-based technologies. Essence has a robust AI governance framework to ensure that the AI Tool complies with all applicable regulations, maintains high ethical standards, provides transparency to product and clinical staff, mitigates discrimination and bias, provides ongoing monitoring and assessment of all AI-supported features and functions, and provides resilience and security. The AI Tool is not intended as a substitute for professional medical judgment, and your provider is solely responsible for your care decisions. Artificial Intelligence is one of many tools utilized by Essence and your provider  and the AI Tool never makes any treatment decisions.

By providing your phone number to Essence, you consent to receiving communications regarding your health benefits, health conditions, and treatment via phone call, text messaging, or both at the phone number you provided to Essence. Standard SMS text messaging may not be a secure method of communication and the information in the texts could be intercepted by a third party. If you are not comfortable receiving text messages to discuss your health, you can opt out of receiving texts from the AI Tool by texting STOP during an SMS interaction or telling the AI Tool you want to opt out during a voice call interaction.

You are responsible for providing current, accurate, and complete information regarding yourself to Essence, your provider, and/or through your use of the AI Tool. Essence will not sell, exchange, or release your personal information, including medical information, submitted by you through the AI Tool to anyone except your provider and any Essence business partners as necessary to operate, support, or maintain the AI Tool. Essence may collect, compile, and use certain statistics about you and your use of the AI Tool. For the sake of clarity, Essence will at all times use your personal information in compliance with all agreements with your provider as well as all statutes and regulations, including specifically the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

SMS and other forms of telephone text messaging are unsecure methods of communication, and therefore messages exchanged with the AI Tool may be intercepted by unauthorized third parties. By texting with the AI Tool, you understand and agree to those risks. Submitting content to the AI Tool is completely voluntary. With this understanding, by using the AI Tool, you agree that if a claim arises based on unauthorized third-party disclosure or other access to content exchanged with the AI Tool, you will release Essence and your provider from any liability related to such claims.

If you are provided with one or more medical devices or other personal data-gathering apparatus (such as, for example, an Oura ring, a scale, blood pressure cuff, heart rate monitor, etc.) which collect your health data ("Device Data"), then this paragraph applies. Device Data may be shared with Essence, which may in turn be used as a part of the AI Tool, including communicating with you directly related to the Device Data. By using the AI Tool, you hereby authorize Essence  to share data with your provider.

The AI Tool cannot be used to change any personal information, including medical coverage information, with Essence or your provider. If you need to notify your provider of a change in personal information, such as change of address, phone number, medical coverage, etc., you must contact your provider directly in the manner such provider prefers. If you need to notify Essence of a change in personal information, such as change of address, phone number, etc., you must contact customer service at the phone number located on the back of your membership card. The AI Tool also cannot be used for any of (1) a grievance against any health care provider or other medical staff, or anyone involved in health care decisions related to your care, (2) a request for medical coverage of any service, device, or other treatment option by your health insurance company, or (3) an appeal of any medical or coverage decision by your health insurance company. You must use the appropriate channels proscribed by your health plan and/or health care provider for any of those actions. Essence cannot and will not be responsible for you attempting to use the AI Tool in any of these ways.