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Terms and Conditions
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    • Terms and Conditions

    MCS PORTAL TERMS AND CONDITIONS

    MCS welcomes you to our Online Services area

    We have developed this section within MCS’ website to provide you access to information and multiple functions that we know will be very useful to you. By accepting these Terms and Conditions, you will have access to updated information about your contract, capability to request cards duplicates, changes of address, and access to your claims and usage of your health plan coverage, among other functions.

    Notification

    The method previously used to inform you regarding the usage of your health coverage has been modifying to comply with the Privacy Standard dispositions of the HIPAA Law. The privacy of your medical information is important to us and we understand that it is personal and should be protected and maintained in extreme confidentiality.

    At MCS, are committed to complying with the Privacy Standard dispositions of the HIPAA Law, which establishes controls over the use and publication of our members’ privileged health information (PHI). The information in this section is a general summary of the medical services received by you during the last year. The information contained in this section is a general summary of the medical services you received during the past year. All the information provided in this site is exact and reliable; nonetheless, MCS is not responsible for the use given to this information. This Security Services Agreement rules the services provided by Medical Card System, Inc. through the Internet.

    I. Services Agreement Acceptance

    You agree to accept the terms and conditions of this Agreement for provided services through the Internet. Any acceptance of all the terms and conditions of the Agreement for the services provided through the Internet, consent of what is being expressed in this agreement. You also accept receiving all publications included in this contract. Also, you accept that any notification regarding the services provided through this agreement will be published electronically. You will be responsible of any notifications regarding changes of email address provided through this agreement. Such changes could be notified at any moment according to the rules indicated in this Agreement.

    MCS can amend this Services Agreement at any moment. MCS will notify any changes by mail or email. If you have any questions regarding these services, you can call the following phone numbers:

    Metro Area: 787.281.2800
    Toll Free: 1.888.758.1616
    For the hearing impaired (TTY): 1-866-627-8182
    Hours of Services: Monday thru Friday from 8:00 am to 8:00 pm
    Saturday from 8:00 am to 4:30 pm.

    II. Definitions

    Controlling Authority - A Controlling Authority is any person that has legal authority to subscribe agreements on behalf of an organization or that has been identifying as such during the registration process.

    Access Administrator - is any person designated by a Controlling Authority to create and maintain users, and has been identified as such during the registration process.

    User - is the insured person with a MCS plan which is registered to use the site, or alternative person that the insured person have authorized to access or use the services.

    Access Identifier - is a value that controls access to your organization’s data in MCS’s Systems.

    III. Services

    Health Information

    The health information we include in the secure area of this site is for illustrative purposes and as a public service to promote health care. It does not represent or substitute a health professional’s advice. If you have a special care need, consult your doctor. MCS is not responsible for the use, interpretation or application by the site’s reader and/or user regarding the health information available on this site. We have provided details below on the services that MCS member will be able to access, once registered in our secure area, My MCS.

    • Providers Directory:Users will have the opportunity to search for their providers of choice in our Provider’s Directory tool. The search is completed by selecting the provider category, specialty, town or provider name. After the search, users can create their own provider directory by clicking on the star located to the right of the provider name, and automatically it will be included in their My Favorite Providers list.
    • Medical Service History:Users will be able to verify their Medical Service History regarding the services they received from the providers they visited. This option can only be accessed by the registered user, and individuals will not have access to the Medical Service History of others. Those who wish to review their own Service History must register for this service.
    • Coverage Certification:Users can print their Coverage Certification, which is valid for 10 days after the document is printed.
    • Learn about your benefits:Users will have access to the details of their health plan coverage with MCS, such as their Certificate of Insurance, Summary of Benefits, or Policy.
    • Pharmacy benefit:Users will have the opportunity to learn about the list of drugs covered by the plan, such as: preferred generic drugs, non-preferred generic drugs, preferred brand name drugs, non-preferred brand name drugs, preferred specialized drugs and non-preferred specialized drugs.
    • Precertification: Users will learn about our Precertification Program, which evaluates whether service requests are studies or procedures, prior to performing them.
    • Online Payments: Users can pay their premiums or late fees through our site. Payments can be made with credit cards such as Visa or Mastercard, and with checking or savings accounts. This payment service is designed to accept monthly payments. It also allows you to make advance payments, as long as they are not for an account that is overdue. If you make a payment with a credit card, you will see it reflected in your account the same day as the transaction. If you use a checking or savings account, the payment could take two (2) to three (3) business days to be reflected in your account. If the transaction is successful, you will see the payment reflected in your online payment history within two (2) to five (5) business days.
    • Formularies:To improve the quality of our services, we give users the ability to view and print the forms necessary for requesting services from their health plan.
    • Request Duplicate cards:Users have the opportunity to request duplicate plan cards that will be sent directly to their residence.
    • Madres y Bebés Saludables Program Registration:MCS offers the opportunity to join the program designed for our pregnant insureds. As soon as the doctor confirms the pregnancy, the user can register for the childbirth course by completing the required fields. Once complete, the insured will be contacted within 5 business days to coordinate the course dates.
    • Educational Modules:Through graphics, videos and interactive tests, users can learn more about various conditions and relevant information regarding their health.
    • Updating My Data: Users can access information regarding their coverage, which includes changes to their address, telephone, security questions, email or password.

    IV. Terms and Conditions

    • Consent and Consent Withdrawal: You recognize that you understand the terms and conditions of this Agreement, and any acceptance of it represents consent of compliance.
    • You accept receiving notifications and publications under this Agreement.
    • You have the right to withdraw you consent to receive electronic communications.
    • Changes in Notifications: You will be responsible of notifying changes in your email address. These changes must be notified at any moment via email to the following email address:supervisorescustomercare@medicalcardsystem.com.
    • Necessary Equipment: To have access to the Internet services through a personal computer, you should use a computer with access to Internet service using a browser or navigator that uses “SSL (secured socket layer) 128 bit encryption".
    • Use: We allow you to have access and use these services only for your personal use and benefit; any other access or use is strictly prohibited.
    • User Access: These services will be available only for Users; you must register each user through the online registration process or any process established by MCS. Also, each user must execute a Confidentiality Agreement online and an online Security Agreement (“Users Agreement”) before having access to the services. You are responsible for all of your actions and omissions, and all users that you authorize and for any responsibility, loses, harm, interdiction, actions, fines, penalties, claims or lawsuits of any kind or nature by or on behalf of any person, part or government authority as a result of the acts and omissions of the user, relating to the use of any tool contained and offered by accessing Electronically. The Access Administrator can deactivate the user’s access to services at any moment through the revocation of online access or through an oral or written request. You can deactivate or request the deactivation of access to services if you have security concerns, including but not limited to the loss or theft of your User Number and Password, publication of confidential information or fraud activity. Also, you can immediately deactivate the access to any discharged employee. If we find out that at any moment, by error or omission in the information provided, that we are able, upon your authority, to terminate the right of the user to use or access the Site or the services. You cannot use MCS’ Site in such manner that violates the laws and regulations of the United States or any other country; or the laws and regulations of any state, city, province, or any other jurisdiction in any such manner and will not pass on any information using the Site, unless you have consent regarding the subject of the information to transfer such information. MCS can deny you access if you do not comply with this Agreement or at any given moment with or without just cause. You are responsible for all the actions or omissions of you and any other authorized user by you, and for any obligation, loss, harm, interdictions, actions, fines, penalties, claims or lawsuits of any kind or nature by or on behalf of any person, part or government authority as a result of the actions of any user of the Site.
    • Rules of Conduct: The Internet services that you are requesting contain sensitive information. Sensitive information is any kind of information that if lost, wrongly used; unauthorized access or modification could adversely affect national interests or the performance of federal programs, or the privacy to which individuals are entitled to under the Privacy Law. MCS keeps a record system to be used in the assignment, control, tracking, and reporting of unauthorized access and the use of computer information systems, and its resources. MCS records all access to Internet services and performs periodic revisions to detect unauthorized accesses or any illegal activity.

    Anyone with access to MCS’ Internet systems containing sensitive information must adhere to the following:

    • Do not publish or lend your ID Number and/or password to any other person. It is meant for your personal use and works as your electronic signature. This means that you may be responsible for the consequences of unauthorized or illegal transactions.
    • Do not browse or use MCS’s data records for unauthorized or illegal purposes.
    • Do not use MCS’ data records for private gains or to carry false representations of you or MCS.
    • Do not publish data from MCS that is not specifically authorized for such purposes.
    • Do not duplicate MCS’ data records, create sub-records of these records, remove or pass on data unless you are specifically authorized to do so.
    • Do not cause corruption and interruption of MCS’ data records.

    A violation of the security requirements could result in the termination of access to the privileges and/or adverse disciplinary action that could include legal action. The local and/or federal laws could provide criminal penalties to any person that illegally accesses or uses a Government-owned or operated computer system. If you become aware of any violation to these security requirements or suspect that another person has used your ID number or password, you should report such information immediately to the Privacy and Security Official.

    • Automated Changes in the Systems: MCS can choose to change your access identifiers to guarantee continuous access to your data.
    • Security: We require each user to have unique information to identify him/her with during the process of accessing or using the services. Currently, this unique information is a User Identification or Password, and later could become a digital certificate. You are responsible for: (1) Maintain under strict confidentially the assigned identification for you; (2) should not let other people use their ID number to access the Site or the services provided in it; and (3) all the charges, harm or losses caused or incurred as a result of the non-compliance from you or your users to maintain strict confidentiality of your respective ID’s. If you becomes aware or suspects of any fraud or any other activity that threatens the security of the Site, you must report it immediately to MCS.
    • Proprietary Right to Intellectual Property: You agree that we (or third parties that provide services or information for the Site) have all the rights, titles, and interests in the Site, and all intellectual property rights over it. You can print a copy of the information included in this Site for your personal use, but you cannot reproduce or distribute the text or graphics to others or copy, substantially, the information in your server or, connect the Site without previous authorization from MCS. All the rights that have not being specifically guarantee are reserve for us. No other right or license is pass on or intended through this agreement.
    • Legal Notice: THE SITE AND THE SERVICES PROVIDED TO YOU ARE PROVIDED AS IS WITH ALL ITS DEFECTS, AND ITS USE IS AT YOUR OWN RISK. UNDER NO CIRCUMSTANCE MCS, ITS AFFILIATES, SUBSIDIARIES, OFFICERS, DIRECTORS, EMPLOYEES, AGENTS OR REPRESENTATIVES WILL BE RESPONSIBLE TO YOU, YOUR AUTORIZED USERS OR ANY OTHER PARTY FOR ANY DIRECT, INDIRECT, SPECIAL OR DAMAGE CAUSED AS A CONSEQUENCE OF ANY USE GIVEN TO THIS SITE OR ANY OTHER HYPER-LIKED WEBSITE. THIS INCLUDES, WITHOUT BEING LIMTED TO ANY LOSSES, BUSINESS INTERRUPTIONS, LOSS OF PROGRAMS OR DATA FROM YOUR EQUIPMENT OR ANY OTHER HARM OF ANY NATURE, EVEN THOUGH MCS IS SPECIFICALLY ADVISE OF THE POSSIBILITY OF THESE DAMAGES.
    • Compensation: You agree to protect, compensate, and hold harmless against to MCS, its affiliates, subsidiaries, officers, directors, employees, agents or representatives for any loss, expense, cost or damage (including reasonable legal fees, experts’ fees, and other reasonable costs of litigation) that may developed as a result of or in any way related to: (1) non-compliance with the terms of this agreement, (2) the illegal or unauthorized use of this Site or services, (3) The illegal or unauthorized use of this Site or services by a person using your ID, and (4) any non-compliance or unauthorized use of the Site and the services of any person or entity to which you have given the responsibilities or user access regarding this Site or these services.
    • Release: You recognize and agree upon the fact that if any right, power or privilege provided here is not exercise properly or timely, it does not constitute an acquittal to it, nor does the partial exercise of it hinder its exercise at a later time or the exercise of any other right, power or privilege.
    • Delegate: You recognize and agree that all persons to which you have delegated operations or user’s access to this Site or the services must subscribe a separate Organization Access Agreement with MCS prior to having access to the self-service website.
    • Miscellaneous: MCS reserves the right to access, read, copy, erase and publish the information in MCS’ systems and equipment. MCS reserves the right to inspect every and each of the records saved in MCS’ equipment.
    • Separation Clause: If any provision or clause of this contract or a portion of it were declared void, illegal or cannot be held by a court of law with jurisdiction, the remaining part of such clause or disposition will not be affected, and will continue to have all the strength and force, irrespectively of the fact that a part of it has been declared void. It’s the intention of the parties that if a court of law declares any provisional clause or any portion of this contract void, illegal or unable to be upheld for the duration of the clause or the area or subject, such court of law could reduce the duration, area, or subject of such disposition, and, in its reduced form, such disposition may then be exercisable and executed.
    • Applicable Law, Competition: This agreement will be ruled by the laws of the Commonwealth of Puerto Rico, without taking into consideration the Conflict Laws. Any dispute regarding this agreement, the Site, or the services, the adequate forum of discussion will be the State or Federal Court, located in San Juan, Puerto Rico.

    V. Children’s Online Privacy Protection Act Compliance

    MCS is in compliance with the requirements of COPPA (Children’s Online Privacy Protection Act). Therefore, MCS does not collect any information from anyone under 13 years of age. Our website, products and services are intended for people who are at least 13 years old, or older.