www.changehealthcare.com
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urlscan Pro
151.101.67.10
Public Scan
Submitted URL: https://bnq6pkyy.r.us-west-2.awstrack.me/L0/https:%2F%2Fclicktime.symantec.com%2F3CrJccA2ZHvjTZEJemzAPf97Vc%3Fu=https%253A%252F%252Fwww.c...
Effective URL: https://www.changehealthcare.com/privacy-notice/vaccination-record
Submission: On June 29 via manual from US — Scanned from US
Effective URL: https://www.changehealthcare.com/privacy-notice/vaccination-record
Submission: On June 29 via manual from US — Scanned from US
Form analysis 3 forms found in the DOM
Name: ContactUs — POST https://tracking.changehealthcare.com/e/f2
<form method="post" name="ContactUs" action="https://tracking.changehealthcare.com/e/f2" onsubmit="return handleFormSubmit(this)" id="form419" class="elq-form" novalidate="novalidate">
<input value="ContactUs" type="hidden" name="elqFormName">
<input value="1647363395" type="hidden" name="elqSiteId">
<input name="elqCampaignId" type="hidden">
<div id="formElement0" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field0" class="label-position top ">First Name <span class="required">* </span>
</label>
<input id="field0" name="firstName" type="text" value="" class="field-size-top-medium" required="">
</p>
</div>
</div>
</div>
<div id="formElement1" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field1" class="label-position top ">Last Name <span class="required">* </span>
</label>
<input id="field1" name="lastName" type="text" value="" class="field-size-top-medium" required="">
</p>
</div>
</div>
</div>
<div id="formElement2" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field2" class="label-position top ">Business Email: <span class="required">* </span>
</label>
<input id="field2" name="emailAddress" type="email" value="" class="field-size-top-medium" data-contact-email-target="true" required="">
</p>
</div>
</div>
</div>
<div id="formElement3" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field3" class="label-position top ">Job Function <span class="required">* </span>
</label>
<select id="field3" name="jobRole1" data-value="<eloqua type='emailfield' syntax='Job_Function1' />" class="field-size-top-medium" required="">
<option value="">-- Please Select -- </option>
<option value="Administrative/Human Resources">Administrative/Human Resources </option>
<option value="Administrator">Administrator </option>
<option value="Billing/Coding">Billing/Coding </option>
<option value="Board Member/Director/Trustee">Board Member/Director/Trustee </option>
<option value="Cardiology">Cardiology </option>
<option value="Care Management/Population Health">Care Management/Population Health </option>
<option value="Claims & Denials">Claims & Denials </option>
<option value="Consulting">Consulting </option>
<option value="Dentistry">Dentistry </option>
<option value="EDI">EDI </option>
<option value="EHR Implementation/Management">EHR Implementation/Management </option>
<option value="Engineering/Technical Staff">Engineering/Technical Staff </option>
<option value="Enrollment">Enrollment </option>
<option value="Executive">Executive </option>
<option value="Finance/Accounting">Finance/Accounting </option>
<option value="General Management">General Management </option>
<option value="Information Systems/Technology">Information Systems/Technology </option>
<option value="Laboratory">Laboratory </option>
<option value="Legal/Regulatory/Compliance">Legal/Regulatory/Compliance </option>
<option value="Medical Auditing">Medical Auditing </option>
<option value="Medical Practice Management">Medical Practice Management </option>
<option value="Member Engagement">Member Engagement </option>
<option value="Nurse/Nursing Executive">Nurse/Nursing Executive </option>
<option value="Office Manager">Office Manager </option>
<option value="Operations">Operations </option>
<option value="Patient Access">Patient Access </option>
<option value="Patient Financial Services">Patient Financial Services </option>
<option value="Pharmacy">Pharmacy </option>
<option value="Physician">Physician </option>
<option value="Physician Practice Management">Physician Practice Management </option>
<option value="Procurement/Purchasing/Supply">Procurement/Purchasing/Supply </option>
<option value="Project Management">Project Management </option>
<option value="Radiology">Radiology </option>
<option value="Revenue Cycle Management">Revenue Cycle Management </option>
<option value="Sales/Business Development/Marketing">Sales/Business Development/Marketing </option>
<option value="Training/Education">Training/Education </option>
<option value="Vendor Relationships">Vendor Relationships </option>
<option value="Other">Other </option>
</select>
</p>
</div>
</div>
</div>
<div id="formElement4" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field4" class="label-position top ">Job Level <span class="required">* </span>
</label>
<select id="field4" name="jobLevel1" data-value="<eloqua type='emailfield' syntax='Job_Lebel1' />" class="field-size-top-medium" required="">
<option value="">-- Please Select -- </option>
<option value="Analyst/Administrator">Analyst/Administrator </option>
<option value="Chief Compliance Officer">Chief Compliance Officer </option>
<option value="Chief Executive Officer">Chief Executive Officer </option>
<option value="Chief Financial Officer">Chief Financial Officer </option>
<option value="Chief Information Officer">Chief Information Officer </option>
<option value="Chief Medical Information Officer">Chief Medical Information Officer </option>
<option value="Chief Medical Officer">Chief Medical Officer </option>
<option value="Chief Operating Officer">Chief Operating Officer </option>
<option value="Chief Quality Officer">Chief Quality Officer </option>
<option value="Chief Technology Officer">Chief Technology Officer </option>
<option value="C-Level">C-Level </option>
<option value="Department Chair">Department Chair </option>
<option value="Director">Director </option>
<option value="Doctor">Doctor </option>
<option value="Individual Contributor">Individual Contributor </option>
<option value="Manager">Manager </option>
<option value="President">President </option>
<option value="Senior Vice President">Senior Vice President </option>
<option value="Vice President">Vice President </option>
<option value="Other">Other </option>
</select>
</p>
</div>
</div>
</div>
<div id="formElement5" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size">
<div class="field-wrapper">
</div>
<!-- SOI update Feb11 START -->
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field5" class="label-position top ">Solution of Interest <span class="required">* </span>
</label>
<select id="field5" name="productSolutionOfInterest1" class="field-size-top-medium" required="">
<option value="" selected="selected">-- Please Select -- </option>
<option value="Decision Support">Clinical Decision Support Solutions </option>
<option value="Clinical Network">Clinical Interoperability Solutions </option>
<option value="Consumer Payments & Communications">Consumer Payments & Communications </option>
<option value="Dental EDI Network">Dental Network Solutions </option>
<option value="Eligibility & Enrollment">Eligibility & Enrollment Solutions </option>
<option value="Imaging">Enterprise Imaging Solutions </option>
<option value="Consulting">Healthcare Consulting Services </option>
<option value="Data & Analytics">Healthcare Data & Analytics Solutions </option>
<option value="Medical Network">Medical Network Solutions </option>
<option value="Medical Record Retrieval & Clinical Review
">Medical Record Retrieval & Clinical Review </option>
<option value="Member Engagement">Member Engagement Solutions </option>
<option value="Patient Access & Eligibility">Patient Access & Financial Clearance Solutions </option>
<option value="Engagement & Experience">Engagement & Experience </option>
<option value="Connected Consumer Health - Provider">Patient Experience Solutions </option>
<option value="Payment Accuracy">Payment Accuracy Solutions </option>
<option value="Pharmacy Benefit Solutions">Pharmacy Benefit Solutions </option>
<option value="Pharmacy Solutions">Pharmacy Solutions </option>
<option value="Provider Network Optimization">Provider Network Optimization Solutions </option>
<option value="Provider Payments">Provider Payment Management Solutions </option>
<option value="Revenue Improvement">Revenue Cycle Management Solutions </option>
<option value="Risk Adjustment Analytics">Risk Adjustment and Quality Solutions </option>
<option value="Transparency & Provider Search">Transparency & Provider Search </option>
<option value="Value-Based Care Enablement">Value-Based Care Enablement </option>
<option value="Value-Based Payments">Value-Based Care Solutions </option>
</select>
</p>
</div>
</div>
</div>
<!-- SOI update Feb11 END -->
<div id="formElement6" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size" style="display: none;">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field6" class="label-position top ">Solution Type </label>
<select id="field6" name="solutionType1" class="field-size-top-medium">
<option value="">-- Please Select -- </option>
<option value="Services">Services </option>
<option value="Technology">Technology </option>
<option value="Unsure">Unsure </option>
</select>
</p>
</div>
</div>
</div>
<div id="formElement7" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size" style="display: none;">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field7" class="label-position top ">Claims Volume </label>
<input id="field7" name="ClaimsVolume" type="text" value="" class="field-size-top-medium">
</p>
</div>
</div>
</div>
<div id="formElement8" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field8" class="label-position top ">Company <span class="required">* </span>
</label>
<input id="field8" name="company" type="text" value="" class="field-size-top-medium" required="">
</p>
</div>
</div>
</div>
<div id="formElement9" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field9" class="label-position top ">Company Type <span class="required">* </span>
</label>
<select id="field9" name="organizationType1" data-value="<eloqua type='emailfield' syntax='Company_Type1' />" class="field-size-top-medium" required="">
<option value="" selected="selected">-- Please Select -- </option>
<option value="Billing Service">Billing Service </option>
<option value="Dental">Dental </option>
<option value="Emergency Medical Service">Emergency Medical Service </option>
<option value="Government Agency">Government Agency </option>
<option value="Healthcare Information Exchange">Healthcare Information Exchange </option>
<option value="Home Health Agency">Home Health Agency </option>
<option value="Hospital Employed Practice">Hospital Employed Practice </option>
<option value="Hospital/Health System">Hospital/Health System </option>
<option value="Imaging Center">Imaging Center </option>
<option value="Independent Practice Affiliated with Hospital">Independent Practice Affiliated with Hospital </option>
<option value="Independent Practice Not Affiliated with Hospital">Independent Practice Not Affiliated with Hospital </option>
<option value="Laboratory">Laboratory </option>
<option value="Partner/Reseller">Partner/Reseller </option>
<option value="Payer">Payer </option>
<option value="Software Vendor">Software Vendor </option>
<option value="Trust">Trust </option>
<option value="Other">Other </option>
</select>
</p>
</div>
</div>
</div>
<div id="formElement10" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size" style="display: none;">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field10" class="label-position top ">Bed Size </label>
<select id="field10" name="BedSize" class="field-size-top-medium">
<option value="" selected="selected">-- Please Select -- </option>
<option value="1-199">1-199 </option>
<option value="200+">200+ </option>
</select>
</p>
</div>
</div>
</div>
<div id="formElement11" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size" style="display: none;">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field11" class="label-position top ">Practice Specialty </label>
<select id="field11" name="ProviderSpecialty" class="field-size-top-medium">
<option value="">-- Please Select -- </option>
<option value="Anesthesia">Anesthesia </option>
<option value="Cardiology">Cardiology </option>
<option value="Emergency Medicine">Emergency Medicine </option>
<option value="Pathology">Pathology </option>
<option value="Radiology">Radiology </option>
<option value="Other">Other </option>
</select>
</p>
</div>
</div>
</div>
<div id="formElement12" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size" style="display: none;">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field12" class="label-position top ">Number of Covered Lives </label>
<input id="field12" name="NumCoveredLives" type="text" value="" class="field-size-top-medium">
</p>
</div>
</div>
</div>
<div id="formElement13" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size" style="display: none;">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field13" class="label-position top ">Practice Management Software Vendor </label>
<input id="field13" name="SoftwareVendor" type="text" value="" class="field-size-top-medium">
</p>
</div>
</div>
</div>
<div id="formElement14" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field14" class="label-position top ">Business Phone <span class="required">* </span>
</label>
<input id="field14" name="busPhone" type="text" value="" class="field-size-top-medium" required="">
</p>
</div>
</div>
</div>
<div id="formElement15" class="sc-view form-design-field sc-static-layout item-padding sc-regular-size">
<div class="field-wrapper">
</div>
<div class="individual field-wrapper">
<div class="_100 field-style">
<p class="field-p">
<label for="field15" class="label-position top ">Country <span class="required">* </span>
</label>
<select id="field15" name="Country" class="field-size-top-medium" required="">
<option value="">Please select </option>
<option value="US">United States </option>
<option value="GB">United Kingdom </option>
<option value="CA">Canada </option>
<option value="IN">India </option>
<option value="NL">Netherlands </option>
<option value="AU">Australia </option>
<option value="ZA">South Africa </option>
<option value="FR">France </option>
<option value="DE">Germany </option>
<option value="SG">Singapore </option>
<option value="SE">Sweden </option>
<option value="BR">Brazil </option>
<option value="">-------------- </option>
<option value="AF">Afghanistan </option>
<option value="AX">Åland Islands </option>
<option value="AL">Albania </option>
<option value="DZ">Algeria </option>
<option value="AS">American Samoa </option>
<option value="AD">Andorra </option>
<option value="AO">Angola </option>
<option value="AI">Anguilla </option>
<option value="AQ">Antarctica </option>
<option value="AG">Antigua and Barbuda </option>
<option value="AR">Argentina </option>
<option value="AM">Armenia </option>
<option value="AW">Aruba </option>
<option value="AU">Australia </option>
<option value="AT">Austria </option>
<option value="AZ">Azerbaijan </option>
<option value="BS">Bahamas </option>
<option value="BH">Bahrain </option>
<option value="BD">Bangladesh </option>
<option value="BB">Barbados </option>
<option value="BY">Belarus </option>
<option value="BE">Belgium </option>
<option value="BZ">Belize </option>
<option value="BJ">Benin </option>
<option value="BM">Bermuda </option>
<option value="BT">Bhutan </option>
<option value="BO">Bolivia </option>
<option value="BA">Bosnia and Herzegovina </option>
<option value="BW">Botswana </option>
<option value="BV">Bouvet Island </option>
<option value="BR">Brazil </option>
<option value="IO">Brit/Indian Ocean Terr. </option>
<option value="BN">Brunei Darussalam </option>
<option value="BG">Bulgaria </option>
<option value="BF">Burkina Faso </option>
<option value="BI">Burundi </option>
<option value="KH">Cambodia </option>
<option value="CM">Cameroon </option>
<option value="CA">Canada </option>
<option value="CV">Cape Verde </option>
<option value="KY">Cayman Islands </option>
<option value="CF">Central African Republic </option>
<option value="TD">Chad </option>
<option value="CL">Chile </option>
<option value="CN">China </option>
<option value="CX">Christmas Island </option>
<option value="CC">Cocos (Keeling) Islands </option>
<option value="CO">Colombia </option>
<option value="KM">Comoros </option>
<option value="CG">Congo </option>
<option value="CD">Congo, The Dem. Republic Of </option>
<option value="CK">Cook Islands </option>
<option value="CR">Costa Rica </option>
<option value="CI">Côte d'Ivoire </option>
<option value="HR">Croatia </option>
<option value="CU">Cuba </option>
<option value="CY">Cyprus </option>
<option value="CZ">Czech Republic </option>
<option value="DK">Denmark </option>
<option value="DJ">Djibouti </option>
<option value="DM">Dominica </option>
<option value="DO">Dominican Republic </option>
<option value="EC">Ecuador </option>
<option value="EG">Egypt </option>
<option value="SV">El Salvador </option>
<option value="GQ">Equatorial Guinea </option>
<option value="ER">Eritrea </option>
<option value="EE">Estonia </option>
<option value="ET">Ethiopia </option>
<option value="FK">Falkland Islands </option>
<option value="FO">Faroe Islands </option>
<option value="FJ">Fiji </option>
<option value="FI">Finland </option>
<option value="FR">France </option>
<option value="GF">French Guiana </option>
<option value="PF">French Polynesia </option>
<option value="TF">French Southern Terr. </option>
<option value="GA">Gabon </option>
<option value="GM">Gambia </option>
<option value="GE">Georgia </option>
<option value="DE">Germany </option>
<option value="GH">Ghana </option>
<option value="GI">Gibraltar </option>
<option value="GB">United Kingdom </option>
<option value="GR">Greece </option>
<option value="GL">Greenland </option>
<option value="GD">Grenada </option>
<option value="GP">Guadeloupe </option>
<option value="GU">Guam </option>
<option value="GT">Guatemala </option>
<option value="GN">Guinea </option>
<option value="GW">Guinea-Bissau </option>
<option value="GY">Guyana </option>
<option value="HT">Haiti </option>
<option value="HM">Heard/McDonald Isls. </option>
<option value="HN">Honduras </option>
<option value="HK">Hong Kong </option>
<option value="HU">Hungary </option>
<option value="IS">Iceland </option>
<option value="IN">India </option>
<option value="ID">Indonesia </option>
<option value="IR">Iran </option>
<option value="IQ">Iraq </option>
<option value="IE">Ireland </option>
<option value="IL">Israel </option>
<option value="IT">Italy </option>
<option value="JM">Jamaica </option>
<option value="JP">Japan </option>
<option value="JO">Jordan </option>
<option value="KZ">Kazakhstan </option>
<option value="KE">Kenya </option>
<option value="KI">Kiribati </option>
<option value="KP">Korea (North) </option>
<option value="KR">Korea (South) </option>
<option value="KW">Kuwait </option>
<option value="KG">Kyrgyzstan </option>
<option value="LA">Laos </option>
<option value="LV">Latvia </option>
<option value="LB">Lebanon </option>
<option value="LS">Lesotho </option>
<option value="LR">Liberia </option>
<option value="LY">Libya </option>
<option value="LI">Liechtenstein </option>
<option value="LT">Lithuania </option>
<option value="LU">Luxembourg </option>
<option value="MO">Macau </option>
<option value="MK">Macedonia </option>
<option value="MG">Madagascar </option>
<option value="MW">Malawi </option>
<option value="MY">Malaysia </option>
<option value="MV">Maldives </option>
<option value="ML">Mali </option>
<option value="MT">Malta </option>
<option value="MH">Marshall Islands </option>
<option value="MQ">Martinique </option>
<option value="MR">Mauritania </option>
<option value="MU">Mauritius </option>
<option value="YT">Mayotte </option>
<option value="MX">Mexico </option>
<option value="FM">Micronesia </option>
<option value="MD">Moldova </option>
<option value="MC">Monaco </option>
<option value="MN">Mongolia </option>
<option value="MS">Montserrat </option>
<option value="MA">Morocco </option>
<option value="MZ">Mozambique </option>
<option value="MM">Myanmar </option>
<option value="MP">N. Mariana Isls. </option>
<option value="NA">Namibia </option>
<option value="NR">Nauru </option>
<option value="NP">Nepal </option>
<option value="NL">Netherlands </option>
<option value="AN">Netherlands Antilles </option>
<option value="NC">New Caledonia </option>
<option value="NZ">New Zealand </option>
<option value="NI">Nicaragua </option>
<option value="NE">Niger </option>
<option value="NG">Nigeria </option>
<option value="NU">Niue </option>
<option value="NF">Norfolk Island </option>
<option value="NO">Norway </option>
<option value="OM">Oman </option>
<option value="PK">Pakistan </option>
<option value="PW">Palau </option>
<option value="PS">Palestinian Territory, Occupied </option>
<option value="PA">Panama </option>
<option value="PG">Papua New Guinea </option>
<option value="PY">Paraguay </option>
<option value="PE">Peru </option>
<option value="PH">Philippines </option>
<option value="PN">Pitcairn </option>
<option value="PL">Poland </option>
<option value="PT">Portugal </option>
<option value="PR">Puerto Rico </option>
<option value="QA">Qatar </option>
<option value="RE">Reunion </option>
<option value="RO">Romania </option>
<option value="RU">Russian Federation </option>
<option value="RW">Rwanda </option>
<option value="KN">Saint Kitts and Nevis </option>
<option value="LC">Saint Lucia </option>
<option value="WS">Samoa </option>
<option value="SM">San Marino </option>
<option value="ST">Sao Tome/Principe </option>
<option value="SA">Saudi Arabia </option>
<option value="SN">Senegal </option>
<option value="CS">Serbia and Montenegro </option>
<option value="SC">Seychelles </option>
<option value="SL">Sierra Leone </option>
<option value="SG">Singapore </option>
<option value="SK">Slovak Republic </option>
<option value="SI">Slovenia </option>
<option value="SB">Solomon Islands </option>
<option value="SO">Somalia </option>
<option value="ZA">South Africa </option>
<option value="ES">Spain </option>
<option value="LK">Sri Lanka </option>
<option value="SH">St. Helena </option>
<option value="PM">St. Pierre and Miquelon </option>
<option value="VC">St. Vincent and Grenadines </option>
<option value="SD">Sudan </option>
<option value="SR">Suriname </option>
<option value="SJ">Svalbard/Jan Mayen Isls. </option>
<option value="SZ">Swaziland </option>
<option value="SE">Sweden </option>
<option value="CH">Switzerland </option>
<option value="SY">Syria </option>
<option value="TW">Taiwan </option>
<option value="TJ">Tajikistan </option>
<option value="TZ">Tanzania </option>
<option value="TH">Thailand </option>
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<div class="col-xs-12">
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<input type="text" class="elq-item-input" name="website" id="fe27679" value="" style="width:100%;">
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<div class="row">
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<div style="text-align:left;" class="col-sm-12 col-xs-12">
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<div class="col-sm-12 col-xs-12">
<div class="row">
<div class="col-xs-12">
<div class="field-control-wrapper">
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<option value="">Select </option>
<option value="Public">Public </option>
<option value="Partnership">Partnership </option>
<option value="Incorporated">Incorporated </option>
<option value="Start Up">Start Up </option>
<option value="Association">Association </option>
<option value="Other">Other </option>
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</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="grid-layout-col">
<div class="layout-col col-sm-12 col-xs-12">
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<div style="text-align:left;" class="col-sm-12 col-xs-12">
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<select class="elq-item-select" id="fe27682" name="learnMore" style="width:100%;" data-value="">
<option value="">Select </option>
<option value="The overall Change Healthcare solution portfolio">The overall Change Healthcare solution portfolio </option>
<option value="A specific solution area">A specific solution area </option>
<option value="Partnership programs at Change Healthcare">Partnership programs at Change Healthcare </option>
<option value="How to become a Partner">How to become a Partner </option>
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</div>
</div>
</div>
</div>
</div>
</div>
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<div class="layout-col col-sm-12 col-xs-12">
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<select class="elq-item-select" id="fe27683" name="productsServices" style="width:100%;" data-value="">
<option value="">Select </option>
<option value="Clinical Solutions">Clinical Solutions </option>
<option value="Rev Cycle Solutions">Rev Cycle Solutions </option>
<option value="Ambulatory Solutions (non-acute)">Ambulatory Solutions (non-acute) </option>
<option value="Connectivity/Integration Solutions">Connectivity/Integration Solutions </option>
<option value="Data Solutions">Data Solutions </option>
<option value="Services (Managed, Implementation, Consulting, Education, Hosting, etc)">Services (Managed, Implementation, Consulting, Education, Hosting, etc) </option>
<option value="Technical">Technical </option>
<option value="EMR/EHR">EMR/EHR </option>
<option value="Digital Health">Digital Health </option>
<option value="Platform">Platform </option>
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</div>
</div>
</div>
</div>
</div>
</div>
</div>
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<div class="grid-layout-col">
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<div style="text-align:left;" class="col-sm-12 col-xs-12">
<label class="elq-label " for="fe27684">Type of partnership interest? <span class="elq-required">* </span>
</label>
</div>
<div class="col-sm-12 col-xs-12">
<div class="row">
<div class="col-xs-12">
<div class="field-control-wrapper">
<select class="elq-item-select" id="fe27684" name="typePartnership" style="width:100%;" data-value="" required="">
<option value="">Select </option>
<option value="API marketplace">API marketplace </option>
<option value="Channel">Channel </option>
<option value="Data subscription">Data subscription </option>
<option value="Technology">Technology </option>
<option value="Vendor">Vendor </option>
</select>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
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<div class="grid-layout-col">
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<div style="text-align:left;" class="col-sm-12 col-xs-12">
<label class="elq-label " for="fe27685">How would you describe the opportunity for partnership between our two organizations? </label>
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<textarea class="elq-item-textarea" style="width:100%;" name="partnershipOppt" id="fe27685"> </textarea>
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<div style="text-align:left;" class="col-sm-12 col-xs-12">
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</label>
</div>
<div class="col-sm-12 col-xs-12">
<div class="row">
<div class="col-xs-12">
<div class="field-control-wrapper">
<select class="elq-item-select" id="fe27686" name="targetUsers" style="width:100%;" data-value="" required="">
<option value="">Select </option>
<option value="Hospitals/health systems">Hospitals/health systems </option>
<option value="Dental">Dental </option>
<option value="Physicians">Physicians </option>
<option value="Nurses">Nurses </option>
<option value="Physician practices">Physician practices </option>
<option value="Exec">Exec </option>
<option value="Technical">Technical </option>
<option value="Administrative">Administrative </option>
<option value="Payers">Payers </option>
<option value="Labs">Labs </option>
<option value="Other">Other </option>
</select>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
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<div class="grid-layout-col">
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<div id="formElement14" class="elq-field-style form-element-layout row">
<div style="text-align:left;" class="col-sm-12 col-xs-12">
<label class="elq-label " for="fe27687">Area of interest for this partnership? </label>
</div>
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<select class="elq-item-select" id="fe27687" name="areaInterest" style="width:100%;" data-value="">
<option value="">Select </option>
<option value="Clinical Orders/Results">Clinical Orders/Results </option>
<option value="Clinical Decision Support">Clinical Decision Support </option>
<option value="Consumer Payments">Consumer Payments </option>
<option value="Coverage Insight">Coverage Insight </option>
<option value="Data and Analytics ">Data and Analytics </option>
<option value="EDI (Claims, Remits, Eligibility, etc)">EDI (Claims, Remits, Eligibility, etc) </option>
<option value="Electronic Chart Collaboration">Electronic Chart Collaboration </option>
<option value="Electronic ePrescribing">Electronic ePrescribing </option>
<option value="Electronic Prior Authorizations">Electronic Prior Authorizations </option>
<option value="Fraud, Waste and Abuse">Fraud, Waste and Abuse </option>
<option value="Population Health">Population Health </option>
<option value="Print Capabilities">Print Capabilities </option>
<option value="Revenue Cycle Management">Revenue Cycle Management </option>
<option value="Quality Solutions">Quality Solutions </option>
<option value="Payment Integrity Solutions">Payment Integrity Solutions </option>
<option value="Engagement Solutions">Engagement Solutions </option>
<option value="Payment Solutions">Payment Solutions </option>
<option value="Risk Adjustment Solutions">Risk Adjustment Solutions </option>
<option value="Network Solutions">Network Solutions </option>
<option value="Consulting">Consulting </option>
<option value="Write in/Other">Write in/Other </option>
<option value="APIs">APIs </option>
</select>
</div>
</div>
</div>
</div>
</div>
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<label class="elq-label " for="fe27688">Do you have other business relationships with Change Healthcare? <span class="elq-required">* </span>
</label>
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<select class="elq-item-select" id="fe27688" name="existingRelationship" style="width:100%;" data-value="" required="">
<option value="">Select </option>
<option value="Yes">Yes </option>
<option value="No">No </option>
</select>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
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<div style="text-align:left;" class="col-sm-12 col-xs-12">
<label class="elq-label " for="fe27689">Contacted us previously about this partnership inquiry? </label>
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<div class="col-sm-12 col-xs-12">
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<div class="col-xs-12">
<div class="field-control-wrapper">
<textarea class="elq-item-textarea" style="width:100%;" name="beenContacted" id="fe27689"> </textarea>
</div>
</div>
</div>
<div class="form-element-instruction">If you have contacted us previously concerning this partnership inquiry, include a list of people within Change Healthcare with whom you have already been in contact. </div>
</div>
</div>
</div>
</div>
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* Why Change
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First Name *
Last Name *
Business Email: *
Job Function * -- Please Select -- Administrative/Human Resources
Administrator Billing/Coding Board Member/Director/Trustee Cardiology Care
Management/Population Health Claims & Denials Consulting Dentistry EDI EHR
Implementation/Management Engineering/Technical Staff Enrollment Executive
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Management Member Engagement Nurse/Nursing Executive Office Manager
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Solution of Interest * -- Please Select -- Clinical Decision Support
Solutions Clinical Interoperability Solutions Consumer Payments &
Communications Dental Network Solutions Eligibility & Enrollment Solutions
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Clearance Solutions Engagement & Experience Patient Experience Solutions
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Solutions
Solution Type -- Please Select -- Services Technology Unsure
Claims Volume
Company *
Company Type * -- Please Select -- Billing Service Dental Emergency Medical
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Bed Size -- Please Select -- 1-199 200+
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Medicine Pathology Radiology Other
Number of Covered Lives
Practice Management Software Vendor
Business Phone *
Country * Please select United States United Kingdom Canada India Netherlands
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Sahara Yemen Zambia Zimbabwe
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THE FORM BELOW AND WE’LL BE IN TOUCH SOON.
We have a long history of helping clients, customers, and partners navigate
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Address 1 *
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Select Public Partnership Incorporated Start Up Association Other
What best describes what you would like to learn more about?
Select The overall Change Healthcare solution portfolio A specific solution
area Partnership programs at Change Healthcare How to become a Partner Other
What type of products or services does your company provide?
Select Clinical Solutions Rev Cycle Solutions Ambulatory Solutions
(non-acute) Connectivity/Integration Solutions Data Solutions Services
(Managed, Implementation, Consulting, Education, Hosting, etc) Technical
EMR/EHR Digital Health Platform
Type of partnership interest? *
Select API marketplace Channel Data subscription Technology Vendor
How would you describe the opportunity for partnership between our two
organizations?
Who are the targeted end users? *
Select Hospitals/health systems Dental Physicians Nurses Physician practices
Exec Technical Administrative Payers Labs Other
Area of interest for this partnership?
Select Clinical Orders/Results Clinical Decision Support Consumer Payments
Coverage Insight Data and Analytics EDI (Claims, Remits, Eligibility, etc)
Electronic Chart Collaboration Electronic ePrescribing Electronic Prior
Authorizations Fraud, Waste and Abuse Population Health Print Capabilities
Revenue Cycle Management Quality Solutions Payment Integrity Solutions
Engagement Solutions Payment Solutions Risk Adjustment Solutions Network
Solutions Consulting Write in/Other APIs
Do you have other business relationships with Change Healthcare? *
Select Yes No
Contacted us previously about this partnership inquiry?
If you have contacted us previously concerning this partnership inquiry,
include a list of people within Change Healthcare with whom you have already
been in contact.
Comments
Thank You
We appreciate your interest in Change Healthcare. A member of our team will
contact you to better understand your needs and discuss potential solutions.
Together, we are accelerating the journey toward improved lives and healthier
communities.
OUR MISSION
Accelerate the Transformation of Healthcare
OUR PEOPLE
Leaders Inspiring Innovation
OUR PLATFORM
At the Center of the Healthcare Ecosystem
PAYMENTS & REVENUE CYCLE
Optimizing Financial Performance
CLINICAL & IMAGING
Transforming Operational Effectiveness & Care
PATIENT & MEMBER ENGAGEMENT
Enhancing the Healthcare Experience
PAYERS
Helping Create Better Member Experiences
PROVIDERS
Supporting Optimal Patient Care Delivery
PHARMACIES
Solutions to Help Streamline Efficiency
PARTNERS
Health Tech Partnership Opportunities
DEVELOPERS
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INSIGHTS
Healthcare Insights from Industry Experts
PATIENT IMPACT
Solutions to Help Improve the Patient Experience
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Solutions to Help Improve Member Experience
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Medical Network
Medical Network
Clinical Decision Support
Clinical Decision Support
Healthcare Data and Analytics
Healthcare Data and Analytics
Dental Network
Dental Network
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Value-Based Care
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Pharmacy Solutions
Pharmacy Solutions
Pharmacy Benefit Solutions
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Risk Adjustment & Quality
Risk Adjustment & Quality
Consulting Services
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Clinical Decision Support
Clinical Decision Support
Clinical Interoperability
Clinical Interoperability
Enterprise Imaging
Enterprise Imaging
Medical Record Retrieval & Clinical Review
Medical Record Retrieval & Clinical Review
Healthcare Data and Analytics
Healthcare Data and Analytics
Value-Based Care
Value-Based Care
Risk Adjustment & Quality
Risk Adjustment & Quality
Pharmacy Solutions
Pharmacy Solutions
Pharmacy Benefit Solutions
Pharmacy Benefit Solutions
Consulting Services
Consulting Services
Patient Engagement & Experience
Patient Engagement & Experience
Member Engagement & Experience
Member Engagement & Experience
Consumer Payments & Communications
Consumer Payments & Communications
Cost Transparency
Cost Transparency
Eligibility & Enrollment
Eligibility & Enrollment
Healthcare Data and Analytics
Healthcare Data and Analytics
Risk Adjustment & Quality
Risk Adjustment & Quality
Pharmacy Solutions
Pharmacy Solutions
Pharmacy Benefit Solutions
Pharmacy Benefit Solutions
Consulting Services
Consulting Services
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Payment Accuracy
Payment Accuracy
Member Engagement & Experience
Member Engagement & Experience
Medical Record Retrieval & Clinical Review
Medical Record Retrieval & Clinical Review
Medical Network
Medical Network
Consumer Payments & Communications
Consumer Payments & Communications
Clinical Decision Support
Clinical Decision Support
Cost Transparency
Cost Transparency
Dental Network
Dental Network
Provider Payment Management
Provider Payment Management
Eligibility & Enrollment
Eligibility & Enrollment
Value-Based Care
Value-Based Care
Clinical Interoperability
Clinical Interoperability
Pharmacy Benefit Solutions
Pharmacy Benefit Solutions
Risk Adjustment & Quality
Risk Adjustment & Quality
Consulting Services
Consulting Services
Healthcare Data and Analytics
Healthcare Data and Analytics
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Revenue Cycle Management
Revenue Cycle Management
Enterprise Imaging
Enterprise Imaging
Consumer Payments & Communications
Consumer Payments & Communications
Clinical Decision Support
Clinical Decision Support
Medical Network
Medical Network
Dental Network
Dental Network
Clinical Interoperability
Clinical Interoperability
Healthcare Data and Analytics
Healthcare Data and Analytics
Consulting Services
Consulting Services
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Pharmacy Solutions
Pharmacy Solutions
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Articles
Articles
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VACCINE RECORD PRIVACY NOTICE
Effective Date: 1/29/2021
The following Privacy Notice (the “Notice”) describes how PDX, Inc. and its
affiliates (“Change Healthcare” or “we,” “us” or “our”) processes your personal
information, including health information, collected from or about you when you
use any Vaccine RecordTM product and any related website, mobile application or
other online offering used to provide the Vaccine Record (collectively, the
“Vaccine Record”). This Notice is a part of, and incorporated into, the Terms of
Use Agreement (“Terms of Use”) applicable to the Vaccine Record and any terms
capitalized herein but not defined shall have the meanings assigned to such
terms in the Terms of Use. By visiting or using the Vaccine Record, you agree to
accept the practices described in this Notice. If you do not agree with, or are
not willing to comply with, any portion of this Notice, do not access or
otherwise use the Vaccine Record.
A. YOUR VACCINATION INFORMATION
In order to use any portion of the Vaccine Record, you will need to request
access to the Vaccine Record and confirm your identity.
The Vaccine Record is offered on behalf of the provider who administered your
vaccination or is associated with your vaccination care (“Vaccination Provider”)
in accordance with an agreement between us and your Vaccination Provider.
Personal Information (defined below) we collect from you through the Vaccine
Record on behalf of your Vaccination Provider (as well as Personal Information
we collect directly from your Vaccination Provider) may be protected health
information, as that term is defined by the Health Insurance Portability and
Accountability Act of 1996 and its implementing regulations (“HIPAA”). Protected
health information we collect from you through the Vaccine Record (as well as
protected health information we collect directly from your Vaccination Provider)
may also be subject to your Vaccination Provider’s notice of privacy practices,
which describes in detail how your Vaccination Provider uses and discloses your
protected health information. When we act on behalf of your Vaccination
Provider, we will be bound by our agreement with your Vaccination Provider. In
addition, the individual rights you have to access, correct and/or modify your
protected health information that are set forth in your Vaccination Provider’s
notice of privacy practices may apply to protected health information we collect
from you through the Vaccine Record on behalf of your Vaccination Provider (as
well as the information we collect directly from your Vaccination Provider).
Thus, reading this Notice and your Vaccination Provider’s notice of privacy
practices (which is provided to you by your Vaccination Provider) will help you
understand how any protected health information we collect from you through the
Vaccine Record or directly from your Vaccination Provider is used and/or
disclosed.
B. THE INFORMATION WE COLLECT AND ACCESS
When you request access to or use the Vaccine Record, we may access information
that relates to you (“Personal Information”). Personal Information is collected
or accessed in various ways. For example, when you request access to the Vaccine
Record, we collect demographic information about you, such as mobile telephone
number, date of birth and contact information. In addition, when you use your
Vaccine Record, we may access information related to your health and medical
history directly from your Vaccination Provider. This information includes,
without limitation, registered mobile telephone number, claims information,
financial information related to the healthcare services provided, demographic
information, vaccine administration information, and other information related
to your medical or claims history.
IF YOU DO NOT WISH YOUR PERSONAL INFORMATION TO BE INCLUDED IN YOUR VACCINE
VACCINE RECORD, PLEASE DO NOT REQUEST OR OTHERWISE USE THE VACCINE RECORD.
In addition to accessing information received from your Vaccination Provider,
Change Healthcare will receive and record information about your use of the
Vaccine Record. For example, Change Healthcare will receive information
regarding when you access the Vaccine Record and your use of the Vaccine
Record’s services. For purposes of monitoring security as well improving your
experiences with the Vaccine Record, this information is linked to your use of
the Vaccine Record.
Change Healthcare will also collect and use certain technical data and usage
information, including but not limited to technical information about your
device, your device’s operating system, Internet Protocol address, general
geographic information and peripherals.
C. HOW WE USE THE INFORMATION WE COLLECT AND ACCESS
To Provide You with Products, Services and Information. If you request access to
your Vaccine Record, we may use your information to:
(a) provide you with products, services and information (for example, we use
your information to display your vaccination status, create a unique QR code
that will link to a webpage that displays a record depicting your vaccination
status or provide information about the vaccine you received);
(b) send you communications, including communications necessary to register for
your Vaccine Record and to facilitate your use of your Vaccine Record; and
(c) detecting, preventing, and responding to fraud, intellectual property
infringement, violations of our Terms of Use, violations of law, or other misuse
of the Vaccine Record.
Using Anonymous and Aggregate Information. In accordance with our agreement with
your Vaccination Provider, we may de-identify your personal information to
remove information that would typically be used to identify you to create
“Anonymous Information.” We may de-identify your personal information using the
HIPAA “Safe Harbor” method or the statistical expert determination method.
Anonymous Information is not PHI and is no longer information subject to this
Notice because it does not reasonably identify or permit the identification of
any individual and is not otherwise attributed or attributable to any one
person. We may then aggregate your Anonymous Information with the Anonymous
Information of other users to create “Aggregate Information.” We may use
Aggregate Information for any lawful purpose, including sharing with third
parties, who may be allowed to use Aggregate Information for their own purposes.
For example, we might use Aggregated Information to improve the Vaccine Record
or combine it with other Anonymous Information for our business purposes if and
as permitted by our agreements with your Vaccination Provider.
Other Uses. To the extent permitted by applicable law, we may use information
(including Anonymous Information or Aggregate Information) to perform other
administrative functions relating to the Vaccine Record.
D. SHARING YOUR INFORMATION
Other than as described in this Notice, we do not sell or provide your
information governed by this Notice to unaffiliated third parties without first
obtaining your authorization. Change Healthcare is not responsible for the
information practices exercised by you or any third party you may authorize to
receive your information or to whom you may provide access to information. We
may disclose your information that we collect:
(a) as and when authorized by your Vaccination Provider, for purposes of your
Vaccination Provider’s treatment, payment, healthcare operations and other
purposes permitted by applicable law;
(b) to our service providers who work on our behalf and have agreed to adhere
to the rules set forth in this Notice and, if applicable, our agreements with
your Vaccination Provider; or
(c) otherwise with your consent and/or at your direction, including when you
provide your Vaccine Record to third parties who may verify the authenticity of
your Vaccine Record with Change Healthcare. Please note, that once we provide
you with your Vaccine Record, you may share the information contained within it
to others, for example by showing your Vaccine Record to someone else and
confirming your intent to do so. When you share the contents of your Vaccine
Record, you are responsible for how the data is used by the recipient.
We may buy or be bought by other businesses or entities. In such event, we may
transfer or assign the information we have collected as part of such merger,
acquisition, sale or other change of control. In such transactions, your
information, including all Personal Information, may be included in the
transferred business assets.
Also, in the unlikely event of our bankruptcy, insolvency, reorganization,
receivership or assignment for the benefit of creditors, or the application of
laws or equitable principles affecting creditors’ rights generally, we may not
be able to control how your information is treated, transferred or used and your
Personal Information may be included in the transferred assets. We may share
Anonymous Information and Aggregate Information with third parties.
E. SECURITY
We strive to maintain reasonable administrative, technical, and physical
safeguards designed to safeguard the information we collect through the Vaccine
Record and directly from your Vaccination Provider. However, no information
system can be 100% secure, so we cannot guarantee the absolute security of your
information. Moreover, we are not responsible for the security of information
you transmit to the Vaccine Record over networks that we do not control,
including the internet, mobile, and wireless networks, or that reside on your
devices or the devices of third parties to whom you disclose access to your
vaccination records.
F. DO NOT TRACK
We do not currently respond to web browser “do not track” signals or other
mechanisms that provide a method to opt out of the collection of information
across the networks of websites and online services in which we participate. If
we do so in the future, we will describe how we do so in this Privacy Notice.
Visit the following website, www.allaboutdnt.org, for more information on this
developing area.
G. INTERNATIONAL USERS
By using the Vaccine Record, you agree to the use and processing in the United
States (U.S.) of your information as set forth in this Notice. If you reside
outside the U.S., your information will be transferred to the U.S., and
processed and stored there under U.S. privacy standards. By using the Vaccine
Record and providing information to us, you agree to such transfer to, and
processing in, the U.S.
H. YOUR PRIVACY CHOICES
If your contact information changes, or if you no longer wish to receive
information or communications from Change Healthcare, please email
cs-support@pdxinc.com.
Change Healthcare can delete information in the Vaccine Record (but not from
other data sources). Should you want to delete any of your information in the
Vaccine Record, please e-mail us at cs-support@pdxinc.com. Change Healthcare
cannot delete any data stored by other entities, even if that information was
provided to Change Healthcare for use in the Vaccine Record.
I. CHILDREN’S PRIVACY
The Vaccine Record is not directed to, nor do we knowingly collect information
directly from, children under the age of 13. Do not allow children under the age
of 13 to sign up for an account. If you become aware that your child or any
child under your care has provided us with information without your consent,
please contact us at the contact information listed below..
J. CHANGES TO THIS NOTICE
We reserve the right to update this Notice from time to time by posting a new
Notice on this page. If we make any changes to this Notice, we will change the
date below. You are advised to consult this Notice regularly for any changes,
and your continued use of the Vaccine Record after such changes have been made
constitutes acceptance of those changes. If we make any revisions that
materially change the ways in which we use or share the information previously
collected from you through the Vaccine Record, we will give you the opportunity
to consent to such changes before applying them to that information..
K. MORE INFORMATION
This Notice was lasted updated on February 2021 by the Change Healthcare Privacy
Office: : ChiefPrivacyOfficer@changehealthcare.com.
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