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NOTICE
OF PRIVACY PRACTICES
THIS
NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED BY OUR PHARMACY
AND DISCLOSED AND HOW
YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE
REVIEW THIS INFORMATION CAREFULLY
PROTECTING
MEDICAL INFORMATION
Our Pharmacy is required by the Health Insurance Portability & Accountability
Act of 1996 (“HIPAA”) to maintain the privacy of your Protected
Health Information (PHI). PHI is considered to be your medical records
and other health information that identifies you. This includes any information
we keep, use, or disclose in any form, whether electronically, on paper,
or orally. As required by HIPAA, we must provide this notice to you and
make a good faith effort to obtain your acknowledgement that you have
received it. This notice explains how we will use and disclose your PHI
while maintaining your privacy, explains your rights with respect to PHI,
and explains our duty to abide by the terms of the notice and any updates
that we may make in the future.
OUR USE OF
YOUR INFORMATION
Under the law we are permitted to use and disclose your PHI without your
authorization for the purposes of treatment, payment, and health care
operations:
* Treatment means providing, coordinating, or managing health care and
related services by one or more health care providers. Examples are when
we
contact your physician or other health care providers to obtain refill
authorizations, ask questions about medication doses, inform them of potential
drug
interactions, or to determine validity of prescription orders. We may
also use and disclose your information when your physician, health care
provider,
or another pharmacy contacts us and says that you have requested them
to provide health care services.
* Payment means such activities as obtaining payment for services, confirming
health plan coverage, and billing or collection activities. Examples are
electronically billing your insurance company or health plan at the time
we fill your prescriptions. Insurance companies or health plans may also
contact
us about services we provide to you.
* Health care operations includes business aspects of running our pharmacy,
such as planning, financial analysis, and customer service. An example
is
when we look at records to evaluate how well our pharmacists and technicians
provide service to you.
We may also use your
PHI without your authorization to provide you with refill reminders; information
about alternatives to medications or services you receive through our
pharmacy; or notices of health screenings, special events, or other wellness
activities we may conduct.
We may release information
about you to a family member or others who are involved in your medical
care. Examples include if a family member
picks up a prescription for you or if you have a nursing aide that assists
you with your medications.
Whenever anyone receives
PHI on your behalf we will provide only the minimum amount of information
necessary to insure your quality of care.
We may disclose PHI
about you for law enforcement purposes as required by law or in response
to a valid subpoena.
Our pharmacy may use
and disclose your PHI when necessary to reduce or prevent serious threat
to your health and safety or the health and safety of another individual
or the public.
Any other uses and
disclosures other than those provided for above (or as otherwise permitted
or required by law) will be made only with your written authorization.
You may revoke such authorization in writing and we are required to honor
and abide by that written request, except for actions we have already
taken relying on your authorization.
YOUR RIGHTS
You have the following rights with respect to your PHI, which you can
exercise by presenting a written request to the Privacy Official:
* The right to request restrictions on certain uses and disclosures, including
any group of persons or person identified by you. We are, however, not
required to agree to a requested restriction.
* The right to reasonable requests to receive confidential communications
from us by alternative means or at alternative locations.
* The right to inspect and copy your PHI. We reserve the right to schedule
this activity and charge a reasonable fee to gather the information and
for
copy expenses.
* The right to amend your PHI.
* The right to receive a list of disclosures of your PHI when you complete
our request form.
* The right to obtain a paper copy of this notice.
We are required by
law to maintain the privacy of your protected health information and to
provide you with notice of our legal duties and privacy practices with
respect to protected health information.
This notice is effective
as of April 14, 2003 and we are required to abide by the terms of the
Notice of Privacy Practices currently in effect. We reserve the right
to change the terms of our Notice of Privacy Practices and to make the
new notice provisions effective for all protected health information that
we maintain. We will post any revised notice in our pharmacy and you may
receive a written copy of a revised notice by requesting orally or in
writing.
COMPLAINT
PROCESS
If you believe your
privacy protections have been violated, you have the right to file a formal,
written complaint with us at the address below, or with the Department
of Health & Human Services, Office of Civil Rights. Our pharmacy can
provide you with the address of the regional office of Civil Rights for
this area. We will not retaliate against you for filing a complaint.
Contact Information
- Please contact us for more information:
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