NOTICE OF PRIVACY PRACTICE|
Effective Date: April 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
UNDERSTANDING PROTECTED HEALTH INFORMATION
This pharmacy is required by law to maintain the privacy of Protected Health Information (PHI) and to provide individuals with notice of our legal duties and privacy practices with respect to PHI. You may request a copy of this notice at any time. PHI is used for the purposes of prescription dispensing, counseling, billing, and communication among any and all health professionals who may contribute to your care and for other specified purposes that are permitted or required by law. Understanding what information is maintained in your records and how the information may be used will help you ensure its accuracy and enable you to direct to whom, when, where, and why others may be allowed access to your PHI. State or Federal law, whichever is more stringent, will govern PHI.
UNDERSTANDING YOUR HEALTH INFORMATION RIGHTS
You have the following rights with respect to your PHI. You have the right to request additional restrictions on disclosure of your PHI, but we are not required to agree to those restrictions. You have the right to access and copy PHI about you that is contained in this pharmacy's records. Please contact our Privacy Officer for details. We have the right to charge you for the cost of reproduction of your PHI. If you are denied access to your PHI, you have the right to appeal this decision to the Secretary of Health and Human Services or his representative. You have the right to confidential communications between this pharmacy and yourself and to have those communications made by alternative means or to alternative locations. If you feel that the PHI we maintain about you is incomplete or incorrect, you may request that we amend it by contacting our privacy officer. You have the right to receive an accounting of the disclosures we have made of your PHI for most purposes other than treatment, payment, or healthcare operations. Other disclosures excluded are direct disclosures to yourself, to family, or to friends who are involved in your care. Other than activity that has already occurred, you may revoke any further authorization to use or disclose your health information.
EXAMPLES OF HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION
TREATMENT PHI will be used by the pharmacist to dispense medication, for cognitive services, or for any other patient related services provided to you, and it may be shared with other healthcare professionals involved in your care.
PAYMENT Disclosure of PHI may occur in order to obtain or provide reimbursement for providing prescriptions or pharmaceutical care services. For reimbursement purposes, your PHI may be disclosed to one or several intermediaries employed by your plan sponsors, such as but not limited to insurers, pharmacy benefits managers, claims administrators, and computer switching companies. PHI may be included on or accompany a bill for our services to you.
HEALTHCARE OPERATIONS Disclosure of PHI may occur during review and assessment of the staff and pharmacist involved in your treatment, during training sessions and compliance activities, and in planning, development, management and administration. PHI could be used to assist in the evaluation of the quality of care that you were provided.
BUSINESS ASSOCIATES During the normal course of our business activities, PHI may be disclosed to one of our business associates. To protect your PHI, we will require these business associates, through a detailed written agreement, to follow the same standards of privacy held by this pharmacy. Our pharmacy computer system vendor is one such business associate.
COMMUNICATIONS WITH INDIVIDUALS OTHER THAN YOURSELF We will use professional judgment and experience when disclosing to a family member, close personal friend, or any other person you identify, PHI relevant to that person's involvement in your care or payment related to your care. We will use professional judgment regarding your best interest in allowing people to pick up filled prescriptions, or similar forms of PHI.
HEALTH RELATED COMMUNICATIONS We may contact you to provide refill reminders, health screenings, wellness events, inoculations, vaccinations, or information about treatment alternatives or other health related benefits and services that may be of interest to you.
FOOD AND DRUG ADMINISTRATION (FDA) We may report and disclose to the FDA or other health oversight agency Protected Health Information relative to adverse events with respect to drugs, food supplements, or product defects in order to enable recall, repair or replacement of said product.
WORKER'S COMPENSATION This pharmacy will release your PHI to the extent authorized by law in matters of Worker's Compensation or other programs providing medical benefits for work related situations.
PUBLIC HEALTH We may disclose your PHI, as required by law, to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
AS REQUIRED BY LAW At any time we are required by Federal or State laws, or by court order, subpoena, warrant, summons, or other legal process to disclose your PHI, we will do so as necessary.
CORRECTIONAL FACILITIES If you are or become an inmate of a correctional institution, we may disclose PHI to the institution or its agents when necessary for your health or the safety of others.
HEALTH OVERSIGHT ACTIVITIES PHI may be disclosed to an oversight agency, such as the Office of Narcotics and Dangerous Drugs or the State Board of Pharmacy, for activities authorized by law. Such activities include, but are not limited to: audits, investigations, and inspections as necessary for our licensure, and for the government to monitor the healthcare system, government programs, and compliance with civil rights laws.
WE RESERVE THE RIGHT TO AMEND OR CHANGE THIS NOTICE If we change or amend this notice, you will be notified the next time you get a prescription from this pharmacy.
COMPLAINTS You have the right to file a complaint regarding your PHI in writing either on our complaint form or by your own letter to our Privacy Officer or to the Secretary of Health and Human Services of the United States. This complaint will be handled without any retaliation to you for filing the complaint.
For additional information regarding our Notice of Privacy Practice, please contact:
SaveWay Compounding Pharmacy
Carol Freedman, Privacy Officer
31 Albe Drive, Unit 1
Newark, DE 19702
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