HIPAA NOTICE OF PRIVACY PRACTICES

RAINSVILLE DRUGS
503 MAIN ST. WEST
P.O. Box 1370
RAINSVILLE, AL 35986
(256) 638-2255

 

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.

 

This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

 

Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your physician, our pharmacy staff and others outside of our pharmacy that are involved in your care and treatment for the purposes of providing pharmaceutical services to you, to pay your pharmacy bills, to support the operation of the pharmacy and any other use required by law.

 

Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your protected health information, as necessary, to home health agency that provides care to you. Information may also be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.

 

Payment: Your protected health information will be used, as needed, to obtain payment for your pharmacy services.

 

Healthcare Operations: We may use or disclose, as needed, your protected health information in order to support the business activities of your pharmacy’s practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of pharmacy students, licensing, and conducting or arranging for other business activities. For example, we may disclose your protected health information to pharmacy students that work in our pharmacy. In addition, members of your household may obtain printouts for this and other healthcare purposes unless you file an objection with our privacy officer. We will also call you by name in the pharmacy when your prescription is ready to be picked up.

 

We may use or disclose your protected health information in the following situations without your authorization. These situations include: as required by law, public health issues as required by law, communicable disease, health oversight, abuse or neglect, food and drug administration requirements, legal proceedings, law enforcement, coroner’s, funeral directors, organ donation research, criminal activity, military activity and national security, worker’s compensation, inmates, required uses and disclosures. Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500.

 

Other Permitted and Required Uses and Disclosures will be made only with consent authorization or opportunity to object unless required by law.

 

You may revoke this authorization, at any time, in writing, except to the extent that your physician or physician’s practice has taken an action in reliance on the use or disclosure indicated in the authorization.

 

YOUR RIGHTS
Following is a statement of your rights with respect to your protected health information.

 

You have the right to Inspect and receive a copy of your PHI, to the extent that they are a part of a designated record set as defined by HIPAA. For example, your prescriptions on file, our patient profile for you and our billing records for products and services provided to you. We request that you make the request 24 hours prior to inspection. You may review your PHI Monday - Friday during business hours. If we cannot provide the information you requested, we will notify you in writing as to the reason. We may charge you a fee for the cost of copying, mailing or other supplies that are necessary to grant your request.

 

You have the right to request a restriction of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. We do reserve the right to refuse any request that will jeopardize your healthcare in any way or prevent us from performing out duties as required by law.

 

You have the right to request to receive confidential communication from us by alternatives means or at an alternative location. You have the right to obtain an additional copy of this notice from us, upon request, even if you have agreed to accept this notice alternatively i.e. electronically.

 

You may request changes in the content of your PHI in our records if you believe they are incomplete, inaccurate or need to be changed. We may be unable to change if we no longer have the records or those changes would cause your PHI to become inaccurate.

 

You have the right to receive an accounting of certain disclosures we have made, if any of your protected health information.

 

We reserve the right to change the terms of this notice and will inform you by mail, and/or posting in pharmacy, of any changes. You then have the right to object or withdraw as provided in this notice.

 

Complaints
You may complain to us (forms are available at the pharmacy at your request) or to the Secretary of Health Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy officer of your complaint.

We will not retaliate against you for filing a complaint.

This notice was published and becomes effective on or before April 14, 2003.

All forms for your requests to change or respond to this notice are available at the pharmacy. Please contact our Privacy Officer at (256) 638-2255 for additional information.

We are required by law to maintain the privacy of, and provide individuals with this notice of our legal duties and privacy practices with respect to protected health information. If you have any objections to this form, please ask to speak with our HIPM Privacy Officer in person or by phone at our main phone number (256) 638-2255.