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At Myconsults.com, we value your relationship, and want
you to know we respect your privacy. We are committed
to protecting your private personal health information,
and we will only use and disclose your personal health
information as necessary to provide you with health
care products and services. Protected health information
(PHI) is any information that we possess, use and disclose
that identifies you and relates to your past, current
or future physical and mental health condition or illness
and the health care products and services that have
been provided to you.
This purpose of this "Notice of Privacy Practices"
(Notice) is to help you understand our legal duties
to protect your PHI and how we may use and disclose
your PHI in relation to your past, present and future
physical or mental health condition or illness and its
treatment. The use and disclosure of your PHI will primarily
involve the health care products and services that we
provide you, such as dispensing your prescriptions.
Specifically, we will use and disclose your PHI as necessary
in providing treatment to you, obtaining payment for
health care products and services provided to you and
other health care operations as described later in this
Notice. This Notice also describes your legal rights
related to your PHI that is in our possession. We take
the obligations described in this Notice very serious,
because we are legally required to comply with this
notice, and because we respect you and your right to
privacy.
Your PHI will only be used and disclosed as described
in this Notice. Should a situation requiring use and
disclosure of your PHI that is not described in this
Notice occur, we will obtain your written authorization
before the use and disclosure. At some future date it
may be necessary for us to revise this Notice. If this
occurs, we will post the revised Notice in the pharmacy
and, if you request, provide a written Notice to you.
The Health Insurance Portability and Accountability
Act of 1996 (HIPAA), provides you with several rights
related to your PHI.
These
rights are summarized below. If you would like more
information about your rights, please ask to speak with
our Privacy Officer at the address or telephone number
above.
Right to Receive Notice of Privacy Practices: You have
the right to receive this written Notice of Privacy
Practices describing how we will protect your PHI and
your rights related to PHI. You are entitled to request
this written Notice at any time.
Right to Request Limitation of Use and Disclosure of
PHI: You have the right to request a limitation on our
use and disclosure of your PHI. But please be aware
that we may not be able to agree to your requested limitation
if it results in our not being able to provide health
care products and services to you or if we are required
to use and disclose the PHI under federal or state law.
All requests for limitation on the use and disclosure
of your PHI must be submitted to our Privacy Officer
in writing using a form that we will provide to you.
Right to Review and Receive a Copy of Records: You have
the right to review or receive photocopies of our records
that contain your PHI, to the extent that these records
are part of a designated record set as defined by HIPAA.
The most common type of records are your prescriptions
on file with us, our patient profile for you and our
billing records for health care products and services
that have been provided to you. If you wish to review
or obtain a copy of a family member's PHI you may need
to complete a "Right to Access and Consent for
Release of PHI to Patient's Authorized Representative".
This is of course subject to any limitations on use
and disclosure of PHI we have on file for that family
member. We will be pleased to allow you to review such
records meeting the requirements of this Notice of Privacy
Practices at no charge during normal business hours.
However, we may charge you a reasonable, cost-based
fee for photocopies of the records, together with any
expenses for mailing, special courier, faxing and supplies
necessary to complete your records request.
If we are unable to provide our records to you, we will
provide you a written explanation of why we are not
able to provide the records. Depending on the reason,
you may submit a written request for us to reconsider.
All requests to review or receive photocopies of our
records that contain your PHI must be submitted to our
Privacy Officer in writing using a form that we will
provide to you.
Right to Request Amendments to Records: You have the
right to request changes in the content of your PHI
contained in our
records
where you believe the content is incomplete, inaccurate
or for some other reason needs to be changed. We may
not be able to agree to your requested change if we
no longer have the records or if the requested change
would cause your PHI to become inaccurate. If we are
not able to agree to your requested change we will notify
you in writing as to why we are not able to agree. You
will then have the right to submit to us a written statement
of disagreement, to which we may elect to further respond
in writing to you. All requests for change to your PHI
in our records must be submitted to our Privacy Officer
in writing using a form that we will provide to you.
Right to Request Confidential Communications: You have
the right to request that we communicate with you about
your PHI in a confidential manner and only to locations
(such as a post office box) or by means (such as personal
cellular telephone) specified by you. All requests for
confidential communications must be submitted to our
Privacy Officer in writing. using a form that we will
provide to you.
Right to an Accounting of Non-Treatment, Payment and
Operations (TPO) Disclosures: You have the right to
obtain an accounting of some of our disclosures of your
PHI made after April 14,2003. By accounting we main
a written record of these disclosures. Some of our disclosures
of your PHI are not required by HIPAA to be included
in the accounting. Most notable among these are disclosures
for purposes of TPO. Other disclosures of your PHI that
are not required to be included in the accounting are
disclosures make directly to you or that you have authorized,
made to family, friends and others who assist you with
your care (caregivers) and made for other purposes allowed
by HIPAA. Please consult with our Privacy Officer for
more information on the disclosures not required to
be included in the accounting.
We are required to provide an accounting of disclosures
for the six (6) year period immediately prior to the
date of your request for the accounting; however, your
request for an accounting can be for a shorter period
of time and cannot precede the HIPAA compliance date.
You may obtain from us, without charge, one accounting
during a twelve-month period. However, if you request
additional accountings during the same twelve month
period we may charge you a reasonable, cost-based fee
for printing or photocopying of the accounting, together
with any expenses for mailing, special courier, faxing
and supplies necessary to fulfill your request for the
accounting. If it becomes necessary for us to charge
you for an accounting, we will notify you in advance
and allow you to withdraw or modify your request for
the accounting.
All
requests for an accounting of our disclosures of your
PHI must be submitted to our Privacy Officer in writing.
Right to File a Complaint: You have the right to file
a complaint if you believe that we have violated your
rights as described above, and to not fear retaliation
or adverse action by us against you for exercising your
right. You can file the complaint with us directly,
or with the United States Department of Health and Human
Services (HHS). Please be assured that we will work
with you to resolve any complaint including providing
you with the address for filing a complaint with HHS.
If you have any concern about our privacy practices
or wish to file a complaint, please contact our Privacy
Officer at the address or telephone number of our pharmacy.
If you have any questions about any of your privacy
rights as described, please contact our Privacy Officer
at the address or telephone number listed at the beginning
of this document.
Normal Pharmacy Activities Resulting in Uses and Disclosures
of your PHI
The Health Insurance Portability and Accountability
Act of 1996 (HIPAA), requires that this "Notice"
describe how we may use and disclose your protected
health information (PHI). These uses and disclosures
are summarized below, but if you would like more information
about any of these please contact our Privacy Officer
at the address or telephone number of our pharmacy.
Treatment: HIPAA regulations define treatment as "the
provision, coordination, or management of health care
and related services by one or more health care providers,
including the coordination or management of health care
by a health care provider with a third party; consultation
between health care providers relating to a patient;
or the referral of a patient for health care from one
health care provider to another". We will maintain
records that contain your PHI and we will use and disclose
your PHI as necessary to provide health care products
and services to carry out and support your treatment.
As a pharmacy, we will use and disclose your PHI as
necessary to maintain your patient profile, which includes
information about you, your medical condition, medications
and prescription devices that you use, any allergies
that you may have and other information, such as any
health insurance that you may have. We will use and
disclose your PHI in dispensing prescription medicines
and related products and services, including counseling
you and your caregivers about proper use of your medications.
We will also use your patient profile to watch for medication
related problems, such a drug interactions and overuse
or under use of your medications that may present a
risk to you. We may discuss such problems with your
other health care professionals, such as your physician
or dentist, and through such discussions, we may use
and disclose your PHI. And of course, we will use and
disclose your PHI to you and your caregivers (if you
allow us), in our discussions with you and your caregivers
about your treatment.
Payment: HIPAA regulations define payment, in relation
to health care providers such as pharmacies, as activities
to obtain reimbursement for the health care products
and services that we provide to you. These activities
include primarily billing you directly or someone who
pays for your health care, such as a family member or
health insurance company, for health care products and
services that we provide to you. Activities related
to billing may include claims management, collections
and related health care data processing. Depending on
who pays for the health care products and services that
we provide you, other activities may include eligibility
determination; drug coverage determination; medical
necessity under a health plan; appropriateness of care,
or justification of charges; including prior authorization
of drugs and services; prospective and retrospective
drug utilization review services. Some examples of PHI
that may be used and disclosed to collect payment are:
Name Address Birthdate Gender Social Security Number
Insurance Member ID Number Relationship to Insured Health
Plan Information Health Care Provider Information
We will use and disclose your PHI to carry out the above
activities as necessary or required to obtain payment
for the health care products and services that we provide
to you. In relation to this, public and private health
care insurance programs that may provide or pay for
your health care can conduct audits, inspections and
investigations of us in relation to our activities and
your activities. We may be required to disclose your
PHI to these programs for purposes of audits, inspections
and investigations. Health care operations: HIPAA defines
health care operations as those activities necessary
and related to our providing of health care products
and services to you. These activities include, but may
not be limited to, the following:
- Conducting quality assessment and improvement activities,
case management, disease management and care coordination,
contacting of health care providers and patients with
information about treatment alternatives and related
functions that do not include treatment.
- Conducting or arranging for medical review, legal
services and auditing functions, including fraud and
abuse detection and compliance programs.
- Our pharmacy management and general administrative
activities, including, but not limited to, activities
relating to implementation of and compliance with the
requirements of HIPAA.
We will use and disclose your PHI to carry out the above
activities as necessary or required, and especially
to monitor and improve the quality of the health care
products and services that are provided to you by us
and other health care professionals.
In addition to treatment, payment and health care operations
as described above, we may use and disclose your PHI
for the following purposes:
Business associates: The health care system is very
complex and as such we may not be able to provide health
care products and services to you without the involvement
of other businesses or persons. Depending on what these
other businesses or persons do for us, they may become
"business associates" as defined by HIPAA.
In many situations it will be necessary for us to provide
your PHI to these business associates so that they can
carry out the activities that we need to have performed
in order to provide you health care products and services.
For patients that have health insurance that includes
a pharmacy benefit, one of our most common business
associates is a health insurance company or a pharmacy
benefits company that processes claims we submit for
payment for health care products and services on your
behalf. We have written contracts with all of our business
associates to whom we provide your PHI so that they
can carry out their activities on our behalf. In an
effort to provide you a level of comfort, you should
know, these contracts require our business associates
to give us their assurance that they, like us, will
protect the privacy of your PHI.
Communications with you concerning your health and treatment:
We want to do whatever we can to assist you with maintaining
your health and obtaining the most benefit from your
treatment. We routinely monitor your prescription medications
for appropriateness and take other steps to help you
use your medication properly. For example, if you forget
to obtain a refill of your medication, we may contact
you to remind you to obtain the refill. We may also
call you or send you materials regarding products and
services that we believe may be of benefit to you. In
the event that a pharmaceutical manufacturer or the
Food and Drug Administration (FDA) is to issue a medication
recall, we may contact you if you are taking the medication
subject to the recall.
Federal and state government agencies: We may disclose
your PHI to federal and state government agencies for
a variety of purposes, most of which are directed at
monitoring health care quality and safety, government
programs related to health care and our compliance with
laws applicable to health care. For example, the United
State Drug Enforcement Administration (DEA) monitors
the distribution and use of controlled substances, while
the FDA monitors adverse drug events. We may disclose
your PHI to such agencies where required by the agency
so that the agency can carry out its required activities.
Related to this, some private businesses, such as the
manufacturers of medications and medical devices, are
legally required to conduct post marketing surveillance
in order to ensure the safety of their products. Disclosing
your PHI for such surveillance may be necessary. A number
of state agencies also conduct health care quality and
safety activities, for which we may disclose your PHI.
For example, some states maintain a controlled substance
monitoring program and require that we report to the
state the prescriptions for controlled substances that
we dispense to you.
Federal and state government health care insurance programs:
If you apply for and receive benefits from federal and
state health care programs, such as Medicare or Medicaid,
your PHI may be disclosed to the agency granting these
benefits. If you are employed by a business that is
required to carry workers' compensation insurance, and
you are injured in such a way that the workers' compensation
plan covers your health care, it may be necessary to
disclose you PHI to the workers' compensation plan.
Such plans have a right to conduct audits, inspections
and investigations of our activities and your activities,
and where required, we will disclose your PHI for these
activities.
Public health and safety: There are several federal
and state laws that require health care providers to
report to various government agencies matters related
to public health. If your physical or mental health
condition and illness is of a nature that requires that
it be reported, then we will disclose your PHI to the
appropriate government agency in order to comply with
these laws. In addition to reporting about physical
and mental health conditions and illnesses, we may also
disclose your PHI to government agencies in other situations
where we are required to submit reports, such as suspected
domestic, child or elder abuse or neglect.
Law enforcement activities: A number of federal, state
and local government agencies are charged with enforcing
the health care and drug laws, and other laws in relations
to the health care products and services that we may
provide to you. In addition, as a state licensed pharmacy,
a variety of federal, state and local health care agencies,
such as the state board of pharmacy, regulate our activities.
These agencies may engage in a number of activities
designed to monitor and improve federal and state health
care programs and systems, including conducting of inspections
and investigations of our activities and the health
care products and services that we provide to our patients.
At any time we are required by federal or state laws,
or by court order, subpoena of other legal mandate,
to disclose your PHI we will do so as necessary.
Legal disputes: Lawsuits and other legal disputes are
common today, and depending on the issues, may involve
your PHI that we possess. In the event that you are
involved in a lawsuit or other legal proceeding, whether
as a plaintiff or a defendant, and without regard to
the basis for the lawsuit, such as medical malpractice
or divorce, we will disclose your PHI when required
to comply with a court order, subpoena, discovery proceeding,
such as a deposition, or other legal mandate served
upon us. We will attempt to notify you prior to the
disclosure if you are not the party to the legal dispute
requesting your PHI so that you and your attorney can
determine whether you want to take legal actions to
prevent disclosure of your PHI.
Disclosures for the benefit of you and others: Events
can occur where we would use and disclosure your PHI
for your benefit and to prevent or reduce the risk of
harm to you. For example, if you are in a car accident
and are unconscious in a hospital emergency room and
the emergency room medical staff calls us with a request
for your PHI, we may disclose it for the purpose of
assisting in your prompt medical treatment. The same
is true if a family member, friend or caregiver contacts
us in an emergency situation, or where an emergency
situation is not present, but we have reason to believe
you are at risk of harm or serious injury and we believe
that disclosing your PHI will assist them in caring
for you. We may also disclose your PHI upon your death
to a funeral director, embalmer, medical examiner or
coroner's office to assist them in carrying out their
legal responsibilities related to your death. Finally,
we may disclose your PHI where necessary to protect
the health and safety of others.
Disclosures
for national security and intelligence: We are legally
required to disclose your PHI when necessary to national
security and intelligence and counter-intelligence activities.
Any disclosure for these purposes would be made only
to authorized government officials.
Disclosures if you are in the military or a veteran:
We may disclose your PHI, if you are a member of any
branch of the armed services, whether on active or reserve
status. If you are a veteran, we may release your PHI.
Particularly if you are receiving health care products
and services from the Veterans Services. Any disclosure
for these purposes would be made only to authorized
government officials.
Disclosures of a miscellaneous nature: We may be required
to disclose your PHI if you are placed into custody
of a federal or state correctional system if necessary
to protect the health and safety of you and others.
Health care is an area where much research is being
conducted, and we may disclose your PHI for purposes
of a research project, but only if we are satisfied
that the research project has been approved by a responsible
institutional review board and the research project
has established adequate methods to protect your privacy.
Much health care research is sponsored through organizations
that conduct fundraising activities, and we may inquire
with you using your PHI to determine your interest in
participating in or otherwise supporting a fundraising
activity. Finally, given the national need for organ
donations, we may disclose your PHI to organizations
that manage organ transplantation programs.
If you have any questions about any of the uses and
disclosures of your PHI as described above, Please contact
our Privacy Officer at the address or telephone number
listed at the beginning of this document.
Uses and Disclosures not Contained in this Notice
If a use and disclosure of your PHI is not contained
in this Notice, we will obtain your written authorization
before the use and disclosure. You may have the right
to refuse to authorize the use and disclosure, or if
you grant the authorization, to revoke the authorization
at any time. If such authorization is requested, we
will provide you with a form that describes the proposed
use and disclosure and your rights related to the requested
authorization.
HIPAA requires that we give you this "Notice of
Privacy Practices" and make a good faith effort
to obtain your written acknowledgement that you were
given this notice. Upon giving you this Notice, you
will be asked to sign a document acknowledging that
you received this notice. We appreciate your cooperation
in reviewing this notice and in giving us your written
acknowledgment.
HIPAA also requires that this Notice, at a minimum,
cover the following three areas.
- How we will use and disclose your personally identifiable
health information.
- Your rights with respect to your personally identifiable
health information.
- Our legal duties to protect the confidentiality of
your personally identifiable health information.
In preparing this Notice, we made every effort to comply
with this HIPAA requirement. Also, you should be aware
that the Federal regulation HIPAA does not take precedence
over State Law when the State Law is more strict. You
may have additional protections under State Law.
Please consult our Privacy Officer if you have any questions
or want more information concerning your health care
and privacy rights under HIPAA or the laws of our state,
or our privacy practices. Also, you should consult our
Privacy Officer if you wish to file a complaint about
our privacy practices or if you believe we have violated
any of your rights as described in this Notice.
Thank you for allowing us the privilege of being your
pharmacy, we look forward to providing you with high
quality health care products and services that will
help to keep you healthy.
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