How
We Safeguard Your Protected Health Information
This notice described how medical information about you
may be used and disclosed and how you can get access to
this information. Review it carefully.
Section
A: Uses and Disclosures of Protected Health Information
1. Under applicable law, we are required to protect the
privacy of your individual health information (information
we refer to in this notice as “Protected Health Information”).
We are also required to provide you with this notice regarding
our policies and procedures regarding your Protected Health
Information and to abide by the items of this notice, as
it may be updated from times to time.
We are permitted to make certain types of uses and disclosures
under applicable law for treatment, payment and health care
operations purposes. We may obtain information to dispense
prescriptions and for the documentation of pertinent information
in your records that may assist us in managing your medication
therapy or your overall health. For treatment purposes,
communication and disclosure between pharmacist and other
health care provider may occur.
For reimbursement purposes, your Protected
Health Information may be disclosed to one or several intermediaries
employed by your plan sponsor including but not limited
to insurers (reimbursement providers), pharmacy benefits
managers, claims administrators, computer switching companies
and manufacturer representatives who are legally obligated
to conduct post-marketing surveillance in order to ensure
the safety of their products.
For health care operations purposes, such
use and disclosure will take place in a number of ways,
including for quality assessment and improvement, provider
review, pharmaceutical compounding activities, reviews and
compliance activities; planning, development, management
and administration. Delivery of health care items will be
conducted in a manner to ensure patient privacy. Your information
could be used, for example, to assist in the evaluation
of the quality of care that you were provided.
We store some of your Protected Health Information in electronic
computer files. We backup our electronic records daily,
and employ other precautions to safeguard the integrity
of your Protected Health Information. In spite of these
precautions it is possible but unlikely that a computer
crash or other technological failure could cause loss of
data. In addition reasonable safeguards are employed to
protect your Protected Health Information stored on electronic
media.
We may contact you, via written or verbal
notice, to provide refill reminders, health screenings,
wellness events, inoculations, vaccinations or information
about treatment alternatives of other health-related benefits
and services that may be of interest to you, including generic
availability and insurance prompted preferred drug opportunities.
In addition, we may disclose
your health information to your plan sponsor.
We may use and disclose your Protected
Health Information, without your authorization when the
pharmacy needs to contact a physician or physician’s
staff and is permitted or required to do so without individual
written authorization.
We may use and disclose your Protected
health Information if we are contacted by another pharmacy
who states they have your request and consent to transfer
pharmacy records to them. Any business associates employed
by Yanceyville Drug Company, Inc is required to comply with
all privacy regulations.
We may disclose Protect Health Information
about you without your authorization to comply with workers
compensation laws, as required by law enforcement, legal
proceedings, public health requirements, health oversight
activities and as required by law. Other uses and disclosures
will be made only with your written authorization and you
may revoke your authorization by notifying us as described
in Section B.
2. Requests from you to restrict disclosure
of your Protected Health Information to persons involved
in your care or payment of your services may or may not
be honored.
3. You have the right to request the following
with respect to your Protected Health Information (i) inspection
and copying; (ii) amendment or correction; (iii) an accounting
of the disclosures of this information by us (we are not
required to account to you for disclosures made for treatment,
payment, operations, disclosures to you, disclosures to
your care givers, for notifications or as otherwise excluded
by law; and (iv) the right to receive a paper copy of this
notice upon request. We may require you to pay for this
request to cover our costs of copying, labor and postage.
In addition, you may request and we must
accommodate the request, it reasonable, to receive communications
of Protected Health Information by alternative means or
alternative locations.
To make this request please contact
in writing:
Yanceyville Drug Co., Inc.
Thomas P. Davis RPH, Pharmacist/Owner
106 Court Square, P.O. Box 1108
Yanceyville, NC 27379
4. We may use your name to reference your
prescriptions and pharmaceutical care services. You may
be required to sign a signature log form to acknowledge
receipt of service, to acknowledge receipt of this notice
and the disclosure of Protected Health Information as outlined
herein. We may disclose this information to other persons
who ask for you or your prescriptions by name. Requests
by you to restrict this information may or may not be honored.
We are able to provide treatment services to you even if
you object to signing the acknowledgment of the receipt
of this notice or
if we decide not to honor a request regarding the information
in this document. We will use reasonable judgment to comply
with your wishes in the event of emergency or your incapacity.
We will inform you of any such uses or disclosures if uses
and disclosures would require your signed authorization
under such circumstances and give you an opportunity to
object as soon as practicable.
5. We may disclose to one of your family
members, to a relative, to a close personal friend or to
any other person identified by you, Protected Health Information
that is directly relevant to the person’s involvement
with your care or payment related to your care. In addition,
we may use or disclose the Protected Health Information
to notify, identify or locate a member of your family, your
personal representative, another person responsible for
your care, or certain disaster relief agencies of your location,
general condition or death. If you are incapacitated, there
is an emergency, or you object to this use or disclosure,
we will do in our judgment what is in your best interest
regarding such disclosure and will disclose only the information
that is directly relevant to the person’s involvement
with your health care.
We will also use our judgment and experience
regarding your best interest in allowing people to pick-up
filled prescriptions, or other similar forms of Protected
Health Information.
6. It is policy of Yanceyville Drug Co.,
Inc. that all employees are trained under the HIPAA guidelines
regarding protected health information.
7. We reserve the right to change the
terms of this notice and to make new notice provisions effective
for all Protected Health Information we maintain. You may
receive a copy of this notice by contacting us as outlined
in Section B, upon receipt of pharmacy care service.
8. If you believe that your privacy rights
have been violated, you may complain to us at the location
described in Section B, or to the Secretary of the Department
of Health and Human Services.
Section
B:
Yanceyville Drug Company, Inc.
Thomas P. Davis RPH, Pharmacist/Owner
106 Court Square, P.O. Box 1108
Yanceyville, NC 27379
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