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Gillespies Drugs
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NOTICE OF PRIVACY PRACTICES
BRADEN MEDICAL SERVICES
NOTICE OF PRIVACY PRACTICES
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.
DATE OF NOTICE: April 14, 2003
SECTION A: Uses and Disclosures of Protected Health Information
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- By law, we are required to maintain the privacy of your health information ("Protected Health Information" or PHI). We are also required to provide you with this Notice regarding our policies and procedures about your PHI and to abide by the terms of this notice. We are permitted to make certain types of uses and disclosures for treatment, payment, and healthcare operations purposes. We may obtain information to dispense prescriptions, medical supplies and/or equipment, and for the documentation of information in your records that may assist us in managing your therapy or your overall health. For treatment purposes, such use and disclosure will take place in providing, coordinating, or managing your healthcare to one or more of your providers, such as when we consult with your physician regarding your medications, treatment or condition. For payment purposes, such use and disclosure will take place to provide reimbursement for providing medical services, such as when your case is reviewed to ensure that appropriate care was rendered. For reimbursement purposes, your PHI may be disclosed to several intermediaries employed by your plan sponsor including but not limited to insurers, pharmacy benefits managers, claims administrators and computer switching companies. For healthcare operations purposes, such use and disclosure will take place in a number of ways, including for quality assessment and improvement; provider review and training; underwriting activities; reviews and compliance activities; and planning, development, management and administration. Your information could be used to assist in the evaluation of the quality of care. We store your PHI in electronic computer files. We backup our electronic records daily and employ other precautions to safeguard the integrity of your PHI. In spite of these precautions it is possible but unlikely that a computer crash or other technological failure could cause the loss of data. Reasonable safeguards are employed to protect your PHI stored on electronic media. We may contact you to provide refill reminders, health screenings, wellness events, vaccinations or information about treatment alternatives or other health-related benefits and services that may be of interest to you. In addition, we may disclose your health information to your plan sponsor. We may disclose your PHI, without your authorization when the company 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 PHI if we are contacted by another provider who states they have your request and consent to transfer pharmacy records to them. From time to time we may employ the services of business associates who may assist us in one or more tasks and who may use, change or create PHI. Business associates are required to comply with all the privacy regulations on your behalf. We may disclose PHI about you without your authorization to comply with workers compensation laws, 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.
- You may ask us to restrict uses and disclosures of your PHI to carry out treatment, payment, or healthcare operations, or to restrict uses and disclosures to family members, relatives, friends, or other persons identified by you who are involved in your care or payment for your care. However, we are not required to agree to your request.
- You have the right to request the following with respect to your PHI: (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. You may request, and we must accommodate the request, if reasonable, to receive communications of PHI by alternative means or at alternative locations. To make this request please contact us in writing as described in Section B.
- We may use your name to reference your prescribed services. You will be required to sign a signature log form to acknowledge receipt of service, to acknowledge receipt of this Notice and the disclosure of PHI as outlined herein. This information may be disclosed by us to other persons who ask for you or your prescriptions or supplies by name. You may restrict or prohibit these uses and disclosures by notifying our Health Insurance Portability and Accountability Act (HIPAA) compliance officer or their representative orally or in writing of your restriction or prohibition. We are not required to honor those requests. 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. In the event of an emergency or your incapacity, we will do in our reasonable judgment what is consistent with your known preference, and what we determine to be in your best interest. We will inform you of any such uses or disclosures, which would require your signed authorization under such circumstances and give you an opportunity to object as soon as possible.
- Unless we have obtained your written consent, we will only disclose your PHI to: (i) you, (ii) the prescriber who issued the prescription or medication order, (iii) certified/licensed health care personnel who are responsible for your care, (iv) a member, inspector, agent, or investigator of the state board of pharmacy or any federal, state, county, or municipal officer whose duty is to enforce the laws of this state or the United States relating to drugs and who is engaged in a specific investigation involving a designated person or drug, (v) an agent of the state medical board when enforcing the statutes governing physicians and limited practitioners, (vi) an agency of government charged with the responsibility of providing medical care to you, upon a written request by an authorized representative of the agency requesting such information, (vii) an agent of a medical insurance company who provides prescription insurance coverage to you, upon authorization and proof of insurance by you or proof of payment by the insurance company for those medications whose information is requested, (viii) an agent who contracts with the pharmacy as a "business associate" in accordance with the regulations promulgated by the secretary of the United States department of health and human services pursuant to the federal standards for privacy of individually identifiable health information, or (ix) in emergency situations, when it is in your best interest.
- 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 or upon the receipt of pharmacy care services.
- 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, Hubert H. Humphrey Building, 200 Independence Avenue SW, Washington, DC 20201. You will not be retaliated against for filing a complaint.
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Section B: Contacting Us - You may contact us for further information at:
Braden Med Services
Diane Braden - HIPAA Compliance Officer
44510 Marietta Road Caldwell, OH 43724
740-732-7201 FAX: 740-732-2377
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