Notice of Privacy Practices
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.
Pharmacies are required by federal and state laws to maintain the privacy of “Protected Health Information” (PHI) and to provide you with notice about your rights and our legal duties and privacy practices with respect to your PHI. We must abide by the terms of this Notice while it is in effect. Some of the uses and disclosures described in this Notice may be limited in certain cases by applicable state laws that may be more stringent than the federal standards. This Notice is effective as of November 17, 2015.
PHI is information about you, including demographic information, which can be reasonably used to identify you and which relates to your past, present, or future physical or mental health or condition, the provision of related health care services to you or the payment for that care. This Notice tells you about the ways in which pharmacies may collect, use, and disclose your PHI to carry out treatment, payment or health care operations and for other specified purposes permitted or required by law. Your rights concerning you PHI are also disclosed in this Notice.
HOW PHARMACIES MAY USE AND DISCLOSE YOUR PHI: We may use and disclose your PHI without your authorization for purposes of payment and health care operations or treatment.
Payment: We use and disclose your PHI in order to process claims and seek reimbursement for your health expenses covered by an insurer or plan.
Health Care Operations and Treatment: We use and disclose your PHI in order to perform our administrative activities, including data management. We may use and disclose your PHI to assist your health care providers (Example: doctors, dentists, hospitals, pharmacies) in your diagnosis and treatment.
OTHER DISCLOSURES OF YOUR PHI PERMITTED OR REQUIRED BY LAW:
- Public Health Activities. Pharmacies may disclose about you, with some limitations, to public health agencies for reasons of preventing or controlling disease and enabling product recalls, repairs, or replacements.
- Communication with Certain Individual Involved in Your Care or Payment. Pharmacies my disclose to any person you identify as relevant to their involvement in your care or related payments.
- As required b Military Command Authorities. Pharmacies may disclose PHI about foreign military personnel to the appropriate agencies.
- Correctional Institutions. If you are or become and inmate of a correctional institution, pharmacies may disclose when necessary to protect your personal or public health.
- Victims of Abuse, Neglect, or Domestic Violence. Pharmacies may disclose to government agencies if there is reasonable proof you are a victim of abuse, neglect, or domestic violence.
- Health Oversight Activities. Pharmacies may disclose to government oversight agencies as authorized by law, including audits, investigations, and inspections, as necessary for our licensure and for the government to monitor the health care system and compliance with laws and regulations.
- Judicial and Administrative Proceedings. Pharmacies may disclose in response to a court order, administrative order, subpoena, discovery request, or other lawful process.
- Coroners, Medical Examiners, Funeral Directors, or Organ Donation.
- Research. Pharmacies may disclose about you provided that research is approved by an institutional review board and certain measures have been taken to protect your privacy.
- Special Government Functions. Pharmacies may disclose to authorized federal officials for national security or intelligence activities.
OTHER DISCLOSURES OF YOUR PHI AS PERMITTED BY YOUR WRITTEN AUTHORIZATION: Other uses or disclosures of you PHI will be made only with your written authorization, unless otherwise permitted or required by law. You may revoke an authorization at any time in writing, except to the extent the pharmacy has already taken action on the information disclosed.
YOUR RIGHTS REGARDING YOUR PHI:
- YOU HAVE THE RIGHT TO ACCESS YOUR PHI, with some limited exceptions. These records include prescription, billing and claims information, and case or medical management records. To inspect or copy your PHI, you must request in writing. The pharmacy may charge you and administrative fee for the costs of copying, mailing, and supplies necessary to fulfill your request. If you are denied access due to certain limited circumstances, you may request that the denial be reviewed.
- YOU HAVE THE RIGHT TO AMEND YOUR PHI, if the PHI maintained by the pharmacy is incorrect or incomplete. Your request must be made in writing and must include the reason you are seeking a change. The pharmacy may deny your request if you ask the pharmacy to amend information that was not created by the pharmacy or you ask the pharmacy to amend a record that is accurate and complete. If the pharmacy denies your request to amend, it must notify you in writing.
- YOU HAVE THE RIGHT TO AN ACCOUNTING OF DISCLOSURES OR YOUR PHI MADE BY THE PHARMACY, with the exception of disclosures related to your treatment, billing or receipt of payment, health care operations, or disclosures made to your or with your authorization. Your request must be made in writing and must include the reason you are seeking an accounting and must state the time period for which you want the accounting. This time period may not be longer than 6 years. We may charge for an accounting and you will be informed of the cost in advance and you may choose to withdraw or modify your request at that time.
- YOU HAVE THE RIGHT TO REQUEST RESTRICTIONS ON THE USE AND DISCLOSURE OF YOUR PHI unless the information is needed for an emergency or required by law. Your request must be made in writing and must state 1)what information you wish to limit; 2)whether you want to limit how we use or disclose your information; 3)to whom you wish the restrictions to apply. We may not agree to your request.
- YOU HAVE THE RIGHT TO RECEIVE CONFIDENTIAL COMMUNICATIONS. You may request that the pharmacy will use a certain method to communicate with you about your PHI or that the pharmacy send pharmacy-related information to a certain location if the communication could endanger you. Your request must be made in writing and must specify how or where you wish to be contacted and must state how the usual way of communicating could endanger you. The pharmacy will accommodate reasonable requests.
- YOU HAVE THE RIGHT TO RECEIVE A PAPER COPY OF THIS NOTICE.
HEALTH INFORMATION SECURITY: Pharmacy employees must follow the pharmacy’s security practices which limit access to customer health information. PHI information will be accessible only to those employees who need it to perform their job responsibilities. In addition, the pharmacies must maintain physical, administrative, and technical security measures to safeguard your PHI.
CHANGES TO THIS NOTICE: We reserve the right to change the terms of this Notice at any time, effective for PHI the pharmacy may already have about you as well as any information the pharmacy receives in the future. The pharmacy will provide you with a copy of the new Notice whenever a material change is made to the privacy practices described in this Notice.
COMPLAINTS OR WRITTEN REQUESTS: If you believe your rights to privacy of your PHI have been violated, you may file a complaint with the pharmacy. The complaint must be in writing. Requests for access to your PHI; amending of your PHI; accounting of PHI disclosures made by the pharmacy; restrictions on the use and disclosure of your PHI; and use of a certain method of communication from the pharmacy must be made in writing and delivered to the pharmacy.
NEXGEN COMPOUNDING PHARMACY
2005 FORT WORTH HWY, SUITE 100
WEATHERFORD, TX 76086