We are required by law to: Maintain the privacy of Protected Health Information (PHI); Give you this notice of our legal duties and privacy practices regarding health information about you; Follow the terms of our notice that is currently in effect.
The following describes the ways we may use and disclose health information that identifies you (“Health Information”). Except for the purposes described below, we will use and disclose Health Information only with your written permission.
We may use and disclose Health Information for your treatment and to provide you with treatment-related health care benefits and services. For example, we may disclose Health Information to doctors, nurses, technicians, pharmacists, or other personnel, including people outside our office, who are involved in your medical care and need the information to provide you with medical care.
We may use and disclose Health Information so that we or others may bill and receive payment from you, an insurance company or a third party for the treatment, products and/or services you received. For example, we may give your health plan information about you so that they will pay for your treatment. We may also use and disclose Health Information for confirming coverage or benefits, collection activities and utilization review.
Under certain circumstances, we may use and disclose Health Information for research. For example, a research project may involve comparing the health of patients who received one treatment to those who received another, for the same condition. Before we use or disclose Health Information for research, the project will go through a special approval process through an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your information. Even without special approval, we may permit researchers to look at records to help them identify patients who may be included in their research project or for other similar purposes, as long as they do not remove or take a copy of any Health Information.
As Required by Law: We will disclose Health Information when required to do so by international, federal, state or local law.
We may use and disclose Health Information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Disclosures, however, will be made only to someone who may be able to help prevent the threat.
We may disclose Health Information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.
If you are an organ donor, we may use or release Health Information to organizations that handle organ procurement or other entities engaged in procurement, banking or transportation of organs, eyes or tissues to facilitate organ, eye or tissue donation and transplantation.
If you are a member of the armed forces, we may release Health Information as required by military command authorities. We also may release Health Information to the appropriate foreign military authority if you are a member of a foreign military.
We may release Health Information for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
We may disclose Health Information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
We may use or disclose your Protected Health Information to provide legally required notices of unauthorized access to or disclosure of your health information.
If you are involved in a lawsuit or a dispute, we may disclose Health Information in response to a court or administrative order. We also may disclose Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute.
We may release Health Information if asked by a law enforcement official if the information is:
We may release Health Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We also may release Health Information to funeral directors as necessary for their duties.
We may release Health Information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.
We may disclose Health Information to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or to conduct special investigations.
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release Health Information to the correctional institution or law enforcement official. This release would be if necessary:
We may release Health Information to transfer your records as part of a sale of the pharmacy business when permitted by law.
Individuals Involved in Your Care or Payment for Your Care: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your Protected Health Information that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.
We may disclose your Protected Health Information to disaster relief organizations that seek your Protected Health Information to coordinate your care, or notify family and friends of your location or condition in a disaster. We will provide you with an opportunity to agree or object to such a disclosure whenever we practically can do so.
The following uses and disclosures of your Protected Health Information will be made only with your written authorization:
You have the following rights regarding Health Information we have about you:
You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records. To inspect and copy this Health Information, you must make your request, in writing, to Pharmacist-in-Charge, Your Pharmacist Name at Your Company Name and Address.
If your Protected Health Information is maintained in an electronic format (known as an electronic medical record or an electronic health record), you have the right to request that an electronic copy of your record be given to you or transmitted to another individual or entity.
You will be notified upon a breach of any of your unsecured Protected Health Information.
If you feel that Health Information, we have is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, you must make your request, in writing, to The Cruz Company 1309 Coffeen Avenue STE 1200, Sheridan, Wyoming, 82801 or email firstname.lastname@example.org.
You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment and health care operations or for which you provided written authorization. To request an accounting of disclosures, you must make your request in writing The Cruz Company 1309 Coffeen Avenue STE 1200, Sheridan, Wyoming, 82801 or email email@example.com.
If you paid out-of-pocket (or in other words, you have requested that we not bill your health plan) in full for a specific item or service, you have the right to ask that your Protected Health Information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we will honor that request.
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by mail or at work. To request confidential communications, you must make your request in writing to The Cruz Company 1309 Coffeen Avenue STE 1200, Sheridan, Wyoming, 82801 or email firstname.lastname@example.org. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.
You have the right to a paper copy of this notice. You may request us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our website, No-X.net. To obtain a paper copy of this notice make a written request to The Cruz Company 1309 Coffeen Avenue STE 1200, Sheridan, Wyoming, 82801 or email email@example.com.
We reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a copy of our current notice at our office. The notice will contain the effective date on the top of the first page.
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and with The Cruz Company 1309 Coffeen Avenue STE 1200, Sheridan, Wyoming, 82801 or email firstname.lastname@example.org.