Notice of Privacy Practices (HIPAA)

Our Pledge Regarding Medical Information

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at our pharmacy. We need this record to provide you with quality care and to comply with certain legal requirements.

How We May Use and Disclose Medical Information

For Treatment

We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, or other personnel who are involved in taking care of you.

For Payment

We may use and disclose medical information about you so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party.

For Healthcare Operations

We may use and disclose medical information about you for pharmacy operations. These uses and disclosures are necessary to run the pharmacy and make sure that all of our patients receive quality care.

Special Situations

We may use or disclose your health information without your permission in the following special situations:

• As required by law
• To avert a serious threat to health or safety
• For public health activities
• For health oversight activities
• For lawsuits and disputes
• For law enforcement purposes
• In response to court orders or subpoenas
• For workers' compensation purposes

Your Rights Regarding Medical Information

Right to Inspect and Copy

You have the right to inspect and copy medical information that may be used to make decisions about your care. To inspect and copy medical information, you must submit your request in writing.

Right to Amend

If you feel that medical information we have about you 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 the pharmacy.

Right to Request Restrictions

You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or healthcare operations.

Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. We will accommodate reasonable requests.

Right to an Accounting of Disclosures

You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment, and healthcare operations.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the pharmacy or with the Secretary of the Department of Health and Human Services. To file a complaint with the pharmacy, contact:

You will not be penalized for filing a complaint.

Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the pharmacy.

Questions

If you have any questions about this notice, please contact our Privacy Officer at (434) 792-8281 or visit us at our pharmacy location.