THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
ScriptAssist Pharmacy is committed to maintaining your privacy and we take our responsibility for safeguarding this information very seriously. ScriptAssist Pharmacy is required by law to provide you with this Notice so that you will understand how we may use or share your “Protected Health Information” (“PHI”) or simply “health information.” PHI is information we obtain to provide services to you and that can identify you. PHI includes your name, past, present or future medical conditions, the provision of healthcare products and services and payment for such products and services, health information and other information we use to provide your prescriptions. We are required to adhere to the terms outlined in this Notice. If you have any questions about this Notice, please contact ScriptAssist Pharmacy.
How We May Use and Disclose Protected Health Information About You
The following categories describe the ways that we use and disclose health information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall into one of the categories.
PHI obtained from ScriptAssist Pharmacy will be used in order to dispense your prescription medications. We may disclose health information about you to doctors, nurses, other pharmacies, health care facilities and/or caregivers to whom you have granted access who are involved in taking care of you.
We may use or disclose your PHI to your insurer, payor, or other agent in order to bill and collect payment for items or services we provided to you. For example, we may contact
your insurance company, health plan, or another third party to obtain payment for services we provided to you. We may also contact you about a payment or balance due.
For Health Care Operations
We may use and disclose health information about you for our day-to-day health care operations. For example, we may use your PHI to monitor the performance of the staff and pharmacists providing treatment and services to you. We may use your PHI to continually improve the quality and the effectiveness of the health care products and services that we provide to you.
Other Allowable Uses of Your Health Information
We may contract with third parties to perform certain services for us, such as billing services, copy services or consulting services. These third party service providers, referred to as Business Associates, may need to access your PHI to perform services for us. They are required by contract and law to protect your PHI and only use and disclose it as necessary to perform their services for us.
Individuals Involved in Your Care or Payment for Your Care – Caregivers
We may disclose health information about you to a friend or family member who is involved in your care that you define to us as a Caregiver. You reserve the right to revoke a Caregivers ability to access you PHI. We may also give information to someone who helps pay for your care. Additionally our pharmacists, using their professional judgment, may disclose PHI to other health care professionals or providers who are directly involved in your care and treatment.
Disclosures to Parents or Legal Guardians
If you are a minor, we may release your PHI to your parents or legal guardians when we are permitted or required under federal and applicable state laws. In those cases, ScriptAssist Pharmacy will follow state laws regarding disclosure of a minor’s PHI.
As Required By Law
We will disclose health information about you when required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety
We may use and disclose health information about you to prevent a serious threat to your health and safety or the health and safety of the public or another person. We would do this only to help prevent the threat.
Organ and Tissue Donation
Consistent with applicable law, we may disclose your PHI to organizations engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
Military and Veterans
If you are a member of the armed forces, we may disclose health information about you as required by military authorities. We may also disclose health information about foreign military personnel to the appropriate foreign military authority.
We may use your PHI to conduct research and we may disclose your PHI to researchers as authorized by law. For example, we may use or disclose your PHI as part of a research study when the research has been approved by an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your information.
We may disclose health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Federal and state laws may require or permit ScriptAssist Pharmacy to disclose certain health information related to the following public health risks. We may disclose health information about you for public health purposes, including: prevention or control of disease, injury or disability; reporting reactions to medications or problems with products; adverse drug reactions; notifying people of recalls of products; and notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease. We may disclose PHI about you to a government authority if we reasonably believe you are a victim of abuse or neglect. We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else.
Health Oversight Activities
We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities may 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.
Judicial and Administrative Proceedings
If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
We may disclose health information when requested by a law enforcement official: in response to a court order, subpoena, warrant, summons or similar process; to identify or locate a suspect, fugitive, material witness, or missing person; about you, the victim of a crime if, under certain limited circumstances, we are unable to obtain your agreement; about a death we believe may be the result of criminal conduct; about criminal conduct at ScriptAssist Pharmacy; and in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors
We may disclose medical information to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death. We may also disclose medical information to funeral directors as necessary to carry out their duties.
National Security and Intelligence Activities
We may disclose health information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law. We may disclose your PHI to authorized federal officials so that they may provide protection to the President, other authorized persons, or foreign heads of state, or conduct special investigations.
Should you be an inmate of a correctional institution, we may disclose to the institution or its agents health information necessary for your health and the health and safety of others.
Other Uses of Health Information
Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
Your Rights Regarding Health Information About You
Although your health record is the property of ScriptAssist Pharmacy, the information belongs to you. You have the following rights regarding your health information:
Right to Inspect and Copy
With some exceptions, you have the right to review and copy your health information. You must submit your request in writing to ScriptAssist Pharmacy: Privacy Office. We may charge a fee for the costs of copying, mailing or other supplies associated with your request.
Right to Amend
If you feel that health information in your record is incorrect or incomplete, you may ask us to amend the information. You have this right for as long as the information is kept by or for ScriptAssist Pharmacy. You must submit your request in writing to ScriptAssist Pharmacy: Privacy Office. In addition, you must provide a reason for your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: was not created by us, unless the person or entity that created the information is no longer available to make the amendment; is not part of the health information kept by or for ScriptAssist Pharmacy; or is accurate and complete.
Right to an Accounting of Disclosures
You have the right to request an “accounting of disclosures”. This is a list of certain disclosures we made of your health information, other than those made for purposes such as treatment, payment, or health care operations. You must submit your request in writing to ScriptAssist Pharmacy: Privacy Office. Your request must state a time period, which may not be longer than six years from the date the request is submitted and may not include dates before January 1st, 2019. Your request should indicate in what form you want the list (for example, on paper or electronically). We may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions
You have the right to request a restriction or limitation on the health information we use or disclose about you. For example, you may request that we limit the health information we disclose to someone who is involved in your care or the payment for your care. You could ask that we not use or disclose information about a prescription you had to a family member or friend. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. You must submit your request in writing to ScriptAssist Pharmacy: Privacy Office. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
Right to Request Alternate Communication
You have the right to request that we communicate with you about medical matters in a confidential manner or at a specific location. For example, you may ask that we only contact you via mail to a post office box. You must submit your request in writing to ScriptAssist Pharmacy: Privacy Office. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will attempt to accommodate all reasonable requests.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice of Privacy Practices even if you have agreed to receive the Notice electronically. You may ask us to give you a copy of this Notice at any time. You may obtain a copy of this Notice at our website, http://www.ScriptAssistRX.com/page-to-be determined to obtain a paper copy of this Notice, contact ScriptAssist Pharmacy: Privacy Office.
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 health information we already have about you as well as any information we receive in the future. If we change this policy, we will alert you to the changes and you will be required to acknowledge and agree to the change before continuing your use of our services. We will also post a copy of the current Notice in ScriptAssist Pharmacy and on the website at: http://www.ScriptAssistRX.com/privacy-policy . The Notice will specify the effective date on the first page, in the bottom right-hand corner. In addition, if material changes are made to this Notice, the Notice will contain an effective date for the revisions and copies can be obtained by contacting ScriptAssist Pharmacy: Privacy Office.
If you believe your privacy rights have been violated, you may file a complaint with ScriptAssist Pharmacy or with the Secretary of the Department of Health and Human Services. To file a complaint with ScriptAssist Pharmacy, contact ScriptAssist Pharmacy: Privacy Office. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
The information contained in this Notice of HIPPA & Privacy Practices is subject to change without notice.
Effective on January 11, 2019
Last updated on May 28, 2019