Notice of Privacy Practices under HIPAA (Health Insurance Portability and Accountability Act of 1996) Guidelines
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.
YOUR HEALTH INFORMATION RIGHTS:
Unless otherwise required by law, your health record is the physical property of the facility that compiled it but the information belongs to you. You have the right to request a restriction on certain uses and disclosures of your information and request amendments to your health record. This includes your right to request, inspect and obtain a copy of your health record. You may revoke your authorization to use or disclose health information except to the extent that action has already been taken.
This organization is required to maintain the privacy of your health information. In addition, provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you. If you have questions, complaints or would like additional information, you may contact the owner or the pharmacist on duty at this location. If you believe your privacy rights have been violated, you can also file a complaint with the Secretary of Health and Human Services.
We will use your health information for payment from a third party payer. The information on or accompanying the bill may include information that indentifies you, as well as your diagnosis, procedures and medications or supplies provided. We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law. As required by law, we may disclose to the FDA health information relative to adverse events with respect to medications and supplies or product defects to enable product recalls. We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Patients will be provided with a hard copy of this notice if desired
EFFECTIVE DATE : April 14, 2003