HOLLADAY HEALTHCARE, INC. NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We value your relationship with us, and know that respect for your privacy is the foundation of that relationship. We are committed to protecting the privacy of your protected health information (PHI) that is in our possession, and only using and disclosing your PHI as necessary to provide you with health care products and services. PHI is any information that we possess, use, and disclose that identifies you and relates to your past, current, or future physical and mental health condition or illness and the health care products and services that have been provided to you.
How Holladay Healthcare, Inc. May Use or Disclose Your Health Information.
For some activities, we must have your written authorization or disclose your health information. However, the law permits Holladay Healthcare, Inc. to use or disclose your health information for the following purposes without your authorization:
*For Treatment: Information obtained by the Holladay Healthcare, Inc. (the Pharmacy) will be used to dispense prescriptions to you. We may disclose health information about you to pharmacists, doctors. nurses, and other persons who are involved in providing your healthcare needs.
*For Payment. We may use and disclose your health information so that your pharmacy services may be billed to, and payment may be collected from, you, an insurance company, or another third party payer.
*For Health Care Operations. We may use and disclose medical information about you for pharmacy management decisions. These uses and disclosures are necessary to ensure quality care of our patients. We will disclose medical information that identifies you to people outside Holladay, who are not involved in your care, with your consent, except for disclosures that are required or permitted by law.
*As Required by Law. We will disclosehealth 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 when necessary to prevent a serious to your health or safety or the health or safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
*Public Health Risks. We may disclose health information about you for public health activities. These activities generally include the following: (1) to prevent or control disease, injury or disability; (2) to report reactions to medications or problems with products; (3) to notify people of recalls of products they may be using; (4) to 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 (5) to notify the appropriate government authority if we believe a person has been the victim of abuse, neglect or domestic violence (we will only make this disclosure if you agree and when required or authorized by law.)
*For Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities, which are necessary for the government to monitor the healthcare system, includes audits, investigations, inspections and licensure.
*For Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose health information about you in response to a court order or administrative order. We may also disclose 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 (which may include written notice to you) or to obtain an order protecting the information requested.
*For Specific Government Functions. We may disclose health information for specific governmental functions.
*Business Associates: The nature of the healthcare system is such that we may not be able to provide health care products and services to you without the involvement of other businesses or persons. Depending on what they do for us, they may become “Business Associates, as defined by HIPAA and other federal laws. In many situations, it will be necessary for us to provide your PHI to these business associates so that they can carry out the activities that we need to have performed in order for us to provide your healthcare products and services. One of our most common Business Associates is a health insurance company or a company that processes claims that we submit for payment of healthcare products and services that we provide to you, if you have health insurance that pays for your prescription medications. Contracts have or will be submitted to all of our business associates to whom we provide your PHI so that they can carry out their activities or our behalf. Very important to you, these contracts require our business associates to give us their written assurance that they, line us, will protect the privacy of your PHI.
When Holladay Healthcare, Inc., May Not Use or Disclose Your Health Information
Except as described in this Notice, Holladay Healthcare, Inc. will not use or disclose your health information without your written authorization. If you do authorize Holladay Healthcare, Inc. to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.
You Have the Following Rights With Respect to Your Health Information
*You have the right to request restrictions on certain uses and disclosures of your health information.
Holladay Healthcare, Inc. is not required to agree to a restriction that you request. If we do agree to any restriction, we will put the agreement in writing and follow it, except in emergency situations. We cannot agree to limit the uses of disclosures of information that are required by law.
*You have the right to inspect and copy your health information as long as the Pharmacy maintains the health information, upon written request. Your health information usually will include prescription and billing records. We may charge a fee for the costs of copying, mailing, or providing other supplies that are necessary to grant your request. We may deny your request to inspect and copy in certain limited circumstances. If you are denied access to your health information, you may request that the denial be reviewed. You have a right to obtain a summary instead of a copy of your health information.
*You have the right to request that Holladay Healthcare, Inc. amend your health information that is incorrect or incomplete. To request an amendment, you must submit a written request to the Pharmacy (the form is available from your pharmacist), along with the reason for the request. Holladay Healthcare, Inc. is not required to amend health information that is accurate and complete. Holladay Healthcare is not required to amend any health information that is accurate and complete, and will provide you with information about the procedure for addressing any disagreement with a denial.
* You have the right to receive an accounting of disclosures of your health information we have made after April 14, 2003 for purposes other than disclosure for (1) Holladay Healthcare, Inc. treatment, payment or healthcare operations, (2) to you or based upon your authorization and (3) for certain functions. To request an accounting, you must submit a written request to Holladay Healthcare, Inc. at the address shown below. You must specify the time limit, which cannot be more than 6 years.
* You may request communications of your health information by alternative means or at alternative locations other that the address we have for you… For other directions, you must submit a written request to us at the address below. Your request must state how or when you would like to be contacted. We will accommodate all reasonable requests.
*If you need to contact us for one of the above reasons or to obtain a copy of our complete Notice of Privacy Practices, submit a written request to:
Holladay Healthcare, Inc., 2560 Landmark Drive, Winston-Salem, North Carolina 27103
We reserve the right to change this Notice. Any revised Notice will be posted at the above address or you can request a copy in writing.
IF YOU BELIEVE YOUR PRVACY RIGHTS HAVE BEEN VIOLATED IN ANY WAY, YOU CAN FILE A WRITTEN COMPLAINT WITH THE COMPLIANCE OFFICER AT THE ABOVE ADDRESS OR WITH THE SECRETARY OF HEALTH AND HUMAN SERVICES, WASHINGTON, D.C. THERE WILL BE NO RETALIATION FOR FILING A COMPLAINT. EFF. 7/1/2013