HIPAA PRIVACY POLICY
Your
Information. Your Rights. Our Responsibilities.
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 Rights
You have the right
to:
• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated
Your Choices
You have some
choices in the way that we use and share information as we:
• Tell family and friends about your condition
• Provide disaster relief
• Include you in a hospital directory
• Provide mental health care
• Market our services and sell your information
•
Raise funds
Our Uses and Disclosures
We may use and share your information as we:
•
Treat
you •
Run our
organization •
Bill
for your services •
Help
with public health and safety issues •
Do
research •
Comply
with the law •
Respond
to organ and tissue donation requests •
Work
with a medical examiner or funeral director •
Address
workers’ compensation, law enforcement, and other government requests •
Respond
to lawsuits and legal actions |
Your Rights
When it comes to your health information, you have
certain rights. This section explains your rights and
some of our responsibilities to help you.
Get an
electronic or paper copy of your medical record
• You can ask to see or get an electronic or paper copies of your medical
records and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health information, usually
within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to
correct your medical record
• You can ask us to correct health information about you that you think
is incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing
within 60 days.
Request confidential communications
• You can ask us to contact you in a specific way
(for example, home or office phone) or to send mail to a different address.
• We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
• You can ask us not to use or share certain health
information for treatment, payment, or our operations. We are not required to
agree to your request, and we may say “no” if it would affect your care.
• If you pay for a service or health care item
out-of-pocket in full, you can ask us not to share that information for the
purpose of payment or our operations with your health insurer. We will say
“yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
• You can ask for a list (accounting) of the times
we’ve shared your health information for six years prior to the date you ask,
who we shared it with, and why.
• We will include all
disclosures except for those about treatment,
payment, and health care operations, and certain other disclosures (such as any
you asked us to make).
• Get a
copy of this privacy notice
You can ask for a paper
copy of this notice at any time, even if you have agreed to receive the notice
electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
• If you have given someone medical power of attorney
or if someone is your legal guardian, that person can exercise your rights and
make choices about your health information.
• We will make sure the person has this authority and
can act for you before we take any action.
File a complaint if you feel your rights are violated
• You can complain if you feel we have violated your
rights by contacting us using the information on page 1.
• You can file a complaint with the U.S. Department
of Health and Human Services Office for Civil Rights by sending a letter to 200
Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or
visiting www.hhs.gov/ocr/privacy/hipaa/complaints/
• We will not retaliate against you for filing a
complaint.
Your Choices
For certain health information, you can tell us your
choices about what we share. If you have a clear
preference for how we share your information in the situations described below,
talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and
choice to tell us to:
• Share information with your family, close friends,
or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory
If you are not able to tell us your
preference, for example if you are unconscious, we may go ahead and share your
information if we believe it is in your best interest. We may also share your
information when needed to lessen a serious and imminent threat to your health
or safety.
In these cases, we never
share your information unless you give us written permission:
• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes
Our Uses and Disclosures
How do we typically use or share
your health information?
We typically use or
share your health information in the following ways.
Treat
you
We can use your
health information and share it with other professionals who are treating you.
Example: A doctor treating you
for an injury asks another doctor about your overall health condition.
Run our
organization
We can use and share
your health information to run our practice, improve your care, and contact you
when necessary.
Example:
We use health information about you to manage your treatment and services.
Bill
for your services
We
can use and share your health information to bill and get payment from health
plans or other entities.
Example:
We give information about you to your health insurance plan so it will pay for
your services.
How else can we use
or share your health information?
We are allowed or
required to share your information in other ways – usually in ways that
contribute to the public good, such as public health and research. We must meet
many conditions in the law before we can share your information for these
purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help
with public health and safety issues
We can share health
information about you for certain situations such as:
• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety
Comply
with the law
We will share information
about you if state or federal laws require it, including with the Department of
Health and Human Services if it wants to see that we’re complying with federal
privacy law.
Respond to organ and tissue donation requests
We
can share health information
about you with organ procurement organizations.
Work with a medical examiner or funeral director
We
can share health information
with a coroner, medical examiner, or funeral director when an individual die.
Address
workers’ compensation, law enforcement, and other government requests
We can use or share
health information about you:
• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agency for activities authorized by law
• For special government functions such as military, national security,
and presidential protective services
Respond
to lawsuits and legal actions
We
can share health information about you in response to a court or administrative
order, or in response to a subpoena.
Our Responsibilities
• We are required by law to maintain the privacy and security of
your protected health information.
• We will let you know promptly if a breach occurs that may have
compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this
notice and give you a copy of it.
• We will not use or share your information other
than as described here unless you tell us we can in writing. If you tell us we
can, you may change your mind at any time. Let us know in writing if you change
your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the
terms of this notice, and the changes will apply to all
the information we have about you. The new notice
will be available upon request, in our office, and on our website.
If you need any
additional information about this Notice or wish to exercise any of your rights
set forth in this Notice, please contact the Privacy Officer at the following
address:
P.O Box 600047
Jacksonville, FL, 32260
Or email the
following Email: Compliance@Citizenpharmacy.us
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Links
to other websites
Our website may contain links to other
websites that can provide useful information to you. Once you click on these
links, however, we cannot be held responsible for the protection and privacy of
any information that you provide while visiting these sites. You should
exercise caution and look at the privacy statement applicable to the website
that you are visiting.