HIPPA Statement
BEDARD HEALTH CARE PHARMACY
Notice of Privacy Practices
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. DATE OF NOTICE: 04/14/03
SECTION A: Uses and Disclosures of Protected Health Information
1. Under applicable law, we are required to protect the privacy
of your individual health information (information we refer
to in this notice as "Protected Health Information").
We are also required to provide you with this Notice regarding
our policies and procedures regarding your Protected Health
Information and to abide by the terms of this notice, as it
may be updated from time to time.
We are permitted to make certain types of uses and disclosures
under applicable law for treatment, payment, and healthcare
operations purposes. We may obtain information to dispense
prescriptions and for the documentation of pertinent information
in your records that may assist us in managing your medication
therapy or your overall health. For treatment purposes, such
use and disclosure will take place in providing, coordinating,
or managing healthcare and its related services by one or more
of your providers, such as when your pharmacist consults with
your physician or a specialist regarding your medications,
treatment or condition.
For payment purposes, such use and disclosure will take place
to obtain or provide reimbursement for providing pharmaceutical
care services, such as when your case is reviewed to ensure
that appropriate care was rendered. For reimbursement purposes,
your Protected Health Information may be disclosed to one or
several intermediaries employed by your plan sponsor including
but not limited to insurers, pharmacy benefits managers, claims
administrators and computer switching companies.
For healthcare operations purposes, such use and disclosure
will take place in a number of ways, including for quality
assessment and improvement; provider review and training; underwriting
activities; reviews and compliance activities; and planning,
development, management and administration. Your information
could be used, for example, to assist in the evaluation of
the quality of care that you were provided.
We store some of your Protected Health Information in electronic
computer files. We backup our electronic recordsdaily
and store our backups offsite, and
employ other precautions to safeguard the integrity of your
Protected Health Information. In spite of these precautions
it is possible but unlikely that a computer crash or other
technological failure could cause the loss of data. In addition
reasonable safeguards are employed to protect your Protected
Health Information stored on electronic media.
In addition, we may contact you to provide refill reminders,
health screenings, wellness events, inoculations, vaccinations
or information about treatment alternatives or other health-related
benefits and services that may be of interest to you. In addition,
we may disclose your health information to your plan sponsor.
In addition we may contact you for the purpose of fund raising
activities.
We may use and disclose your Protected Health Information,
without your authorization when the pharmacy needs to contact
a physician or physician's staff and is permitted or required
to do so without individual written authorization. We may use
and disclose your Protected Health Information if we are contacted
by another pharmacy who states they have your request and consent
to transfer pharmacy records to them.
From time to time we may employ the services of business associates
who may assist us in one or more tasks and who may use, change
or create Protected Health Information. Business associates
are required to comply with all the privacy regulations on
your behalf.
We may disclose Protected Health Information about you without
your authorization to comply with workers compensation laws,
as required by law enforcement, legal proceedings, public health
requirements, health oversight activities and as required by
law.
Other uses and disclosures will be made only with your written
authorization, and you may revoke your authorization by notifying
us as described in Section B.
2. You may ask us to restrict uses and disclosures of your
Protected Health Information to carry out treatment, payment,
or healthcare operations, or to restrict uses and disclosures
to family members, relatives, friends, or other persons identified
by you who are involved in your care or payment for your care.
However, we are not required to agree to your request.
3. You have the right to request the following with respect
to your Protected Health Information: (i) inspection and copying;
(ii) amendment or correction; (iii) an accounting of the disclosures
of this information by us (we are not required to account to
you for disclosures made for treatment, payment, operations,
disclosures to you, disclosures to your care givers, for notifications
or as otherwise excluded by law); and (iv) the right to receive
a paper copy of this notice upon request. We may require you
to pay for this request to cover our costs of copying, labor
and postage.
In addition, you may request, and we must accommodate the
request, if reasonable, to receive communications of Protected
Health Information by alternative means or at alternative locations.
To make this request please contact, in writing:
BEDARD HEALTHCARE PHARMACY
BEDARD HEALTH CARE
PHARMACY
Michael
R. Nadeau, President
61 College Street
Lewiston, Maine 04240
207-786-0138
|
Steven R. Royer,
Vice President
61 College Street
Lewiston, Maine 04240
207.786-0138
|
4. We may use your name to reference your prescriptions and
pharmaceutical care services. You may be required to sign a
signature log form to acknowledge receipt of service, to acknowledge
receipt of this Notice and the disclosure of Protected Health
Information as outlined herein. We may disclose this information
to other persons who ask for you or your prescriptions by name.
You may restrict or prohibit these uses and disclosures by
notifying a pharmacy representative orally and in writing of
your restriction or prohibition. We are not required to honor
those requests. We are able to provide treatment services to
you even if you object to sign the acknowledgment of the receipt
of this Notice or if we decide not to honor a request regarding
the information in this document. In the event of an emergency
or your incapacity, we will do in our reasonable judgment what
is consistent with your known preference, and what we determine
to be in your best interest. We will inform you of any such
uses or disclosures if uses and disclosures would require your
signed authorization under such circumstances and give you
an opportunity to object as soon as practicable.
5. We may disclose to one of your family members, to a relative,
to a close personal friend, or to any other person identified
by you, Protected Health Information that is directly relevant
to the person's involvement with your care or payment related
to your care. In addition we may use or disclose the Protected
Health Information to notify, identify, or locate a member
of your family, your personal representative, another person
responsible for care, or certain disaster relief agencies of
your location, general condition, or death. If you are incapacitated,
there is an emergency, or you object to this use or disclosure,
we will do in our judgment what is in your best interest regarding
such disclosure and will disclose only the information that
is directly relevant to the person's involvement with your
healthcare. We will also use our judgment and experience regarding
your best interest in allowing people to pick-up filled prescriptions,
or other similar forms of Protected Health Information.
6. We reserve the right to change the terms of this Notice
and to make new Notice provisions effective for all Protected
Health Information we maintain. You may receive a copy of this
Notice by contacting us as outlined in Section 8 or upon the
receipt of pharmacy care services.
7. If you believe that your privacy rights have been violated,
you may complain to us at the location described in Section
B or to the Secretary of the Department of Health and Human
Services, Hubert H. Humphrey Building, 2(00 Independence Avenue
SW, Washington, DC 20201. You will not be retaliated against
for filing a complaint.
Section B: Contacting Us
You may contact us for further information at:
BEDARD HEALTH CARE PHARMACY
Michael R. Nadeau, President
61 College Street
Lewiston, Maine 04240
207-786-0138 |
Steven R. Royer,
Vice President
61 College Street
Lewiston, Maine 04240
207.786-0138 |
