Notice of Privacy Practices
The following is a notice of Custom Care Pharmacy Services privacy practices with regard to your medical information and how we may use and disclose your protected health information (PHI) for treatment, payment and health care operations, as well as for other purposes that are permitted or required by law. You have certain rights regarding the privacy of your PHI and we also describe those rights in this notice.
Custom Care Pharmacy Services reserves the right to change the provision of our Notice and to make new provisions effective for all PHI we maintain. Our Privacy Officer is Adam Rosinski.
What is Protected Health Information?
Protected Health Information (PHI) consists of individually identifiable health information, which may include demographic information Custom Care Pharmacy Services collects from you or creates or receives from a health care provider, a health plan, your employer or a healthcare clearinghouse and that relates to: (1) your past, present or future physical or mental health or condition; (2) the provision of healthcare to you; or (3) the past, present or future payment for the provision of healthcare to you.
WAYS WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION:
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your health care and any related services. We may also disclose your health information to other providers who may be treating you. Additionally, we may disclose your health information to another provider who has been requested to be involved in your care. For example, your PHI may be disclosed to doctors, nurses, technicians or other personnel, including individuals outside of our company, who are involved in your medical care.
Payment
We may use and disclose your PHI to obtain payment for the healthcare services we provide to you. For example, your PHI may be disclosed to your health plan so they will pay for services rendered.
USES AND DISCLOSURES THAT REQUIRE YOU TO BE GIVEN THE OPPORTUNITY TO OBJECT OR OPT OUT:
Others involved in your care
Unless you object, we may disclose relevant portions of your PHI to a member of your family, a relative, a close friend or any other person you identify as being involved in your medical care or payment of care. We may disclose such information as necessary if we determine it is in your best interest based on our professional judgment. You will be given the opportunity to agree or object to future disclosures after the fact if necessary.
Emergencies / Disaster Relief
We may disclose your PHI in emergencies and to disaster relief organizations that seek your PHI to coordinate your care, or notify family and friends of your location or condition in a disaster. You will be given the opportunity to agree or object to future disclosures after the fact if necessary.
USES AND DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION:
Marketing
PHI for marketing purposes will only be disclosed with the individual’s written authorization.
Sale of PHI
Disclosure that constitutes a sale of PHI will only be disclosed with the individual’s written authorization.
USES AND DISCLOSURES NOT COVERED BY THIS NOTICE:
Uses and disclosures of your PHI not covered by this notice or the laws that apply to use will only be made with your written authorization. You may revoke such authorization in writing at any time and we will no longer disclose health information about you for the reasons stated in your authorization. Disclosures made in reliance on the authorization prior to the revocation are not affected by the revocation.
INDIVIDUAL RIGHTS:
Breach Notification
We are required to notify patients whose PHI has been breached. Notification must occur by first class mail within sixty (60) days of the event. A breach occurs when an unauthorized use or disclosure that compromises the privacy and security of PHI poses a significant risk for financial, reputational, or other harm to the individual. The notice must: (1) contain a brief description of what happened, including the date of the breach and the date of discovery; (2) the steps the individual should take to protect themselves from potential harm resulting from the breach; (3) a brief description of what we are doing to investigate the breach, mitigate losses and protect against further breaches.
Cash Patients / Clients
If a patient pays in full for their services out of pocket they can demand that the information regarding the service not be disclosed to the patient’s third party payer since no claim is being made against the third party payer.
Access to e-Health Records
If your PHI is maintained in an electronic format, you have the right to request an electronic copy of your record be given to you or transmitted to another individual or entity. If your PHI is not readily producible in an electronic format, your record will be provided in hardcopy form. We may charge you a reasonable amount for the labor associated with transmitting the electronic record.