Privacy Policy
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.
At University Compounding pharmacy, we’re committed to providing quality customer service and keeping you informed. At this time, we want to tell you about a federal requirement for privacy. The U.S. Department of Health and Human Services set standards for ensuring the privacy of personal health information. These regulations went into effect on April 14, 2003. We are committed to keeping your healthcare information confidential. You may obtain a paper copy of this notice upon request at any time. To obtain a paper copy, contact the store Privacy Officer at (248) 267-5002.
You have the following rights with respect to Protected Health Information (PHI) about you:
- You may request a restriction on certain uses and disclosures of PHI. To request additional restrictions on uses or disclosure of your PHI, send a written request to the store Privacy Officer at 6054 Livernois Road, Troy, MI 48098. We are not required to agree to those restrictions.
- You have the right to access, copy or inspect your PHI. This means you may come to our offices and inspect and copy most of the medical information about you that we maintain. The designated record will usually include prescription and billing records. If you wish to inspect and copy your medical information, you must send a written request to the store Privacy Officer at 6054 Livernois Road, Troy, MI 48098. We may charge you a fee for the cost of copying, mailing, labor, and supplies that are necessary to fulfill your request. We may deny your request to inspect and copy in certain limited circumstances. If you are denied access to PHI about you, you may request that the denial is reviewed.
- You may request an amendment of your PHI. The right to amend your PHI. The right to request amending your PHI. If you feel the PHI we maintain about you is incomplete or incorrect, you may request that we amend it. You may request this as long as we maintain the PHI. To request an amendment, you must send a written request to the store Privacy Officer at 6054 Livernois Road, Troy, MI 48098. You must include a reason that supports your request. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with the decision and we may give a rebuttal to your statement.
- You may receive an accounting of our use and disclosure of your PHI. You have the right to request an accounting from us of most disclosures made after April 14, 2003 (other than those relating to treatment, payment, or health care operation). The accounting will exclude certain disclosures, such as disclosures made directly to you, disclosures you authorize, disclosures to family members or friends involved in your care, and disclosures for notification purposes. If you wish to request an accounting of the medical information about you that we have used or disclosed that is not exempted from the accounting requirement, you must send a written request to the store Privacy Officer at 6054 Livernois Road, Troy, MI 48098. Your request must specify the time period, but may not be longer than 6 years. The first accounting you request within a 12 month period will be provided free of charge, but you may be charged for the cost of providing additional accountings. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time.
- You may request PHI communication by alternative mean or alternative locations. For instance, you may request that we contact you about medical matters in writing or at a different address or post office box. To request alternative communication of PHI about you, send a written request to the store Privacy Officer at 6054 Livernois Road, Troy, MI 48098. Your request must state how or where you would like to be contacted. We will attempt to accommodate all reasonable requests.
Protected Health Information (PHI) may be used and disclosed by us in the following manners:
- Your PHI will be used for treatment. Information obtained by the pharmacist will be used to dispense prescription medications to you. We will document in your record information related to the medications dispensed to you and services provided to you.
- Your PHI will be used for payment purposes. If you have insurance coverage, we will contact your insurer or pharmacy benefit manager to determine whether it will pay for your prescription and the amount of your copayment. We will bill you or a 3rd party payor for the cost of the prescription medications dispensed to you. The information on or accompanying the bill may include information that identifies you, as well as the prescriptions you are taking.
- Your PHI will be used for healthcare operations. The pharmacy may use information in your health record to monitor the performance of the pharmacists providing treatment to you. This information will be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.
- Your PHI may likely be disclosed to our business associates. There are some services provided by us through contracts with business associates. Examples include: pharmacy Franchise Corporation, pharmacy computer software vendor, prescription insurance companies or pharmacy benefit managers, claim processing vendors, our legal counsel in cases of litigation. To protect PHI about you, we require the business associate to appropriately safeguard the PHI.
- Your PHI may likely be disclosed to individuals involved in your care or payment for your care. Healthcare professionals such as pharmacists, using their professional judgment, may disclose to a family member, another relative, close personal friend or any person you identify, PHI relevant to that person’s involvement in your care or payment related to your care.
- Your PHI may likely be disclosed to provide health-related communications. We may contact you to provide refill reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
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 PHI may likely be disclosed to the Food and Drug Administration (FDA). We may disclose to the FDA, or persons under the jurisdiction of the FDA, PHI relative to adverse events with respect to drugs, foods, supplements, products and product deficits, or post marketing surveillance information to enable product recalls, repairs, or replacements.
- Your PHI may likely be disclosed in Worker’s Compensation cases. We may disclose PHI about you as authorized by and as necessary to comply with laws relating to worker’s compensation or similar programs established by law.
- Your PHI may likely be disclosed to Public Health authorities. As required by law, we may disclose PHI about you to public health or legal authorities charged with preventing or controlling disease, injury or disability.
- Your PHI will be disclosed as required by law. We must disclose PHI about you when required to do so by law.
- Your PHI may likely be disclosed for law enforcement purposes. We may disclose PHI about you for law enforcement purposes as required by law or in response to a valid subpoena or another legal process.
- We are permitted to disclose your PHI for research purposes. We may disclose PHI about you to researchers when an institutional review board has reviewed the research proposal and established protocols to ensure the privacy of your information has approved their research.
- We are permitted to disclose your PHI to coroners, medical examiners, and funeral directors for identifying a deceased person, determining a cause of death, or carrying on their duties as authorized by law.
- We are permitted to disclose your PHI with organizations that handle organ or tissue procurement. Consistent with applicable law, we may disclose PHI about you to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
- We are permitted to disclose PHI for purposes of notification. We may use or disclose PHI about you to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and your general condition.
- We are permitted to disclose your PHI to correctional institutions. If you are or become an inmate of a correctional institution, we may disclose PHI to the institution or its agents when necessary for your health or the health and safety of others.
- We are permitted to disclose your PHI to avert a serious threat to health or safety. We may disclose PHI about you when necessary to prevent a serious threat to your health and safety of the public or another person.
- We are permitted to disclose your PHI to the military. If you are a member of the armed forces, we may release PHI about you as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate military authority.
- We are permitted to disclose your PHI for National Security and Intelligence activities. We may release PHI about you to authorized federal agents for intelligence, counterintelligence, and other national security activities authorized by law.
- We are permitted to disclose your PHI to protective services for the President and others. We may disclose PHI about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
- We are permitted to disclose your PHI in cases of abuse, neglect or domestic violence. We may disclose PHI about you to a government authority, such as a social service or protective services agency if we reasonably believe you are a victim of abuse, neglect or domestic violence. We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else or the law enforcement or public official that is to receive the report represents that it is necessary and will not be used against you.
The Pharmacy will obtain your written authorization before using or disclosing PHI about you for purposes other than those provided for above or as otherwise permitted or required by law. You may revoke the authorization in writing at any time. Send a written request to the store Privacy Officer at 6054 Livernois Road, Troy, MI 48098. Upon receipt of the written request for revocation, we will stop using or disclosing information about you, except to the extent that we have already taken action in reliance on the authorization. If revoked, we may not be able to service your pharmacy health care needs.
For more information about the Pharmacy’s privacy practices or to report a problem, you may contact the store at (248) 267-5002. If you believe your rights have been violated, you can file a complaint with the store Privacy officer or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.
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What personal data we collect and why we collect it
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