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.
As part of the federal Health Insurance Portability and Accountability Act of 1996, known as HIPAA, the healthcare provider has created this Notice of Privacy Practices (Notice). This Notice describes the healthcare provider’s privacy practices and the rights you, the individual, have as they relate to the privacy of your Protected Health Information (PHI). Your PHI is information about you, or that could be used to identify you, as it relates to your past and present physical and mental health care services. The HIPAA regulations require that the healthcare provider protect the privacy of your PHI that the healthcare provider has received
or created.
This healthcare provider will abide by the terms presented within this Notice. For any uses or disclosures that are not listed below, the healthcare provider will obtain a written authorization from you for that use or disclosure, which you will have the right to revoke at any time, as explained in more detail below. The healthcare provider reserves the right to change the healthcare provider’s privacy practices and this Notice. Revisions to the Notice will be posted in the healthcare provider’s facility and, upon your request, provided to you in a paper format.
The following is an accounting of the ways that the healthcare provider is permitted, by law, to use and disclose your PHI.
Uses and disclosures of PHI for Treatment: We will use the PHI that we receive from you to fill your prescription and coordinate or manage your health care.
Uses and disclosures of PHI for Payment: The healthcare provider will disclose your PHI to obtain payment or reimbursement from insurers for your health care services.
Uses and disclosures of PHI for Health Care Operations: The healthcare provider may use the minimum necessary amount of your PHI to conduct quality assessments, improvement activities, and evaluate the healthcare provider’s workforce.
The following is an accounting of additional ways in which the healthcare provider is permitted or required to use or disclose PHI about you without your written authorization. All uses and disclosures will be to the minimum necessary amount of your PHI. Many of these uses and disclosures will never be made by the healthcare provider; however, we are required by law to notify you of them as a health care provider.
Uses and disclosures as required by law: The healthcare provider is required to use or disclose PHI about you as required and as limited by law.
Uses and disclosure for Public Health Activities: The healthcare provider may use or disclose PHI about you to a public health authority that is authorized by law to collect for the purpose of preventing or controlling disease, injury, or disability. This includes the FDA so that it may monitor any adverse effects of drugs, foods, nutritional supplements and other products as required by law.
Uses and disclosure for Public Health Activities: The healthcare provider may use or disclose PHI about you to a government authority if it is reasonably believed you are a victim of abuse, neglect or domestic violence.
Uses and disclosure about victims of abuse, neglect or domestic violence: The healthcare provider may use or disclose PHI about you to a government authority if it is reasonably believed you are a victim of abuse, neglect or domestic violence.
Uses and disclosures for health oversight activities: The healthcare provider may use or disclose PHI about you to a health oversight agency for oversight activities which may include audits, investigations, inspections as necessary for licensure, compliance with civil laws, or other activities the health oversight agency is authorized by law to conduct.
Disclosures for judicial and administrative proceedings: The healthcare provider may disclose PHI about you in the course of any judicial or administrative proceedings, provided that proper documentation is presented to the healthcare provider.
Disclosures for law enforcement purposes: The healthcare provider may disclose PHI about you to law enforcement officials for authorized purposes as required by law or in response to a court order or subpoena.
The following is an accounting of the ways that the healthcare provider is permitted, by law, to use and disclose your PHI.
Uses and disclosures of PHI for Treatment:
We will use the PHI that we receive from you to fill your prescription and coordinate or manage your health care.
Uses and disclosures of PHI for Payment: The healthcare provider will disclose your PHI to obtain payment or reimbursement from insurers for your health care services.
Uses and disclosures of PHI for Health Care Operations:
The healthcare provider may use the minimum necessary amount of your PHI to conduct quality assessments, improvement activities, and evaluate the healthcare provider’s workforce.
The following is an accounting of additional ways in which the healthcare provider is permitted or required to use or disclose PHI about you without your written authorization. All uses and disclosures will be to the minimum necessary amount of your PHI. Many of these uses and disclosures will never be made by the healthcare provider; however, we are required by law to notify you of them as a health care provider.
Uses and disclosures as required by law: The healthcare provider is required to use or disclose PHI about you as required and as limited by law.
Uses and disclosure for Public Health Activities:
The healthcare provider may use or disclose PHI about you to a public health authority that is authorized by law to collect for the purpose of preventing or controlling disease, injury, or disability. This includes the FDA so that it may monitor any adverse effects of drugs, foods, nutritional supplements and other products as required by law.
Uses and disclosure about victims of abuse, neglect or domestic violence:
The healthcare provider may use or disclose PHI about you to a government authority if it is reasonably believed you are a victim of abuse, neglect or domestic violence.
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.
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 agencies for activities authorized by law, For special government functions such as military, national security, and presidential protective services.
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
• 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.)
• 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)
• 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.)
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 the disclosures except for those about treatment,
payment, and health care operations, and certain other disclosures (such as
any you asked us to make). We’ll provide one accounting a year for free but
will charge a reasonable, cost-based fee if you ask for another one within
12 months.
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.
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.
Get an electronic or paper copy of your medical record
You can ask to see or get an electronic or paper copy of your medical record
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.
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.
- You can complain if you feel we have violated your rights by contacting us. You may contact us at (844) 385-8337 to file a complaint, you may submit your complaint by visiting the “Contact Us” webpage form, completing it entirely and submitting it. You may also email your complaint/comments to info@invictus.pharmacy
- 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.
We can change the terms of this notice, and the changes will apply to all information we have about you. The
new notice will be available upon request, in our office, and on our web site. Certain significant changes will also appear below along with the date and brief explanation of change and purpose.
July 24, 2020 - Updated content/sections titled, "Our Responsibilities", "Complaints", "Your Health Information Rights", "Our Uses and Disclosures", "Other Uses and Disclosures". Eliminated sample content which appeared initially due to error. Expanded on Patient's rights section, provided clear instructions on how to file a complaint, elaborated on Invictus Pharmacy's use of PHI and defined what our responsibilities are. Purpose is to provide a more clear and accurate version of Invictus Pharmacy's Privacy Policy.
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