Coleman Pharmacy of Crawford County, Inc. Notice of Privacy Practices

Uses and Disclosure of Your Health Information

We use and disclose health information about you for the following purposes:

Treatment: We may use and disclose your health information to a physician or other healthcare provider providing treatment to you.

Payment: We may use and disclose your health information to obtain payment for services we provide to you.

Healthcare Operations: We may use and disclose health information about you for pharmacy operations. These uses and disclosures are necessary to run the pharmacy and ensure you receive quality pharmacy care.

Your Authorization: Except as described in this notice, we will not use or disclose without your written authorization. If you do authorize us to use or disclose your health information for another purpose, you may revoke authorization in writing at any time.

To Your Family and Friends: We must disclose your health information to you. We may disclose your health information to another person to the extent necessary to help with your healthcare or with payment for your healthcare, but only if you agree that we may do so.

Persons Involved in Care: We may use or disclose health information to notify, or assist in the notification of a family member, your personal representative or another person  responsible for your care of your location, general condition or death. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of emergency circumstances, we will disclose pertinent health information based on our professional judgment. We will also use our professional judgment to make reasonable inferences of your best interest in allowing a person to pick up prescriptions, medical supplies or similar forms of health information.

Required by Law: We will disclose health information about you when required by law. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.

National Security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose health information to authorized federal officials required for lawful intelligence, counterintelligence and other national security activities. We may disclose to correctional institutions or law enforcement officials having lawful custody or protected health information of inmate or patient under certain circumstances.

 Workers’ Compensation: We may disclose health information about you to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.

Health Oversight Activities: We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities which are necessary for the government to monitor the healthcare system include: audits, investigations, inspections and licensure.

Patient Rights With Respect to Your Health Information

Access: You have the right to inspect or obtain copies of your health information as long as the pharmacy maintains the health information. Your information usually will include prescription and billing records. You must make a written request to obtain your health information. You may obtain a form from us to request access, We may charge a fee for the costs of copying, mailing or other supplies that are necessary to grant your request.

Restriction: You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency.)

Disclosure Accounting: You have the right to receive a list of instances in which our business associates or we disclosed your health information for purposes other than treatment, payment, healthcare operations and certain other activities for the last 6 years but not before August 1, 2009.  If you request this information more than once in a 12 month period, we may charge you a reasonable, cost-based fee for responding to additional requests.

Alternate Communication: You have the right to request that we communicate with you by alternative means or to alternative locations. You must make your request in writing. Your request must specify the alternative means or location and provide a satisfactory explanation how payments will be handled under the alternative means or location you request.

Amendment: You have the right to request that we amend your health information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request under certain circumstances.

For More Information or to Report a Problem

If you have questions or would like additional information about pharmacy privacy practices, you may contact Coleman Pharmacy of Crawford County, Inc (DBA Coleman Pharmacy of Alma), by mail at P.O. Box 2550, Alma, AR 72921, in person at 18 Hwy 162 South, Alma, AR 72921, by  phone (479)632-2248 or fax (479)632-2386. If you believe your privacy rights have been violated, you can file a complaint with us at the above address or the US Department of Health and Human Services. We support your right to the privacy of your health information. There will be no retaliation for filing a complaint.