BEACHY'S PHARMACY

149 Main St., P.O. Box 189

Grantsville, MD 21536

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.

When you have a prescription filled, you disclose information about yourself and/or members of your family. The collection, use and disclosure of this information, referred to as your "medical record" are regulated by law. Safeguarding your personal and/or financial information is something that we take very seriously at Beachy's Pharmacy. We are providing this notice to inform you of what we do with the information you provide to us.

UNDERSTANDING YOUR RIGHTS

Your medical record is the physical property of Beachy's Pharmacy but the content belongs to you. You have the right to request restrictions on certain uses and disclosures of your information, and to request amendments be made to your health record. Your rights include being able to review or obtain a paper copy of your record, and to be given an account of all disclosures.  You may also request communications of your health information be made by alternative means or to alternative locations. Other than activity that has already occurred, you may revoke any further authorizations to use or disclose your health record.

OUR RESPONSIBILITIES

We are required to maintain the privacy of your health record and to provide you with this notice. We are required to abide by this notice and to notify you if we are unable to grant your special requests about your medical record. We reserve the right to change our practices, and if so will provide you with a copy of the revised notice. Other than for reasons described in this notice, we agree not to use or disclose your record without your authorization.

To receive additional information or report a problem you may contact our privacy officers, Sue Beachy or Gerry Beachy at 301-895-5177 or at the address above. If you believe your privacy rights have been violated, you can file a complaint with us or the Secretary of Health and Human Services.

TREATMENT

Information given to us will be recorded in your medical record. The sharing of this information may progress to others involved in your care, such as other physicians or pharmacists.

PAYMENT

Your health care information will be used in order to receive payment for services rendered by this office. A bill may be sent to either you or a third party payer  that includes documentation that identifies you and the name, directions, and quantity of your prescription along with your doctor's information.

HEALTH CARE OPERATIONS

Your record may be reviewed for risk management or quality improvement purposes in our efforts to improve the quality of the care we provide.

SPECIFIC DISCLOSURES:

Business Associates-Some or all of your health information may be subject to disclosure through contracts for services to assist this office in providing health care. To protect your information, we require these Business Associates to follow the same standards held by this office through terms detailed in a written agreement.

Notification-Your record may be used to notify or assist family members, personal representatives, or other persons responsible for your care to enhance your well-being or your whereabouts.

Communication with Family-Using best judgment, a family member, or close personal friend, identified by you, may be given information relevant to your care.

Funeral Directors-Your information may be disclosed consistent with laws governing mortician services.

Organ Procurement Organizations-Your information may be disclosed consistent with laws governing entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation or transplant.

Marketing-We reserve the right to contact you with information about treatment alternatives and other health-related benefits that may be appropriate to you.

Fund Raising-We reserve the right to contact you as part of general fund-raising efforts.

Food and Drug Administration-We are required by law to disclose health information to the FDA related to any adverse effects of food, supplements, products, and product defects for surveillance to enable product recalls, repairs, or replacements.

Worker's Compensation-We will release information to the extent authorized by law in matters of worker's compensation.

Public Health-We are required by law to disclose health information to public health and/or legal authorities charged with tracking reports of birth and morbidity. We are further required by law to report communicable disease, injury, or disability.

Correctional Facilities-We will release information on incarcerated individuals to correctional agents or institutions for the necessary welfare of the individual or for the health and safety of other individuals. The rights in this notice will not be extended to incarcerated individuals.

Law Enforcement-(1) Your information will be disclosed for law enforcement purposes as required under state law or in response to a valid subpoena. (2) Provisions of federal law permit the disclosure of your information to appropriate health oversight agencies, public health authorities, or attorneys in the event that a staff member or business associate of ours believes in good faith that there have been unlawful conduct or violations of professional or clinical standards that may endanger one or more patients, workers, or the general public.

Privacy Practices Availability: The terms described in this notice will be posted where registration occurs. All individuals receiving care will be given a hard copy. The effective date of this notice in April 14, 2003.

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