How We May Use and Disclose Your PHI

The following categories describe different ways that we use and disclose your PHI. For each category of uses or disclosures, we will explain what we mean and give some examples. Not every use or disclosure in any category is listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

  1. Treating you. We can use your PHI and share it with other professionals who are treating you. An example of this practice is providing your prescription information to the pharmacy of your choice so that it may be dispensed.
  2. Billing for your services. We can use and share your PHI to bill and get payment from health plans or other entities. For example, we may contact your insurer to determine whether it will pay for your prescription and the amount of your copayment.
  3. Running our pharmacy. We can use and share your PHI to run our pharmacy, improve your care, and contact you when necessary as we provide services to you. For example, we may use your PHI to review and assess the quality of the services we provide to you. We also may disclose your PHI to our attorneys and auditors for assistance with legal compliance

How We Won't Use Your PHI

  1. We do not ask for, collect, or store genetic information
  2. We do not ask for, collect, or store HIV status or psychotherapy notes
  3. Marketing purposes
  4. Sale of your PHI

Your Health Information Rights

You have the following rights with respect to your PHI that we maintain:

  1. Get an electronic or paper copy of your medical record. You can ask to see or get a copy of an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this by contacting the Privacy Officer at the address listed on the next page. We will provide a copy or a summary of your PHI, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
  2. Get a copy of this Notice. You may request a copy of this Notice at any time. To obtain a paper copy of the Notice, please call Preveon Specialty Pharmacy at 909-266-0016.
  3. Receive written notification following a breach of your unsecured PHI.
  4. Provide alternative communications on the Notice to individuals with disabilities in another format in compliance with Section 504 of the Rehabilitation Act of 1973 or the Americans with Disabilities Act of 1990.
  5. We shall honor requests to restrict certain disclosures of your PHI to a health plan regarding services or a health care item for which you have paid Preveon Specialty Pharmacy out of pocket in full.
  6. Request a restriction on certain uses and disclosures of PHI. You have the right to request certain restrictions on our use or disclosure of your PHI that we maintain. To request such a restriction, please provide a written request to the HIPAA Privacy Officer at the address listed below.
  7. Inspect and obtain a copy of PHI. You have the right to inspect or obtain a copy of PHI about you that is contained in a “Designated Record Set” for as long as Preveon Specialty Pharmacy maintains your PHI in the designated record set.
  8. The Designated Record Sets we maintain include your enrollment form and billing records. To inspect or copy PHI about you, you must send a written request to the HIPAA Privacy Officer at the address listed on the next page. We may charge you a fee for the costs of copying, mailing, and supplies that are necessary to fulfill your request. We may deny your request in certain limited circumstances. If you are denied access to your PHI, you may request that the denial be reviewed.

  9. Ask us to correct your medical record. If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it. You may request an amendment for as long as we maintain the PHI in a designated record set. To request an amendment, you must send a written request to the HIPAA Privacy Officer at the address listed below. You must include a reason that supports your request for amendment. In certain cases, we may deny your request for amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with the decision and we may provide a rebuttal to your statement.
  10. Although Preveon Specialty Pharmacy at this time does not engage in fundraising communications, in the event we do, you may opt out of fundraising communications.
  11. Receive an accounting of disclosures of PHI. You have the right to receive an accounting of certain disclosures we have made of PHI about you for most purposes other than treatment, payment, and health care operations. The accounting will exclude certain disclosures, such as those made directly to you, disclosures you authorize, disclosures to friends or family members involved in your care, and disclosures for notification purposes. The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations. To request an accounting, you must submit a request in writing to the HIPAA Privacy Officer at the address listed below. Your request must specify the time period for which the accounting is requested, which may not be longer than three years. The first accounting you request within a twelve-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.
  12. Request communications of PHI by alternative means or at alternative locations. You may request that we contact you concerning your PHI by alternative means and/or at alternative locations. For example, you may request that we contact you about medical matters only in writing or at a different residence. To request to receive communications of your PHI by alternative means or at alternative locations, you must submit a written request to the HIPAA Privacy Officer at the address listed below. Your request must state how or where you would like to be contacted. We must accommodate all reasonable requests. We will not ask you to provide a reason for your request.

Other Ways We May Use or Disclose Your PHI for the Following Purposes:

  1. Business Associates. Some of the services we provide are delegated to contractors, known as Business Associates. We will provide your PHI to those of our contractors who require the information to perform certain services on our behalf. For example, we may provide PHI to a claims submission service that ensures that our claims are submitted in the appropriate form to the appropriate payors. To protect you, we require the Business Associate and their contractors to appropriately safeguard the PHI.
  2. Communication with individuals involved in your care or payment for your care. We may disclose to a person involved in your care or payment for your care PHI relevant to that person’s involvement in your care or payment.

Aggregated or De-Identified Data

We may use aggregate or de-identified data for various business purposes to learn more about the benefits of our program and how we may improve our services or create additional service offerings.

Contact Information or to Report a Problem

If you have any questions or would like additional information about Preveon Specialty’s privacy practices, you may contact the Preveon Specialty Privacy Officer. If you believe your privacy rights have been violated, you may file a written complaint with the Secretary of the United States Department of Health and Human Services. You will not be penalized or otherwise retaliated against in any way for filing a complaint.