Effective Date: April 14, 2003
Revision Date: September 25, 2005
We understand that your medical information is personal. We are committed to protecting your medical information. Triangle Compounding is required by law to maintain the privacy of your protected health information (“PHI”), to follow the terms of this Notice, and to give you this Notice of our legal duties and privacy practices concerning your health information. We must follow the terms of the current Notice.
We may use your PHI to dispense prescriptions to you. We may disclose your PHI to treating physicians, pharmacists and other persons who are involved in dispensing your prescription.
We may use and disclose your PHI so that your pharmacy services may be billed to, and payment collected from you, your insurance company or a third party.
We may use and disclose your PHI for pharmacy operations, which include activities necessary to run the Pharmacy, and to make sure that you receive quality customer service.
We may use or disclose your PHI for prescription refill reminders, to tell you about health-related products or services, or to recommend possible treatment alternatives that may be of interest to you.
We may disclose your PHI to a family member or friend who is involved in your medical care or payment for your care, provided you agree to this disclosure, or we give you an opportunity to object to the disclosure. If you are unavailable or are unable to object, we will use our best judgment to decide whether this disclosure is in your best interests.
We will disclose your PHI when required to do so by federal, state or local law.
We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
We may disclose your PHI for public health activities, such as those aimed at preventing or controlling disease,preventing injury, reporting reactions to medications or problems with products, and reporting the abuse or neglect of children, elders and dependent adults.
We may disclose PHI to a health oversight agency for activities authorized by law. These oversight activities, which are necessary for the government to monitor the health care system, include audits, investigations, inspections and licensure.
If you are involved in a lawsuit or dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose your PHI in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request (which may include written notice), or to obtain an order protecting the information requested.
We may disclose your PHI (1) if you are a member of the armed forces, as required by military command authorities; (2) if you are an inmate, or in custody, to a correctional institution or law enforcement official; (3) in response to a request from law enforcement, under certain conditions; (4) for national security reasons authorized by law; and (5) to authorized federal officials to protect the President, other authorized persons, or foreign heads of state.
We may disclose your health information for workers’ compensation or similar programs.
We may also disclose your PHI to organ procurement or similar organizations for purposes of donation or transplant.
We may release your PHI to a coroner or medical examiner, for example, to determine a person’s cause of death. We may also disclose your PHI to funeral directors consistent with applicable law to enable them to carry out their duties.
We may disclose your PHI to a person legally authorized to act on your behalf, such as a parent, legal guardian, administrator or executor of your estate, or other individual authorized under applicable law.
Except as described in this Notice, we will not use or disclose your PHI without your written authorization. If you do give us authorization to use or disclose your PHI, you may cancel your authorization in writing at any time. If you cancel your authorization, this will stop any further use or disclosure for the purposes covered by your authorization, except where we have already acted on your permission.
If you would like to exercise any of these rights, contact the pharmacy to get the appropriate form, or submit a written request to Triangle Compounding Pharmacy Stores, Inc., 550 New Waverly Place, Suite 110, Cary, NC 27518. A paper copy of this Notice may be obtained from Triangle Compounding Pharmacy Pharmacy upon request, or downloaded here.
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for PHI we already have about you and any information we receive in the future. We will post a copy of the current Notice in the pharmacy. If we change our Notice, you may obtain a copy of the revised Notice by visiting our Web site at www.trianglecompounding.com or upon request.
If you have questions about this Notice, contact Triangle Compounding Pharmacy, 550 New Waverly Place, Suite 110, Cary, NC 27518. If you believe your privacy rights have been violated, you may file a written complaint, and there will be no retaliation, with the Compliance Officer at the above address, or with the Secretary of the Department of Health and Human Services, Office of Civil Rights.
