NOTICE OF PRIVACY PRACTICES
We at SeattleMeds
value the trust you place in us and we know that respect for your privacy is the foundation for that trust. We are absolutely
committed to meeting our legal obligations to safeguard the privacy of your protected health information. This
is your Notice of Privacy Practices from SeattleMeds which describes how we may
use and disclose your protected health information in order to carry out treatment, payment and health care operations and
for other specified purposes that are required or permitted by law. We are required by the Health Insurance Portability
and Accountability Act of 1996 ("HIPAA") to provide this notice. Please review it carefully.
Protected health information or "PHI" is defined as the information we must collect about you in order to deliver
and receive payment for our products and services which include basic demographic information that will personally identify
you and that relates to your past, present or future physical or mental health or condition and related health care services.
This notice also describes your rights regarding the use and disclosures we must make regarding your PHI.
We are also required by HIPAA to maintain the privacy of your PHI and abide by the terms of this notice. The remainder
of this notice serves as a description of how we may disclose your PHI in order to provide you with our services and how we
must abide by our legal obligations to protect the privacy of your PHI.
Use and Disclosure of Protected Health Information Without
The following categories
are examples of different ways that SeattleMeds may use and disclose your protected health information
without getting a special form of written permission from you called an “authorization” under the HIPAA Privacy
Rules. This information provides examples of certain ways we might disclose your PHI, however there may
be instances in which we may disclose your PHI which are not listed. These reasons will always be in compliance
with the rules and regulations set forth by HIPAA.
Treatment: We will
use and disclose your protected health information in order to provide you with the medications we dispense to you and the
corresponding services we perform for you. For example, our pharmacists and pharmacy staff will use your PHI to dispense
prescription medications to you. As a result, we will create and maintain a record of all prescriptions dispensed to you by
SeattleMeds and the corresponding services we deliver.
Payment: We may use and disclose your PHI as needed in order to obtain payment for the products
and services we provide to you. For example, in order to receive payment from your insurance provider, we must disclose
certain PHI to your insurer or their agent in order to obtain payment for your prescription and to determine the amount
of your co-payment or co-insurance. In all cases, we will disclose only the minimal information required by the insurer to
receive payment for prescriptions and corresponding services we provide to you.
For Health Care Operations: We may use or disclose your PHI to allow us to perform our business operations and to prove
the quality of the care we provide to our customers. For example, within our organization, we may use your PHI to conduct
quality improvement activities or other activities to make sure that you receive quality customer service.
As Required by Law: We may disclose your PHI to the extent that disclosure is required by federal, state, or local
law. The use or disclosure will be made only in compliance with the law and information provided will be limited only to the
minimum necessary to meet the requirements of the law. Unless authorized by you, we will not disclose your
health care information, except if the recipient needs to know the information and the disclosure is: to a person who the
pharmacist reasonably believes is providing health care to you; to any other health care provider reasonably believed to have
previously provided health care to you, to the extent necessary to provide health care to you, unless you have instructed
the SeattleMeds Privacy Officer in writing not to make the disclosure.
Sexually Transmitted Diseases. We will not disclose any information regarding your
treatment for a sexually transmitted disease, except in situations where the subject of the information has provided us with
a written authorization allowing the release or where we are authorized or required by state or federal law to make the disclosure.
Public Health: We may disclose your PHI to public health or other legal authorities
as permitted by law for the purpose of preventing or controlling a communicable disease, injury, or disability.
Food and Drug Administration: We may disclose your protected health information
to a person or company required by the Food and Drug Administration (FDA) to report adverse events, product defects, to enable
product recalls, to make repairs, or to conduct post marketing surveillance, as required.
Oversight Activities: We may disclose
your protected health information to a health oversight agency such as the Washington State Board of Pharmacy, or the Drug
Enforcement Administration for such proceedings as audits, investigations, proceedings, or other activities necessary for
appropriate oversight as authorized or required by law.
Judicial and Administrative Proceedings: We may disclose your PHI in response to a
court order or in response to a subpoena, discovery request, or other lawful process during a judicial or administrative proceeding.
To Avert a Serious Threat to Health or Safety: We may use and disclose protected health information about
you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another
To Coroners, Funeral Directors, and for Organ Donation: We may disclose your protected health information to a coroner or medical
examiner for identification purposes, to determine cause of death, or for the coroner or medical examiner to perform other
duties authorized by law.
Research: We may use and disclose your PHI for medical research purposes when the research protocol in question has been approved
by an appropriate review board and includes measures to ensure the privacy of your PHI.
Military and Veterans: If you are a member of the armed forces, we may
PHI as required by military command authorities. We may also disclose PHI about foreign military personnel
to appropriate military authorities.
National Security and Intelligence Activities: We may disclose PHI to authorized federal officials
for the purpose of conducting intelligence operations, counterintelligence operations, protection of the President, and other
national security activities authorized by law.
Correctional Institution: If you are incarcerated or become an inmate of a correctional institution
or are in the custody of law enforcement, we may disclose your PHI to the law enforcement official responsible for your providing
health care services, maintaining your health and safety, or maintaining the health and safety of others while you are in
the custody of law enforcement or a correctional institution.
Workers’ Compensation: Your protected health information may be disclosed
by us as authorized to comply with workers’ compensation laws and other similar programs established by law.
Victims of Abuse, Neglect, or Domestic Violence: We may disclose protected health information about you to a government authority, such as a social
service or protective services agency, if we reasonably believe you are a victim of abuse, neglect, or domestic violence.
Refill and Appointment Reminders; Health Related Benefits and Services: We may contact you to provide refill or appointment reminders or information
about treatment alternatives or other health-related benefits and services that may be of interest to you.
to You or for HIPAA Compliance Investigations: We may disclose your protected health information to you or to your personal representative and we are required to disclose
your protected health information in certain circumstances described below in connection with your rights of access to your
protected health information and to an accounting of certain disclosures of your protected health information. We must
also disclose your protected health information to the Secretary of the United States Department of Health and Human Services
when requested by the Secretary in order to investigate our compliance with the privacy regulations issued under the Health
Insurance Portability and Accountability Act of 1996.
Other Uses and Disclosures That May Be Made
Without Your Authorization
also may use and disclose your protected health information in the three instances set forth below without getting your authorization
under the HIPAA Privacy Rules, although you may in certain circumstances have the opportunity to agree or object to these
uses and disclosures. If you are not present or able to agree or object to the use or disclosure of the protected health
information, then we may, using our professional judgment, determine whether the disclosure is in your best interest.
Others Involved in Your Healthcare: We may disclose to a member of your family, a relative, a close friend or any other person you identify,
your protected health information directly related to that person’s involvement in your care or payment related to your
Notification: We may use or disclose protected health information about you to notify or assist in notifying a family member, personal
representative, or another person responsible for your care, your location, general condition or death.
Relief: We may use or disclose
your protected health information to an authorized public or private entity to assist in disaster relief efforts. You may
have the opportunity to object unless we determine that to do so would impede our ability to respond to emergency circumstances.
Uses and Disclosures of Protected Health Information With Your Authorization
Other uses and disclosures of your protected health
information will be made only with your written authorization as required under the HIPAA Privacy Rules, unless otherwise
permitted or required by law as described above. You may revoke this authorization in writing at any time except to
the extent that we have taken an action in reliance on the authorization.
Your Health Information Rights
You have the following rights with respect to protected health information
Obtain a Paper Copy of the Notice Upon Request. You have the right top request a copy of the most current version
of this notice from us at any time, even if you have agreed to receive it electronically. To obtain a paper copy of
this notice, contact our privacy officer at 206-382-2087 or e-mail us at email@example.com.
Right to Request a Restriction on Certain Uses and Disclosures of Protected Health Information. You may request additional restrictions be placed on your PHI by sending a written request
to the Privacy Officer. We will give your request proper consideration, but we are not required to agree
to those restrictions. Additionally, we cannot agree to any restrictions on disclosures of PHI that are
legally required. To request a special restriction, you must make your request in writing to our privacy officer or
e-mail us at firstname.lastname@example.org.
Right to Inspect and Copy your Protected Health Information. You
have the right to obtain and inspect a copy of your PHI for as long as we maintain the protected health information. The PHI
will include prescription and billing records and any other records we use for making decisions about your healthcare. To
inspect or copy your protected health information, you must send a written request to our privacy officer or e-mail us at
email@example.com. We may charge you a fee for the costs of copying, mailing, or other supplies that are necessary to grant your request.
Request an Amendment of Protected Health Information. If you feel that your PHI is incomplete or incorrect, you may request an amendment of that
information. To request an amendment, you must send a written request to our privacy officer or e-mail
us at firstname.lastname@example.org. In addition, you must include a reason that supports your request. We may deny your request for amendment if it is not in
writing or does not include a reason that supports the request. If we deny your request for amendment, you have the right
to file a statement of disagreement with the decision and we may prepare a rebuttal to your statement and we will provide
you with any such rebuttal.
Receive an Accounting of Disclosures of Protected Health Information. You have the right to receive an accounting of
disclosures we have made of your PHI since April 14, 2003. This list will not include many types of disclosures, including
those made for treatment, payment, or health care operations; disclosures we have made directly to you or your personal representative;
disclosures to friends or family members involved in your care; disclosures for notification purposes; and disclosures made
with your authorization. To request an accounting, you must submit your request in writing to our privacy officer or e-mail
us at email@example.com.
Request Confidential Communications of Protected Health Information. You have the right to request that we communicate with you about PHI
in a certain way. For example, you can ask that we only contact you at work or by mail. To request confidential communication
of protected health information you must submit your request in writing to our privacy officer or e-mail us at firstname.lastname@example.org. Your request must state how or when you would like to be contacted. We will accommodate all reasonable requests.
Right to file a Complaint. If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary
of the Department of Health and Human Services. To file a complaint with us, please contact SeattleMeds,
1305 Madison Street, Seattle, Washington 98104, Attention: SeattleMeds
Privacy Officer. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
If you have questions as how to file a complaint please e-mail us at email@example.com.
For More Information or to Report a Problem
If you have questions or would like additional information about our privacy practices, you
may contact the SeattleMeds Privacy Officer at 206-382-2087 or firstname.lastname@example.org.