RICE PHARMACY I2O9 NORTH MAIN STREET BEAVER DAM. KY .12320 'frc!lmenl. Our organrzation may use your identiliablc heahh information to treat you. For exanrple, tle may perform a follow-up interview and we may use lhc results lo hclp us modify your treatment plan. Many ofthe people who work lbr our organization may use ofdisclose your identifiable hcalth infornlation in order lo reat you or lo assisl othcrs in your lrealment. Additionally. we may disclose your rdenlrllabl( heallh rnformati,rn lo olhers who ma) assist in your care. such as your physician. therapists, spouse. children, 270-27,1-331E NOTICE OF PRTVACY PRACTICES As Required by the Privacy Regulations Promulgated Pursuant to the Health lnsurance Pofiability and Accounrability Act of 1996 (HIPAA) THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOII MAY BE USED AND DISCLOSED AND HOW YOU CAN CET ACCESS TO YOTIR IDENTIFIABLE HEALTH INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY. .\. ol R ( oul l ltE\t our organization tr) \ ot R PRt\ is dedicated to maintaining the privacy use and disclose your idenlifiablc heahh information in ordcr to bill and collcct payment for the seNices and items you may receive from us. For exsmple. we may contact your health insurer to ceniry that you arc eligible for benefits (and for what range of benellts), and we may provide your insurcr with details regarding your treatmenl to determine ifyour insurer will cover, or pay fot, yout treatment- we also may use and disclose your identifiable health intbrmation to obtain paymenl from third pa(ies who may be responsibl€ lbr such costs. such as family members. Also. wc may use your rdenlitiable health infomation to billyou directly for serviccs and items will privacy practices lhat we havc in effcct al the time. 3, To summarize, this notice provides you with the following imponanl information: 4. ot rs oNs Pl-u,\su ( o\ L\( l : ..\vu Atx)tIt lls Nol l('8. ( use and drsclose your idenlifiable heahh rnformalron to operate our business. As examples ofthe ways in which we may use and Appointmcnt Rcmindcrs. Our organizalion may usc and 6 1 Rclarse of Informrtion to Frmily/lriends. Our organization may release your idenlifiablc health information to a friend or fanlily mcmbcr who is helpiog you pay for your health care ofwho assists in tating care ol you. Disclosures Required By Lxw. Our organizalion will RICE PHARMACY NORTH MAIN STREET BEAVER DAM, KY 42320 270-274-331E D . \\'r \tAl I sti .\\D t)ts( t.oslt l'ot R }j.\l. s use \Ie are lNt) t)ts( t.osl Ru otr \ ot R ll)!]\'l lIl1,\l]l,u ]t\r.l I l\ ( uRl \t\ sPu( 1,\1. ( IR( ( \lsl \\( t:s t,st,t Thc follo$ing categorics describe uniquc scenarros in which we may use or disclose your idcnlifiable health inli)rmatxnr: t Herlth Oversight Activitics. Our organization may disclose your identifiable health informalion to a health oversight agency for activities authorized by law. Oversight aclivilics can include, fbr cxamplc, investigations, inspections. audits. surveys. licensure, and disciplinary actions: civil, administrative, and criminal procedures or actions:or other activities necessar!'for lhe govemment to monitor govemment programs. compliance with civil rights laws. and the hcalth care syslem in general. J. Lrrrsoils rnd Similrr Prorccdings. Our organization may use and disclose your identitiable health information in response lo a court or administrative order ifyou are involved in a lawsuit or similar procecding. We also may disclose your identifiable health infonnation in response to a discovery request. subpoena or other lawful process by another party involved in the disputc, but only if we have made m cffort to inform you of the rcquest or lo obtain an order protecling the information the party has requested. inform you ofhealth-related benefils or services thal may be of interest to you. and disclose your identiliable health infomalion when required to do so by federal. state. or local law. 2OS l\t.oR \ o\ l\ I lt !ot-l.oll t\(; \\,\\ Herlth Crre Operrtions. Our oBanization may Haalth-Relslcd Benclits and Services. Our organi2lation may use and disclos€ your identifiable health infomalion to LEVI RICE I 2. disclose your identifiable health information to contact you and remind you of visits/deliveries. lhr terms ofthis notice rpply to sllrecords contsining your identifieble he!llh informetion lhst sre cresled or rctained by our prlctice, \le rcscrve thc right to revisr or rmend our notice of pritacy prrctices. Any revision or &mendmeni to this notic€ *ill bc effrclive for all ofyour rccords our prrctice h&s crcf,ted or neintf,inrd in lhe pssl, end for sn) ofyour rccords *e miy cresle or m{intrin in the future. Our orgaoization will post r copy ofour currenl nolice in our omces in r promincnl locrtion, rnd )ou me!' request s copy ofour most current nolice during any ollice visit. medicalsurveillance. ditclose your information for our operations. our organization may use your health information to €valuate th€ quality of care you received from us or to conduct cost-management and business planning aclivitres for our pracltce. How we moy use and disclose your identifiable health information Your privrcy rights in your identifiable health information Our obligalions conceming the use and disclosure of your identifi able health infoImation. communicable disease Notirying a person regarding a potential risk for spreading or contracting a disease or condition Reporting rsactions to drugs or problems with products or devices Notilring individuals ifa product or device they may be using has been recallcd Notirying appropriate govemment agency(ies) and authority(ies) regarding the potential abuse or neglecl of an adult patient (including domestic violence)i however. we llill only disclose lhis informalion ifthe patient agrees or we are required or authorized by law to disclore this information Nolirying your employer under limited circumstanccs related primarily to workplace injury or illness or Pryment. Our organization ma] ofyour confidenlia,ity ofheakh information that identifies you. we also are required by law to provide you wilh this notice oI our legal duties and privacy practices conceming your identifiable health information. By law. we must follow the terms ofthe notice of Maintaining vital records, such as births and deaths Reponing child abuse or ncglecl Prevcnting or conlrolling disease, injury. or disability Notilying a person regardinS potcntial exposurc to a of parenls. \( I idcnlifiablc health information. ln conducting our busincss. wc creale records regarding you and the treatment and services we provide to you. wc arc required by law lo maintain thc t,. tl'\ otr Public Herlth Riskt. Our organization may drscloso your idenlifiable heallh inlbrmation lo public health authorities who are authori4d by la\r' to collcct inlormatron for the purpose of The lbllowinB categories describe thc dillcrent ways in which we ma) use and disclose your idcnlifiable hcalth inlbrmalion: { Lrw f,nforcement. We may release identifiable health information ifasked to do so by a law enforcement ofliciall Regffding a crime victim in certain situations. ifwe are . . . . . . unable to obtain the person's agreement Concemin8 a death we believe might have resulled from criminal conduct Regarding criminal conducl at our offices In response to a warant, summons, coun order. subpoena. or similar leSal process To idenliry/locatc a suspect. materialwitness. 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