THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED BY SCRIPT CARE, LTD. AND ITS SUBSIDIARIES AND AFFILIATES ("Script Care"), AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Script Care recognizes that your health information is personal, and we are committed to protecting it. Script Care's use and disclosure of your health information is also very important to our ability to provide you with quality care, and to comply with certain laws. This Notice applies to Script Care's uses and disclosures of individually identifiable Protected Health Information ("PHI") received or created by Script Care as a healthcare provider under the Standards for Privacy of Protected Health Information disseminated under the Health Insurance Portability and Accountability Act of 1996,1 subject to applicable state laws.
We may use and disclose your PHI to provide treatment to you or for the treatment activities of another healthcare provider. Some examples include:
We may disclose your PHI to physicians, pharmacists, nurses, and other healthcare providers and suppliers who are involved in your care for purposes of your treatment.
We may also use and disclose your PHI to tell you and your physician or other healthcare provider about or recommend treatment options or alternatives, or to tell you and your physician or other healthcare provider about health-related benefits, products or services under your benefit plan. In addition, depending on your condition, we may use and disclose your PHI for purposes of contacting you regarding your prescription refills, compliance with dosage requirements, proper drug administration, drug precautions and side effects, and product storage.
For those participating in our disease management programs, your PHI may be used and disclosed by Script Care's pharmacists, nurses and case managers to provide you with health education, reminders about upcoming appointments, to monitor your compliance with therapies and to assist in the coordination of your care with physicians and other healthcare providers and suppliers.
We may use and disclose your PHI for our various therapeutic intervention programs. We may review your PHI to help us identify potential issues related to your treatment, such as proper dosage or potential drug interactions. We may use and disclose your PHI for purposes of contacting your retail pharmacist and your physician or other healthcare provider prior to dispensing a prescribed drug in the event we have identified a potentially inappropriate therapy, such as potential drug to drug interactions, or if we have identified issues related to frequency or dosage, as well as other recommendations regarding your drug regimen.
We may also use and disclose your PHI to contact your physician for purposes of recommending alternative medications when appropriate, alerting your physician regarding potential drug interactions, potential dosing issues, potential side effects and issues related to your compliance with therapy.
We may also use and disclose your PHI to advise you or your physician or other healthcare provider that an alternative generic medication is available or that a specific medication is not preferred or approved by your health plan or third party payer.
We may also use or disclose your PHI in order to get paid for treatment provided to you by Script Care or for the payment activities of another entity. For example:
We may use your PHI to create the bills that we submit to the insurance company or health plan sponsor to receive payment for the services we provide to you.
We may use your PHI to determine if you are eligible for insurance coverage or benefits under a health plan or other program.
We may disclose certain portions of your PHI to your insurance or health plan sponsor for payment audit purposes or to our business associates who perform billing, adjudication, claims processing or other related services for us.
We may use your PHI during payment-related data processing.
We may also use or disclose your PHI for our operations related to healthcare. For example:
We may use your PHI to evaluate the quality of care you received from us, or to evaluate the performance of those involved with your care.
We may use and disclose your PHI to provide utilization reports and other data analyses to your plan sponsor for purposes of prescription benefits management.
We may also use and disclose your PHI to perform periodic quality assurance reviews and audits, to develop protocols, and for purposes of case management and care coordination.
PHI may be provided to our internal auditors, attorneys, accountants, and other consultants to make sure we are complying with the laws that affect us.
We may use and disclose your PHI in conducting data analysis for purposes of providing information and data to your plan sponsor, new program development and providing services to improve outcomes and effectively manage prescription drug costs.
In addition, we may also disclose your PHI to another healthcare provider, health insurance plan, or healthcare clearinghouse for purposes of their operations related to healthcare. However, we will only do so if they have or have had a relationship with you and if the PHI they request pertains to that relationship. In addition, we will disclose your PHI to these third parties for limited purposes only, such as conducting quality improvement activities, reviewing the performance of a healthcare provider, or training purposes.
If you ask us to copy your PHI, we may charge you a reasonable amount as allowed by law. Alternatively, we may provide you with a summary or explanation of your PHI, as long as you agree to that and to the cost, in advance.
We may deny your request if you ask us to amend information that:
If we deny the requested amendment, we will tell you in writing how to submit a statement of disagreement or complaint, or to request inclusion of your original amendment request in your PHI.
Your request for a list of disclosures must be made in writing and be addressed to our Customer Service Department at 6380 Folsom Dr., Beaumont, Texas 77706. We will respond to your request within 60 days (or 90 days if the extra time is needed). The list we provide will include disclosures made within the last six years unless you specify a shorter period. The first list you request within a 12-month period will be free. You will be charged our costs for providing any additional lists within the 12-month period.
Please refer to the notice of privacy practices of your benefit plan or other healthcare provider with respect to the uses and disclosures of PHI received or created by Script Care in the course of performing services for or on behalf of such health plan or other healthcare provider.