NOTICE OF PRIVACY PRACTICES ALTA RX, LLC

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

ALTA RX, LLC is required to comply with the following health care privacy rules as they relate to the Health Insurance Portability and Accountability Act (HIPAA):

  • Ensure that medical information that identifies you is kept private;
  • Provide you with this Notice of Privacy Practices (Notice) of our legal duties and privacy practices with respect to medical information about you; and
  • Follow the terms of this Notice that are currently in effect.

Alta Rx believes it is our duty to protect your health information because we understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of medical services and products you receive through Alta Rx. This record is needed to provide you with quality care and to comply with certain legal requirements. This Notice applies to all records of your care whether generated by Alta Rx personnel or obtained from other health care entities with whom you are associated. These health care entities may have different policies or notices regarding the use and disclosure of your medical information.

HOW ALTA RX MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION

The following categories describe ways that Alta Rx may use and disclose protected health information. Protected health information is any information about you that may link you to your medical condition or medical information. For each category, we will explain the types of information that will be disclosed and give at least one example. All of the ways we are permitted to use and disclose information will fall within one of these categories. However, not every use or disclosure in a category will be listed.

  • Treatment: We may use protected health information to provide you with medical services and products. We may disclose protected health information about you to physicians, nurses or other health care entities to provide you with your supplies. For example, we may request diagnosis information from your physician to ensure that the correct supplies are being provided for treatment. We may use your protected health information to communicate with you regarding treatment options or other health related products or services. We may receive financial remuneration from third parties for making subsidized treatment communications. At any point in time, you may opt out of receiving subsidized treatment communications by calling 855.686.1859.
  • Payment: We may use and disclose protected health information to bill and collect payment for health care services and products we provide. Also, we may disclose your information to other health care providers or entities involved in the coordination of your care for their billing purposes. For example, we may inform your health insurance provider about supplies you are going to receive to obtain a prior approval or to determine if your plan will cover the supplies.
  • Health Care Operations: We may use and disclose your protected health information for a variety of business activities that are called health care operations. For example, we may use protected health information to evaluate the performance of our staff in providing services and products to you or to work with others who assist us in complying with this Notices and other applicable laws. Also, if you requested that we send order updates to your email address, we may use and disclose protected health information for that purpose

In addition to treatment, payment and health care operations, Alta Rx may use and disclose your protected health information as follows:

  • Alternative Treatment/Supplies: We may use and disclose protected health information to inform you of new alternatives and products that may help you manage your health.
  • Supply Reminders: We may use and disclose your protected health information to contact you about your supply needs and provide supply reminders.
  • Business Associates: We provide some services through other companies termed “business associates”. Federal law requires us to enter into business associate contracts to safeguard your protected health information as required by Alta Rx and by law.
  • Individuals Involved In Your Care of Payment For Your Cure: We may release protected health information about you to a friend or family member who you have listed as a contact involved in your medical care. Additionally, we may give information to an individual who helps pay for your care.
  • Disclosures to Parents or Legal Guardians: If you are a minor, we may release your protected health information to your parents or legal guardians when we are permitted or required under federal and applicable state law.
  • As Required By Law: We will use and disclose protected health information about you when required to do so by federal, state or local law.
  • Public Health Risks: We may disclose protected health information about you for public health activities. Examples of these include notification for product recalls or reporting problems about products.
  • Health Oversight Activities: We may disclose protected health information about you to a health oversight agency for activities authorized by law. Examples of these activities include audits, investigations, inspections and licensure.
  • Law Enforcement: We may release protected health information about you if asked to do so by a law enforcement official.
  • Threat to Health/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 person.
  • Certain Government Functions: We may release protected health information about you to authorized federal officials for the following government functions: intelligence, counterintelligence and other national security activities authorized by law; to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state; or to conduct special investigations; to a member of the armed forces as required by military command authorizes; or to correctional institutions or law enforcement officials.
  • Health-Related Benefits/Services: We may use and disclose medical information about you to inform you of health-related benefits, services or products that may help you manage your health.
  • Workers’ Compensation: We may release protected health information about you for worker's compensation or similar programs. These programs provide benefits for work-related injuries or illness.

OTHER USES OF MEDICAL INFORMATION

Other uses and disclosures of medical information not included in this Notice or by laws that apply to its use will be made only with your written authorization. For instance, we will not use or disclose your protected health information that contains psychotherapy notes. We will not use or disclose your protected health information for marketing purposes and we will not sell your protected health information unless permitted under applicable law. If you provide us with permission to use or disclose medical information about you, you may revoke that authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written request. Note: We are unable to take back any disclosure(s) that we have already made with your authorization or pursuant to this Notice of Privacy Practices. Additionally, we are required by law to retain records of the medical services and products that we provided to you for a specific period of time.

YOU HAVE THE FOLLOWING RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION

  • Right to Inspect and to Receive A Copy: You have the right to inspect and to receive a copy of your protected health information that may be used to make a decision about your care. Usually, this includes medical and billing records. If you request a copy of your information, it must be submitted in writing and we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request under certain circumstances. You will be provided with a reason for the denial.
  • Right to Request Restrictions: You have the right to request that we limit how we use or disclose your protected health information. We will consider your request, but are not legally bound to agree to the restrictions, except we must follow all restrictions on communications to health plans for payment or health care operation purposes that pertain solely to health care services or items for which you have paid us in full. We cannot agree to limit uses or disclosures that are required by law.
  • Right to Choose How We Contact You: You have the right to request that we contact you at an alternate address or by alternate means.
  • Right to Have Protected Health Information Amended: You have the right to request that we amend, correct or supplement your protected health information maintained by Alta Rx. Note: Alta Rx may request for this to be submitted in writing. If you believe that we have information that is either inaccurate or incomplete, we may amend, correct or supplement the information and notify others who have copies of the information you deem to be inaccurate or incomplete. We may deny your request under certain circumstances. You will be provided with a reason for the denial.
  • Right to Find Out What Disclosures Have Been Made: You have the right to request a detailed listing of disclosures other than instances of disclosure for which you gave consent or signed an authorization (examples include for treatment, payment, operations, law enforcement or to you or your family). This request must be submitted in writing and include your name, address and a time period, which may not be longer than six (6) years and may not include dates before 1/1/2011. There will be no charge for up to one (1) list per year. For additional lists, there may be a fee to cover the cost of preparing the list.
  • Right to Receive This Notice: You have the right to receive a paper copy of this Notice and/or an electronic copy by email upon request. Note: To receive a copy of our complete privacy policy, give us a call: 855.686.1859.
  • Right to File A Complaint About Our Privacy Practices: If you believe that your privacy rights have been violated or if you are dissatisfied with our privacy policies or procedures, you may file a complaint with the Privacy Officer at Alta Rx (855.686.1859) or the Secretary of the Department of Health and Human Services. We will not take any action against you or change our treatment of you in any way if you file a complaint.

CHANGES TO THIS NOTICE

We reserve the right to change our privacy practices that are described in this Notice. We reserve the right to make the revised or changed privacy practices applicable to protected health information we already have about you as well as any information we receive in the future. A copy of our current Notice will be posted in our offices and can be available to you by giving us a call: 855.686.1859.

Effective Date: This Notice is effective as of January 1, 2014

Mailing Address:

Privacy Officer
Alta Rx
9883 South 500 West
Sandy, UT 84070