Henry Ford Pharmacy values your privacy and we work hard to ensure that all of your personal information is kept safe and secure in accordance with HIPAA and Fair Information Practice Principles. If you ever have any questions or concerns about the measures we take to safeguard your information please feel free to contact us at any time.
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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Commitment To Privacy
You have entrusted Henry Ford Pharmacy with the responsibility of providing quality pharmacy services for you and your family. We are dedicated to maintaining your trust. We know that the privacy of your personal medical information is important to you. That's why we take our responsibility to protect the privacy of your personal medical information very seriously.
This privacy notice describes how we safeguard your privacy as we provide coverage and services to you. It describes the personal information we collect about patients, how we use it, and with whom we share it. This notice also explains your rights and certain obligations we have regarding the use and disclosure of health information.
This notice applies to all of the records of your care generated by Henry Ford Pharmacy
and their employees, medical staffs, staff personnel, volunteers, students and trainees, as well as those outside the organization with whom we've contracted for assistance for health care services. All of these entities, sites and locations may share your medical information for treatment, payment or health care operations, as described in this Notice and by law. Your doctor may have different notices and policies about the use and disclosure of your medical information created in his or her office or clinic. We are required by law to make sure that medical information that identifies you is kept private, give you this notice of our legal duties and privacy practices concerning your medical information, and follow the terms of the notice that is currently in effect.
Our Use and Disclosure of Your Medical Information
Each time you receive services from a hospital, physician or other health care provider, a record of your encounter is made. Typically this record contains your symptoms, examination and test results, diagnoses, treatment and a plan for future care or treatment. This information is often referred to as your health or medical record. This information, linked with your name or other identifying information is used in many ways such as providing care, obtaining payment for your care and running our business.
As permitted by HIPAA and Michigan State law, we may use or disclose your medical information for several purposes. Here are some examples of how we may use or disclose your medical information. Except as listed below, we will not use or disclose your medical information without your written authorization. If you give us written authorization, you can cancel that authorization except for uses and disclosures already made based on your authorization.
Payment: We may use and disclose your medical information as needed to get paid for the medical care that we provide to you or to assist others who care for you to get paid for that care. For example, we may share your medical information with a billing company or with your health insurance plan to obtain prior approval for your care or to make sure your plan will cover your care.
Treatment Alternatives, Health Benefits, and Marketing: We may use and disclose your medical information to tell you about treatment alternatives, and health-related benefits and services. We may use your information to tell you about our products or services or to provide gifts of nominal value to you or your family.
Individuals Involved in Your Care or Payment for Care: We may release health information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. If you are an inpatient or in the emergency room, we may also tell your family or friends about your condition and location, with authorization when required. In addition, we may disclose information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
Research: Under certain circumstances, we may access health information about you for research purposes. All research projects are subject to approval by a review board. This board reviews the risks and benefits of a proposed research project including the use of health information in accordance with federal regulations. Before we use or disclose health information for research, the project will have been approved through this review process. We may disclose your health information in preparation for conducting research (e.g., to help look for patients with specific medical conditions). Health information used in preparation for conducting research will not leave the institution.
To Avert a Serious Threat to Health and Safety: We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of another person.
We may disclose health information as required by State and Federal laws and regulations including:
Community/public health activities and reports such as disease control, abuse or neglect, and health and vital statistics.
Administrative oversight activities such as audits, investigations, licensure, or determining cause of death.
Court Order or legal processes related to law enforcement activities including custody of inmates, legal actions or national security activities.
Organ and Tissue Donation and Transplant reports as required by regulatory organizations as necessary to facilitate organ or tissue donation and transplant.
Workers compensation or other rehabilitative activities reporting as required by law or insurers to provide benefits for work-related or victim injuries or illnesses.
Law enforcement release of information if asked to do so by a law enforcement individual.
Coroners, Medical Examiners, and Funeral Directors. We may release health information to a coroner, medical examiner or funeral director.
National Security and Intelligence Activities. We may release health information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.
Protective Services for the President of the United States and Others. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official.
Your Individual Rights
Access and Copies: Generally, you have the right to look at or receive a copy of medical information that we keep about you. We may charge you for our costs related to your request. We may deny your request to inspect and copy your records in certain, very limited, circumstances. For example, a request may be denied if review of the records is reasonably likely to endanger the life or physical safety of the individual or another person. If you are denied access to health information, you may request that the denial be reviewed. A licensed health care professional will be chosen by Henry Ford Pharmacy to review the request and denial.
Disclosure list: You have the right to receive a list of your medical information disclosures we made without your authorization. The request can be for a time period up to six years from the date of disclosure. Your first request in a 12-month period is free. After that, we may charge for additional requests.
Amendments: If you believe that information in your record is incorrect, or that information is missing, you have the right to ask us to amend the record by including your position. We may deny your request if it is not in writing or if it does not include a reason to support the request. In addition, we may deny the request if our information is complete and accurate, was not created by us, is not part of the health information kept by or for the hospital or is not part of the information that you would be permitted to inspect and copy under certain circumstances.
Confidentiality: You have the right to request that your medical information be shared with you in a confidential manner, such as at home rather than at work. Restrictions: You may submit a written request to restrict how we use or disclose medical information about you. We will send you a written response informing you about our ability to honor your request.
Copies of our Notice of Privacy Practices: You can ask for a copy of our current Notice of Privacy Practices at any time. If this Notice of Privacy Practices was sent to you electronically, you may request a paper copy.
Who to Contact: To exercise any of the rights described above, please send a written request to our Privacy Official / Contact Person listed on page one of this Notice.
Changes To Our Notice Of Privacy Practices
We may change our Notice of Privacy Practices from time to time. The changes will apply to all medical information about you that we have at the time of the change, and to all medical information about you that we keep in the future. Generally, the changes will take effect when they appear in a revised Notice of Privacy Practices. A copy of our current notice will be posted in our facilities and be available to all patients. To learn more about our privacy practices, contact our Privacy Official/Contact Person listed on the first page of this Notice.
If you are concerned about a violation of your privacy rights, you may contact the Privacy Official/Contact Person listed on the first page of this Notice. You may also send a written complaint to the Secretary of the United States Department of Health and Human Services. You will not be penalized for filing a complaint.
If you have any questions about this Notice of Privacy Practices, or questions or complaints about how we handle your medical information, please contact:
Henry Ford Pharmacy Corporate Offices
30100 Telegraph Road, Suite 200
Bingham Farms, MI 48025
(877) 575-MEDS (6337)