News Home HIPAA Information

Terry's Pharmacy, Inc.

• 310 E. Central Ave. LaFollette, TN
  Phone: 423-562-4928, Fax 423-566-4044
  
  
• 2707 Jacksboro Pike, Jacksboro, TN
  Phone: 423-563-7455, Fax 423-563-7448

All of us at Terry's Pharmacy value your relationship with us, and we know that respect for your privacy is the foundation of that relationship. We are committed to protecting the privacy of your protected health information (PHI) that is in our possession, and only using and disclosing your PHI as necessary to providing you with heath care products and services. PHI is any information that we posses, use, and disclose that identifies you and relates to your past, current, or future physical and mental health condition or illness and the heath care products and services that have been provided to you. This "Notice of Privacy Practices" (Notice) has been created to help you understand our legal duties to protect your PHI and how we may use and disclose your PHI in relation to your past, present, and future physical or mental health condition or illness and its treatment. We will mainly use and disclose your PHI in relation to the health care products and services that we provide you, such as dispensing your prescriptions. Specifically, we will use and disclose your PHI as necessary to provide treatment to you, obtaining payment for health care products and services provided to you, and other health care operations and activities as described later in this Notice. This Notice also describes the legal rights that you have related to your PHI that is in our possession. We take the matters described in this Notice very seriously because of our relationship with you and the requirement that we comply with this Notice. Terry's Pharmacy is required to follow the terms of this Notice. We will not use or discolse PHI about you without your written authorization, except as described in this Notice. We reserve the right to change our practices and this NOtice and to make the new Notice effective for PHI we maintain. Upon request, we will provide any revised Notice to you. You have the following rights with respect to PHI about you:

• Obtain a paper copy of the Notice upon request: You may request a copy of the Notice at any time. Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy. To obtain a paper copy, contact our Pharmacy Privacy Officer at the address or telephone number of our pharmacy.
  
  
• Request a restriction on certain uses and disclosures of PHI: You have the right to request a limitation on our use and disclosures of your PHI. But please be aware that we may not be able to agree to your requested limitation if it results in our not being able to provide health care products and services to you or if we are required to use and disclose the PHI under federal or state law. All requests for limitations on the use and disclosure of your PHI must be submitted to our Pharmacy Privacy Officer in writing using a form that we will provide to you.
  
  
• Inspect and obtain a copy of PHI: You have the right to access and copy PHI about you contained in a designated record set for as long as the Pharmacy maintains the PHI. The designated record set usually will include prescription and billing records. All requests to review or receive photocopies of our records that contain your pHI must be submitted to our Pharmacy Privacy Officer in writing using a form that we will provide to you. We may charge you a fee for the costs of copying, mailing and supplies that are necessary to fulfill your request. We may deny your request to inspect and copy in certain limited circumstances. If you are denied access to PHI about you, you may request that the denial be reviewed.
  
  
• Request an amendment of PHI: If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it. You may request an amendment for as long as we maintain the PHI. All requests for changes to your PHI in our records must be submitted to our Pharmacy Privacy Officer in writing using a form that we will provide to you. You must include a reason that supports your request. In certain cases, we may deny your request for amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with the decision and we may give a rebuttal to your statement.
  
  
• Receive an accounting of disclosures of PHI: You have the right to an accounting of the disclosures we have made of PHI about you after April 14, 2003 for most purposes other than treatment, payment, or heath care operations. The accounting will exclude certain disclosures, such as disclosures made directly to you, disclosures you authorize, disclosures to friends or family members involved in your care, and disclosures for notification purposes. The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations. All requests for an accounting of our disclosures of your PHI must be submitted to our Pharmacy Privacy Officer in writing, using a form that we will provide to you. Your request must specify the time period, but may not be longer than six years. The first accounting you request within a 12 month period will be provided free of charge, but you may be charged for the cost of providing additional accountings. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time.
  
  
• Request communications of PHI by alternative means or at alternative locations: For instance, you have the right to request that we communicate with you about your PHI in a confidential manner and only to locations (such as a post office box) or by means (such as personal cellular telephone) specified by you. All requests for confidential communications must be sumitted to our Pharmacy Privacy Officer in writing, using a form that we will provide to you. Your request must state how or where you would like to be contacted. We will accommodate all reasonable requests.

The following are descriptions and examples of ways we use and disclose PHI:

• We will use PHI for treatment — Example: Information obtained by the pharmacists will be used to dispense prescription medications to you. We will document in your record information related to the medications dispensed to you and service provided to you.
  
  
• We will use PHI for payment — Example: We will contact your insurer or pharmacy benefit manager to determine whether it will pay for your prescription and the amount of your co-payment. We will bill you or a third-party payer for the cost of prescription medications dispensed to you. The information on or accompanying the bill may include information that identifies you, as well as the prescriptions you are taking.
  
  
• We will use PHI for heath care operations — Example: The pharmacy may use information in your health record to monitor the performances of the pharmacists providing treatment to you. This information will be used in an effort to continually improve the quality and effectiveness of the heath care and service we provide.

We are likely to use or disclose PHI for the following purposes:

• Business associates: There are some services provided by us through contracts with business associates. When these services are contracted for, we may disclose PHI about you to our business associate so that they can perform the job we have asked them to do and bill you or your third-party payer for services rendered. To protect PHI about you, we require the business associate to appropriately safeguard the PHI.
  
  
• Communication with individuals involved in your car or payment for your care: Health professionals such as pharmacists, using their professional judgment, may disclose to a family member, other relative, close personal friend or any person you identify, PHI relevant to that person's involvement in your care or payment related to your care.
  
  
• Health-related communication: We may contact you to provide refill reminders or information about treatment alternatives or other health related benefits and services that may be of interest to you.
  
  
• Food and Drug Administration (FDA): We may disclose to the FDA, or persons under the jurisdiction of the FDA, PHI relative to adverse events with respect to drugs, foods, supplements, products and product defects, or post marketing surveillance information to enable product recall, repairs, or replacement.
  
  
• Worker's compensation: We may disclose PHI about you as authorized by and as necessary to comply with laws relating to worker's compensation or similar programs established by law.
  
  
• Public health: As required by law, we may disclose PHI about you to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
  
  
• Law Enforcement: We may disclose PHI about you for law enforcement purposes as required by in response to a valid subpoena or other legal process.
  
  
• As required by law: We must disclose PHI about you when required to do so by law.
  
  
• Health oversight activities: We may disclose PHI about you to an oversight agency for activities authorized by law. These oversight activities include audits, investigations, and inspections as necessary for our licensure and for the government to monitor the heath care system, government programs, and compliance with civil rights law.
  
  
• Judicial and administrative proceedings: If you are unloved in a lawsuit or a dispute, we may disclose PHI about you in response to a court or administrative order. We may also disclose PHI about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but on if efforts have been made to tell you about the request or to obtain an order protecting the requested PHI.

We are permitted to use or disclose PHI about you for the following purposes:

• Research: We may disclose PHI about you to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your information.
  
  
• Coroners, medical examiners, and funeral directors: We may release PHI about you to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also disclose PHI to funeral directors consistent with applicable law to carry out their duties.
  
  
• Organ or tissue procurement organizations: Consistent with applicable law, we may disclose PHI about you to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
  
  
• Fundraising: We may contact you as part of a fundraising effort.
  
  
• Notification: We may use or disclose PHI about you to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and your general condition.
  
  
• Correctional institution: If you are or become an inmate of a correctional institution, we may disclose PHI to the institution or its agents when necessary for your health or the heath and safety of others.
  
  
• To avert a serious threat to health or safety: We may use or disclose PHI about you when necessary to present a serious threat to your health and safety or the heath and safety of the public or another person.
  
  
• Military and veterans: If you are a member of the armed forces, we may release PHI about you as required by military command authorities. We may also release PHI about foreign Military personnel to the appropriate military authority.
  
  
• National security and intelligence activities: We may release PHI about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
  
  
• Protective services for the President and others: We may disclose PHI 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.
  
  
• Victims of abuse, neglect, or domestic violence: We may disclose PHI about you to a government authority, such as a social service or protective services agency, if we reasonable believe you are a victim of abuse, neglect, or domestic violence. We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else or the law enforcement or public official that is to receive the report represents that it is necessary and will not be used against you.

The pharmacy will obtain your written authorization before using or disclosing PHI about you for purposes other than those provided for above or as otherwise permitted or required by law. you may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing PHI about you, except to the extent that we have already taken action in reliance on the authorization. If you have questions or would like additional information about the pharmacy's privacy practices, you may contact our Pharmacy Privacy Officer at the address or telephone number of our pharmacy. You have the right to file a complaint if you believe that we have violated your rights as described above and to not fear retaliation or adverse actions by us against you for exercising your rights. You can file the complaint with us directly or with the United States Department of Health and Human Services (HHS). Please be assured that we will work with you to resolves any complaint, including providing you with the address for a filing a complaint with HHS.