TWIN VALLEY PHARMACY
HEALTH INFORMATION PRACTICES
"YOU ARE NOT REQUIRED TO SIGN THE ACKNOWLEDGEMENT FORM"
We are required by law to inform you of your rights regarding the use and disclosure of your PERSONAL HEALTH INFORMATION.
We will only use your PERSONAL HEALTH INFORMATION for purposes of TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS.
EXAMPLES OF HOW WE USE YOUR INFORMATION-
a. IN TERMS OF TREATMENT. Health Information obtained by our staff from you or another health care provider, another family member, or someone in charge of your care may be recorded in our medical records. We may use this Information for many treatment reasons, including, but not limited to, verifying the accuracy of your prescription(s) being filled, and to help you avoid known drug allergies and adverse drug interactions, All prescriptions filled in our pharmacy will be recorded. We may also provide your health information to other health care providers involved in your care to assist them on providing services to you. You may indicate to us that you do not want anyone else to pick up your medications i.e.; (husband, wife, children, etc.) and it will be indicated in your health record.
b. IN TERMS OF PAYMENT. Your health plan or insurance company may require certain information about your condition and/or the prescriptions you fill with us, before payment will be made, or for pre-authorization purposes. Accordingly, for billing purposes, we may disclose your health information to your health plan or insurance company. You can refuse to allow us to do so, but by not allowing us to communicate with your insurance company, we are forced to charge you a cash price for each prescription filled and you will then have to seek direct reimbursement from your insurance company.
c. IN TERMS OF HEALTH CARE OPERATIONS. Members of our staff may review health information in your record to assess the care and outcome in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of our services.
The complete NOTICE OF HEALTH INFORMATION PRACTICES, is available for you to read upon request. If you have questions regarding our policy, please contact our Privacy Official at 964-9467.