Larry J. Frieders, R.Ph.
~ The Compounder
340 Marshall Ave Unit 100 ~ Aurora, IL 60506
630.859.0333 FAX 630.859.0114
If you subscribe
to our newsletter, or purchase any products
from The Compounder, your name and email
address will be placed in a database. As
with all other personal information, only
authorized employees of The Compounder ever
have access to this data. We do not give our
email addresses to any outside companies.
The Compounder does not sell or rent your
email address to anyone. We may use your
name and address to send you information on
other when we believe it may suit your
interests. And, although we disagree with
it, we must turn over any pertinent
information to any law enforcement agency
that takes the proper steps to require it.
For our retail
pharmacy customers.
NOTICE of PRIVACY PRACTICES
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.
USE and DISCLOSURE OF HEALTH INFORMATION
Our practicemay use
your health information for purposes of
providing you treatment, obtaining payment
and conducting health care operations. Your
health information may be used or disclosed
for these purposes while you are our
patient. We have established policies to
guard against unnecessary disclosure of your
health information.
OUR DUTIES
Our practice is mandated by
law to maintain the privacy of your health
information and to provide you (or your
representative) this Notice informing you of
our duties and privacy practices. We are
required to abide by terms of this Notice
which is subject to occasional amendment.
We reserve the right to change the terms of
our Notice and to make any changes effective
for all health information in our
possession. If our practice changes this
Notice, a copy of the revised Notice will be
provided to you or your designated
representative with comments regarding the
nature of the change. You or your
representative have the right to express
complaints to this practice and to the
Secretary of Health and Human Services if
you or your representative believe that your
privacy rights have been violated. Any
complaints regarding privacy violations
should be made in writing to the Privacy
Official. We encourage you to express any
concerns you may have regarding the privacy
of your information. You will not be
retaliated against in any way
for filing a complaint.
CONTACT PERSON
Our contact person for all
issues regarding patient privacy and your
rights under the Federal privacy standards
is the Privacy Official. The Privacy
Official may be contacted at the address on
the cover of this brochure.
EFFECTIVE DATE:
April 14, 2003
IF YOU HAVE ANY QUESTIONS
REGARDING THIS NOTICE, PLEASE CONTACT the
Privacy Official or owner/operator - listed
at the head of this page.
YOUR RIGHTS
With Respect to Your Health
Information
You are entitled to the
following rights regarding your health
information :
Right to request restrictions.
You have the right to request restrictions
on certain uses and disclosures of your
health information. You may request a limit
on the disclosure of your health information
to someone who is involved in your care.
However, our practice is not required to
agree to your request if it will negatively
affect your care. If you wish to make a
request for restrictions, please contact the
Privacy Official.
Right to receive confidential
communications.
You have the right
to request that our practice communicates
with you in a certain way. For example, you
may ask that we only conduct communications
pertaining to your health information with
you privately with no other family members
present. If you wish to receive confidential
communications, please contact the Privacy
Official. We will require that you
provide any reason for your request and will
attempt to honor your reasonable requests
for confidential communications.
Right to amend health care
information.
If you or your representative believes that
your health information records are
incorrect or incomplete, you may request
that these records be amended. That request
may be made as long as the information is
maintained by this practice. We require the
request for an amendment of records be made
in writing to the Privacy Official. We may
deny the request if it is not in writing or
does not include a reason for the change.
The request also may be denied if your
health information records were not created
by health care professionals within our
practice, if the records you are requesting
are not part of our records, if the health
information you wish to amend is not part of
the health information you or your
representative are permitted to inspect and
copy, or if, in the opinion of health care
professionals within our practice, the
records containing your health information
are accurate and complete.
Right to a paper copy of this
notice.
You (or your representative) have a right to
a separate paper copy of this Notice at any
time even if you have received this Notice
previously. To obtain a separate paper copy,
please contact the Privacy Official or any
staff member at our practice. A copy of our
Notice of Privacy Practices will be
displayed on our website if one is
maintained by our practice.
Right to inspect and copy
your health information.
You have the right to inspect and copy your
health information, including billing
records. A request to inspect and copy
records containing your health information
may be made to the Privacy Official.
Right to an accounting.
You or your representative have the right to
request an accounting of disclosures of your
health information made by our practice for
reasons other than for treatment or health
operations. The request for an accounting
must be made in writing to the Privacy
Official. The
request should specify the time period for
the accounting (starting on April 14, 2003).
Accounting requests may not be made for
periods of time in excess of six years.
The following represents the
circumstances under which your health
information may be used and disclosed:
Providing Treatment.
We may use your
health information to coordinate care within
our own practice, and with others involved
in your care, such as specialists and other
health care professionals. For example,
doctors involved in your care will need
information about your symptoms in order to
prescribe appropriate medications and
treatments. We also may disclose your
health care information to individuals
outside of our practice involved in your
care, including family members and others
whom you have designated, pharmacists,
suppliers of medical equipment, health care
professionals and others involved in your
coordination of care.
Obtaining Payment.
Upon receiving
care, our practice may include health
information about you in invoices sent for
the purpose of collecting payment from your
health plan. For example, we may be required
by your insurance company to provide
information regarding your health care
status so that reimbursement will be made.
We also may need to obtain prior approval
from your insurance company or may need to
explain to them your need for the services
we will be providing.
Conducting Health Care
Operations.
Our practice may use and disclose health
care information for our own operations in
order to assist in everyday functions, and
as necessary to provide quality care to all
of our patients. We have defined our health
care operations include activities such as:
Health assessments and
quality improvement activities.
Activities designed to
improve wellness and improve the quality
of life.
Care coordination between
patient and other health care
professionals.
Contact of health care
professionals and patients about
treatments, alternatives, and other
related areas.
Professional review and
performance evaluation.
Training programs
including those in which student interns
or practitioners in health care learn
under our supervision and guidance.
Training of non-health
care professionals.
Accreditation,
certification, licensing or
credentialing activities.
Review and auditing,
including compliance reviews, medical
reviews, legal services, financial
services, and compliance programs.
Business planning and
development including cost management
and planning related analyses and
formulary development.
Business management and
general administrative activities of the
practice.
For example, our practice may
use your health information in combination
with our other patients in evaluating how to
more effectively serve our entire network of
patients. We may disclose your health
information to our professional staff and
contracted personnel for training purposes,
or to evaluate staff performance. We may
contact you as a reminder regarding an
upcoming appointment, or contact you or your
family as a reminder of our services
available to you (unless you tell us you do
not want to be contacted).
AUTHORIZATION TO USE OR
DISCLOSE HEALTH INFORMATION
Other than what is stated in
this brochure, our practice will not
disclose your health information other than
with your written authorization. If you or
your representative give us authorization to
use or disclose your health information, you
may revoke that authorization in writing at
any time.
There are federal privacy
rules which allow health care providers to
use or disclose your health information
without authorization from you for a number
of reasons.
When Legally Required.
We will disclose
your health information when it is required
to do so by any Federal, State or local law.
When There Are Risks to
Public Health.
We may disclose
your health information for public
activities for the purpose of:
Preventing or controlling
disease, injury or disability, reporting
disease, injury, vital events such as
birth or death and conducting public
health surveillance, investigations and
interventions.
Reporting adverse events,
product defects, tracking products or
enabling product recalls, repairs and
replacements and conducting
post-marketing surveillance and
compliance with requirements of the Food
and Drug Administration.
Notifying a person who
has been exposed to a communicable
disease or who may be at risk of
contracting or spreading a disease.
Supplying information to
employer about an individual who is a
member of the workforce as legally
required.
Reporting Abuse, Neglect Or
Domestic Violence.
We are allowed to notify government
authorities if we believe a patient is the
victim of abuse, neglect or domestic
violence. Our practice will make this
disclosure only when specifically required
or authorized by law or when the patient
agrees to the disclosure.
Conducting Health Oversight
Activities.
We may disclose your health information to a
health oversight agency for activities
including audits, civil administrative or
criminal investigations, inspections,
licensure or disciplinary action. However,
we may not disclose your health information
if you are the subject of an investigation
and your health information is not directly
related to your receipt of health care or
public benefits.
In Connection With Judicial
And Administrative Proceedings.
Our practice may disclose your health
information in the course of any judicial or
administrative proceeding in response to an
order of a court or administrative tribunal
as expressly authorized by such order or in
response to a subpoena, discovery request or
other lawful process, but only when we have
made reasonable efforts to either notify you
about the request or to obtain an order
protecting your health information.
Worker’s Compensation.
Our practice may release your health
information for worker’s compensation or
similar programs.
Law Enforcement Purposes.
Our practice may disclose your health
information to a law enforcement official
for law enforcement purposes as follows:
As required by law for
reporting of certain types of wounds or
other physical injuries pursuant to the
court order, warrant, subpoena or
summons or similar process.
For the purpose of
identifying or locating a suspect,
fugitive, material witness or missing
person.
Under certain limited
circumstances, when you are the victim
of a crime.
To a law enforcement
official if we have a suspicion that
your death was the result of criminal
conduct including criminal conduct at
our place of business.
In an emergency in order
to report a crime.
Coroners And Medical
Examiners.
Our practice may disclose your health
information to coroners and medical
examiners for purposes of determining your
cause of death or for other duties, as
authorized by law.
Funeral Directors.
Our practice may disclose your health
information to funeral directors consistent
with applicable law and if necessary, to
carry out their duties with respect to your
funeral arrangements. If necessary to carry
out their duties, we may disclose your
health information prior to and in
reasonable anticipation of your death.
Organ, Eye Or Tissue Donation.
Our practice may
use or disclose your health information to
organ procurement organizations or other
entities engaged in the procurement, banking
or transplantation of organs, eyes or tissue
for the purpose of facilitating the donation
and transplantation.
Research Purposes.
We may, under some circumstances, use your
health information for research. Before we
disclose any of your health information for
such research purposes, the project will be
subject to an extensive approval process.
We will ask your permission if any
researcher will be granted access to your
individually identifiable health
information.
In the Event of A Serious
Threat To Health Or Safety.
Our practice may, consistent with applicable
law and ethical standards of conduct,
disclose your health information if we, in
good faith, believe that such disclosure is
necessary to prevent or lessen a serious and
imminent threat to your health or safety or
to the health and safety of the public.
Specified Government
Functions. In
certain circumstances, the Federal
regulations authorize us to use or disclose
your health information to facilitate
specified government functions relating to
military and veterans, national security and
intelligence activities, protective services
for the President and others, medical
suitability determinations and inmates and
law enforcement custody.
Rev. 01/08/03
Reviewed July 17, 2004 ljjf Feb 4,
2008 ljjf
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Disclaimer:
Any health related information is for educational purposes only.
None of the information provided here is to be construed as medical
advice. Before applying any therapy or use of herbs, you may want to
seek advice from your health care professional. The information on
our website should not be a substitute for physician evaluation or
treatment by a health care professional and is not intended to
provide or confirm a diagnosis.