Introduction

Ada Hillside Pharmacy values 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 provide you with health car products and services.  PHI is any information that we possess, use and disclose that identifies you and relates to your past, current or future physical and mental health condition or illness and the health care products and services that have been provided to you.

Note:  Click HERE for Non-PHI-Related Privacy Practices

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 use and disclose your PHI as necessary to provide treatment to you (such as dispensing your prescriptions), obtaining payment for health care products and services provided to you (described later in this Notice.)  This Notice also describes the legal rights that you have related to your PHI that is in our possession.  At some future time it may be necessary for us to revise this notice.  If such becomes necessary we will post the revised Notice in the pharmacy as well as on our web site and if you request, provide a written Notice to you.

Your Rights With Respect To Your PHI

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides you with several rights related to your PHI.  These rights are summarized below.

1. You have the right to receive this written Notice of Privacy Practices describing how we will protect your PHI and your rights related to PHI.  You are entitled to request this written Notice at any time.

2. You have the right to request a limitation on our use and disclosure of your PHI.  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 or services to you or if we are required to use and disclose the PHI under federal or state law.  All requests for limitation on the use and disclosure of your PHI must be submitted to our pharmacy Privacy Officer in writing using a form we will provide you with.

3. You have the right to review or receive photocopies of our records that contain you PHI.  The most common such records are your prescriptions on file with us, our patient profile for you and our billing records for health care products and services that have been provided to you.  We will allow you to review such records at no charge during normal business hours.  However, fees may be applied to cover the costs of supplies, copying, mailing, special courier and faxing necessary to fulfill you request for records.  If we are unable to provide our records to you, we will provide you a written explanation of why we are not able to provide the records.  All requests to review or receive photocopies of our records that contain you PHI must be submitted to our Pharmacy Privacy Officer in writing using a form that we will provide you with.

4. You have the right to request changes in the content of your PHI contained in our records where you believe the content is incomplete, inaccurate or for some other reason needs to be changed.  We may not be able to agree to your requested change if we no longer have the records or if the requested change would cause your PHI to become inaccurate.  If we are not able to agree to your requested change, we will notify you in writing as to why we are not able to agree.  You will then have the right to submit to us a written statement of disagreement to which we may elect to further respond in writing to you.   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 you with.

5. You have the right to obtain a written record of some of our disclosures of your PHI made after April 14, 2003.  Some of our disclosures of your PHI are not required by HIPAA to be included in the accounting.  These are for purposes of treatment, obtaining payment and carrying out health care operations.  Other disclosures of your PHI that are not required to be included in the accounting are disclosures made directly to you or that you have authorized, made to family, friends and others who assist you with your care (caregivers) and made for other purposes allowed by HIPAA.

6.   The period of time for which we are required to provide the accounting is no earlier than April 14, 2003.  You may obtain from us, without charge, one accounting during a 12-month period. However, if you request additional accountings during the same 12-month period, we may charge you a cost-based fee for printing or photocopying of the accounting, together with any expenses for mailing, special courier, faxing and supplies necessary to fulfill your request.  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 you with.

7. You have the right to file a complaint if you believe that we have violated your rights as described above.  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 resolve any complaint, including providing you with the address for filing a complaint with HHS.

Ways That We May Use And Disclose Your PHI

The Health Insurance Portability and Accountability Act of 1996 requires that this notice tell you how we may use and disclose your PHI.

1. Treatment - HIPAA defines treatment as "the provision, coordination or management of health care and related services by one or more health care providers, including the coordination or management of health care by a health care provider with a third party, consultation between health care providers relating to a patient or the referral of a patient for health care from one health care provider to another." We will maintain records that contain your PHI and we will use and disclose your PHI as necessary to provide health care products and services to carry out and support your treatment.  As a pharmacy, we may use and disclose your PHI as necessary to maintain a patient profile on you which may include information about you, your medical condition, medications and prescription devices that you use and allergies that you may have and other information, such as any health insurance that you may have.  We may use and disclose your PHI in dispensing prescription medicines and related products and services, including counseling you and your caregivers about the proper use of your medications.  We may discuss such problems with your other health care professionals, such as your physician or dentist.  Finally, we may use and disclose your PHI to you and your caregivers in our discussions with you and your caregivers about your treatment.

2. Payment - HIPAA defines payment as activities to obtain reimbursement for the health care products and services that we provide to you.  These activities include billing you directly or someone who pays for your health care, such as a family member, care giver, health insurance company, auto insurance company or casualty insurance company, for the health care products and services that we provide you, other activities may include determination of eligibility or coverage, medical necessity, review of health care services with respect to medical necessity, coverage under a health plan, appropriateness of care or justification of charges utilization review activities precertification and preauthorization of services, concurrent and retrospective review of services and disclosure to consumer reporting agencies, law enforcement officials and attorneys of some or all of the following PHI necessary for collection of payment: name and address, date of birth, social security number, payment history, account number or numbers and name and address of the health care provider and/or health plan.

3. Health Care Operations - HIPAA defines health care operations as those activities necessary and related to our providing of health care products and services to you.  These activities include, but may not be limited to the following:

1. Conducting quality assessment and improvement activities, case management and care coordination and contacting of health care providers and patients with information about treatment alternatives and related functions that do not include treatment.

2. Contacting or arranging for medical review, legal services and auditing functions, including fraud and abuse detection and compliance programs.

3. Our pharmacy management and general administrative activities, including, but not limited to, activities relating to implementation of and compliance with the requirements of HIPAA.

4. Periodic statements to yourself or family members you designate, including end-of-year insurance or tax information.

5. On-site and off-site wellness screenings and counseling including treatment and payment for such.

4. Business Associates - The nature of the health care system is such that we may not be able to provide health care products and services to you without the involvement of other businesses or persons.  It will be necessary for us to provide your PHI to these business associates so that they can carry out the activities that we need to have performed in order to provide you health care products and services.  Contracts have or will be submitted to all or our business associates to whom we provide your PHI so that they carry out their activities on our behalf.  These contracts require our business associates to give us their assurance that they will protect the privacy of your PHI.

5. Disclosure Of Your PHI Not Involving Treatment, Payment and Health Care Operations - We may find it necessary to communicate with businesses and individuals not already described above.  Most of these disclosures will be related to providing treatment to you and to carrying out payment and health care operations as discussed above.  We may also communicate with you directly, as well as others who assist you with your health care, commonly referred to as caregivers.  We will disclose your PHI to these caregivers or appropriate others, as we believe necessary and appropriate for your health care.

6. Communications With You Concerning Your Health Treatment - We routinely monitor your prescription medications for appropriateness and take other steps to help you use your medication properly.  We may contact you to remind you to obtain a refill.  We may also call you or send you materials regarding products and services that we believe may be of benefit to you.  In the event of medication recall, we may contact you, if you are taking the medication subject to the recall.

7. Federal and State Government Agencies - We may disclose you pHi to federal and state government agencies for a variety of purposes.  For example, the United States Drug Enforcement Administration (DEA) monitors the distribution and usage of controlled substances, while the United States Food and Drug Administration (FDA) monitors adverse drug events.  Some private businesses such as the manufacturers of medications and medical devices are legally required to conduct post-marketing surveillance in order to ensure the safety of their products.  Disclosing your PHI for such surveillance may be necessary.

8. Federal and State Government Health Care Insurance Programs - If you apply for and receive benefits from federal and state health care programs, such as Medicare or Medicaid, your PHI may be disclosed to that agency.  If you are employed by a business that is required to carry worker's compensation insurance and you are injured, it may be necessary to disclose your PHI to the workers' compensation plan.  Such plans have a right to conduct audits, inspections and investigations of our activities and your activities.  Where required, we will disclose your PHI for these activities.

9. Matters of Public Health and Safety - There are federal and state laws that require health care providers to report to various government agencies matter related to public health.  If your physical or mental health condition and illness is of a nature that federal or state law requires that it be reported, then we will disclose your PHI to the appropriate government agency in order to comply with these laws.  In addition to reporting about physical and mental health conditions and illnesses, we may also disclose your PHI to government agencies in other situations where we are required to submit reports, such as suspected domestic, child or elder abuse or neglect.

10. Law Enforcement Activities - A number of federal, state and local government agencies enforce health care and drug laws and other laws in relation to the health care products and services that we may provide to you.  A variety of federal, state and local health care agencies such as the state board of pharmacy, regulate our activities.  These agencies may conduct inspections and investigations of our activities and the health care products and services that we provide to our patients.  At any time we are required by federal or state laws or by court order, subpoena or other legal mandate to disclose your PHI, we will do so as necessary.

11. Legal Disputes - Lawsuits and other legal disputes may involve your PHI that we possess.  In the event that you are involved in a lawsuit or other legal proceeding, whether as the plaintiff or defendant and without regard to the basis for the lawsuit, such as medical malpractice or divorce, we will disclose your PHI when required to comply with a court order, subpoena, discovery proceeding, such as a deposition or other legal mandate served upon us.

12. Disclosures For the Benefit Of You and Others - A variety of events could occur where we would use and disclose your PHI for your benefit and to prevent or reduce the risk of harm to you.  For example, if you are in a car accident and are unconscious in a hospital emergency room and the emergency room medical staff calls us with a request for your PHI, we may disclose it for the purpose of assisting in your prompt medical treatment.  Finally we may disclose your PHI where necessary to protect the health and safety of others.

13. Disclosures For National Security and Intelligence - We are legally required to disclose your PHI where necessary to national security activities and intelligence and counterintelligence activities.  Disclosures related to this may also include those where required in relation to the protection of the President of the United States.  Any disclosure for these purposes would be made only to authorized government officials.

14. Disclosures If You Are In The Military or A Veteran - We may disclose your PHI if you are a member of any branch of the armed services, whether on active or reserve status, as required by the U.S. Military.  If you are a veteran, we may release your PHI, particularly if you are receiving health care products and services from the Veteran's Services.  Any disclosure for these purposes would be made only to authorized government officials.

15. Disclosures of a Miscellaneous Nature - We may be required to disclose your PHI if you are placed into the custody of a federal or state correctional system, if necessary to protect the health and safety of you and others.  Health care is an area where much research is being conducted and we may disclose your PHI for purposes of a research project.  Finally, given the national need for organ donations, we may disclose your PHI to organizations that manage organ transplantation programs.

Use and Disclosures Not Contained in This Notice

If a use and disclosure of your PHI is not contained in this Notice, then we will obtain your written authorization before the use and disclosure.  You may have the right to refuse to authorize the use and disclosure or if you grant the authorization, to revoke the authorization at any time.  If such authorization is requested, we will provide you with a form that describes the proposed use and disclosure and your rights related to the requested authorization.

Conclusion

HIPAA requires that we give you this "Notice of Privacy Practices" and make a good faith effort to obtain your written acknowledgement that you were given this Notice.  Upon giving you this Notice, you will be asked to sign a document acknowledging that you received this Notice.  We appreciate your cooperation in reviewing this Notice and in giving us your written acknowledgement.

HIPAA Requires That This Notice, At A Minimum, Cover The Following Three Areas:

1. How we will use and disclose your protected health information.

2. Your rights with respect to your protected health information.

3. Our legal duties to protect the confidentiality of your protected health information.

In preparing this Notice, we made every effort to comply with this HIPAA requirement.  We also want to advise you that in addition to the privacy and other rights given to you by HIPAA, our state may from time to time enact laws that also provide you privacy and other rights in relation to your health care and your protected health information.

Please consult our Pharmacy Privacy Officer if you have any questions or want more information concerning your health care and privacy rights under HIPAA or the laws of our state or our privacy practices.  Thank you again for allowing us the privelege of being your pharmacy.  We look forward to continuing to be of service to you.

Privacy Officer:  Jim Byington
Ada Hillside Pharmacy

Non-PHI-Related Privacy Practices

Ada Hillside Pharmacy operates an online store, where items may be purchased that do not involve PHI issues.  We recognize that respecting user privacy over the Internet is of utmost importance. The following privacy statement is designed to provide information about the privacy and data collection practices for the site: http://www.MYADARX.COM. The Site is operated by Ada Hillside Pharmacy.

If you have questions or concerns regarding this statement, you should first contact our site coordinator at info@myadarx.com or by postal mail to:

Ada Hillside Pharmacy
6745 Fulton St
Ada MI 49301

Identifying Information. In general, you can visit the Site without telling us who you are or providing any information about yourself. In some areas of the Site, we ask you to provide information that will enable us to process an order, offer services that require registration, assist you with technical support issues or to follow up with you. Generally, Ada Hillside Pharmacy requests identifying information when you:

1. Register on any of our web sites.

2. Place an order.

3. Provide feedback to an online survey or tell us about an idea or suggestion.

4. Participate in a rebate program, contest, or other promotional offer.

5. Request a SPECIAL SERVICE

6. Request information or files from customer service.

In these instances, Ada Hillside Pharmacy will ask for your name, address, e-mail address, phone number and other appropriate information needed to provide you with these services. In all instances, if you receive a newsletter or other mailing from us, you will always be able to "unsubscribe" to these mailings at any time.

What Ada Hillside Pharmacy Will Do With Your Information. If you choose to give us personal information for any of the purposes above, this information is retained by Ada Hillside Pharmacy and will only be used by Ada Hillside Pharmacy to support your customer relationship with us. We will not add you to a mailing list, or newsletter without your registration for this service. We will only contact you if further information is required from you to complete a service.

What Others May Do With Your Information. Ada Hillside Pharmacy does not share, rent, or sell any personally identifying information provided through our Site (such as your name or email address) to any outside organization for use in its marketing or solicitations. From time to time Ada Hillside Pharmacy may use agents or contractors who will have access to your personal information to perform services for Ada Hillside Pharmacy (such as DATABASE MAINTENANCE, FURTHER EXAMPLES), however, they are required by us to keep the information confidential and may not use it for any purpose other than to carry out the services for Ada Hillside Pharmacy. In addition, Ada Hillside Pharmacy may also share aggregate information about its customers and its web site visitors to advertisers, business partners, and other third parties. For example, we might share that our users are x percent PCs users and y percent Macintosh users. None of this information, however, will contain personal, identifying information about our users.

Ada Hillside Pharmacy On-line Store. The Ada Hillside Pharmacy On-line Store is designed to give you options concerning the privacy of your identifying information. If you choose, you can set up an account. This will allow you to have a customized order page for express ordering and to view your purchasing history. To protect your privacy, we have designed the Sites to include certain steps to verify your identity before granting you access or enabling you to make corrections in an account. You will always have access to this account information and can view it, update it or correct it at any time. To access your information, you will need to use a password.

When purchasing products through the our web site, the order form will also ask you to provide a daytime telephone number. However, the telephone number is only used to quickly resolve questions relative to an order, such as to clarify customer email addresses that are inactive, or entered incorrectly.

Third Party Links. www.myadarx.com does provide links to other sites. Other Internet sites and services have separate privacy and data collection practices. Once you leave www.myadarx.com, Ada Hillside Pharmacy cannot control, and has no responsibility for, the privacy policies or data collection activities at another site.

Cookies. At times, we will use a feature on your web browser to send your computer a "cookie". We do not use cookies to retrieve any personal information from your computer. We only use cookies to learn ways to enhance our Sites, and to give you better, more personalized service while in our web site. You can reset your browser to refuse all cookies or indicate when a cookie is sent. However, some functions of the Sites will not function if you refuse cookies. These areas of our web site will have information posted about cookies, and when a cookie will be uploaded to your computer.

Children's Privacy Protection. Ada Hillside Pharmacy is sensitive to the heightened need to protect the privacy of children under the age of 13. The vast majority of the material on our web site is not intended for children and is not targeted to children under the age of 13. We do not knowingly collect data from children and, if we learn that we have received personal data from a child, we will remove this information from our database.

Changes to this Policy. Ada Hillside Pharmacy may from time to time revise its privacy policy. You should therefore periodically visit this page, so you are aware of any such revisions. We will not, however, use your existing information in a manner not previously disclosed. You will be advised and have the opportunity to opt out of any new use of your information.

Contacting Us. If you have any questions about our privacy policy and/or the practices of our web site, you can write to:

Ada Hillside Pharmacy
6745 Fulton St
Ada MI 49301

Credit Card Security.
We know customers are concerned about credit card security. We use one of the worlds largest funds transfer agencies - PayPal.

If you choose to use a PayPal account, your personal credit card information will not be given to Ada Hillside Pharmacy.