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.
Riverside Pharmacy Associates LLC, dba Apex Specialty Pharmacy (Apex), provides specialty medicines that require additional care. In this notice, we use the terms “our” and “we” for all Riverside Pharmacy Associates LLC operations. Our notice does not apply to anyone else. Your health plan and other health care providers should give you their own Notice of Privacy Practices.
What is this notice for?
We are required by law to protect the privacy and security of your health information, and to provide you with this notice of our legal duties and privacy practices. We also are required to follow the notice that is currently in effect. This notice explains your rights, and our duties, under a federal law called the Health Insurance Portability and Accountability Act, also called HIPAA. The notice also explains how we may use your health information and when we may share or “disclose” that information to others. State laws and regulations may impose further limits or requirements on our ability to use or disclose your health information or certain categories of your health information. We will follow more stringent state laws and regulations that apply to us and your health information. In this notice, we refer to health information that is protected by HIPAA as “PHI,” which is an abbreviation for “protected health information.” PHI includes information that may identify you and relates to your past, present or future physical or mental health or condition, the health care you receive or the payment for such health care.
You have rights about how the PHI that we have about you can be used and disclosed. These rights include:
Right to ask us to limit how we use and share your PHI.
You can ask us not to use or share certain PHI for treatment, payment, our operations, or for certain disclosures to family members or others involved in your care. We are not required to agree to your request, and we may say no including if it would affect your care. You must send your request in writing to the address found at the end of this notice. The request should explain what PHI you want to limit and how you want the limit to apply. Whether or not we agree to your request, we will respond in writing to notify you of our decision. If we agree to your request, we will abide by the agreement except when you require emergency treatment. In that case, we will use or disclose the PHI that is necessary to provide emergency care.
Right to ask to receive confidential communications.
You may request that we communicate with you by alternative means or at alternative locations. For example, you may ask that we use a specific address, like a work address and not a home address to communicate with you. We must agree as long as your request is not unreasonable and so long as you provide an alternative address or method of contact.
To ask for a confidential communication, please call 855.257.2584 and ask for the Compliance Officer
Right to look at and copy your medical record.
To get a paper or electronic copy of your medical record and certain other health information we have about you, you must send your request in writing to the address at the end of this notice. We will usually respond within 30 days. In some cases, we may deny your request for specific reasons permitted by HIPAA. If we do, we will send you a letter to explain why we denied your request. We will also explain your rights to have the denial reviewed. We may charge you a reasonable cost-based fee for providing you a copy of your medical record and certain other health information we have about you. We may ask you if it is okay for us to send you just a summary of your medical record and certain other health information we have about you. You do not have to agree to receive just the summary.
Right to ask us to correct your medical record and certain other health information we have about you.
You must send us this request in writing to the address at the end of this notice. You must explain why we should make the correction to your medical record and/or certain other health information we have about you. We typically will respond within 60 days. We will tell you in writing whether we will make the corrections, and if not, why not.
Right to ask for a list of certain instances we shared your PHI.
You can request that we provide you with a list of certain instances in which we shared your PHI. The list may include any period of time during the six years before the date of your request. We will typically respond within 60 days. To request this list, you need to send a written request to the address printed at the end of this notice and state that it is for “Accounting for Disclosures.” We will not charge you for the first request during any one-year period. We may charge a reasonable fee for more requests during the same one-year period. The list that we provide you, however, will not include certain instances where we shared your PHI, including in the following situations:
- To treat you
- To get paid for the medical care we provide
- To perform health care operations
- To you
- For disaster notification
- With your written permission
- For national security purposes
- To law enforcement personnel
Right to restrict PHI from health plans.
You may also ask us not to share information about a prescription with your health plan for payment or health care operations purposes if you (or someone on your behalf) pay us directly for the prescription.
- You must ask us for these things before we receive the prescription from your doctor.
- We will agree if you (or someone on your behalf) pay for the medicine in full prior to shipment.
- We ship medicine only to members of the health plans we serve. We may still confirm you are a member of one of the health plans we serve. We will not tell the health plan about the medicine you want to buy.
- We will charge you the full retail price for your medicine. We may charge shipping and handling fees.
- We will still share your PHI as required by law. For example, we may share your PHI under a court order, as part of a fraud investigation, or to track controlled substances.
How we may use and share your PHI
We typically use and share your PHI to treat you, to get paid for the medical care we provide, and to run our business. Sometimes we may use or share your PHI if we provide you an opportunity to agree or object. Sometimes the law requires us or allows us to use or share your PHI for legal or other reasons. For other cases, we need your permission to use or share your PHI. All of these are explained later in this Notice.
To treat you.
We may use and share your PHI to treat you or to allow someone else to treat you. State law may limit our right to share PHI with others treating you. We may need to confirm that you gave them permission to get your PHI. For example, we may share your PHI with doctors, pharmacists and nurses who are treating you.
To get paid for medical care we provide.
We may use or share your PHI to get paid for treating you. For example, we may bill your insurance company for medications we provide you. To run our business. We may use or share your PHI to run our business, also called “health care operations.” For example:
- We may use your PHI to evaluate the quality of service we gave you.
- We may use your PHI to evaluate anyone who provided care to you.
- We may use your PHI for business planning purposes.
Individuals involved in your care or payment for your care
In certain circumstances, we may share your PHI with a family member or close friend who is involved in your medical care or to someone who helps pay for your care, when you are incapacitated or in an emergency, or when you agree or fail to object when given the opportunity. If you are unavailable or unable to object, we will use our best judgment to decide if the disclosure is in your best interests. For example:
- We may share your PHI with your family or caregivers unless you object.
- We may share some of your PHI with others involved in your care (for example, you may have a family member on the phone while we discuss your medicine).
- We may share some of your PHI with anyone paying for your care (for example, this could include your parents or spouse, if you are covered by their insurance).
- We may share your PHI with entities assisting with disaster relief efforts.
Other ways we may share your PHI
We may use and share your PHI without your permission in these cases:
As required by law. We use and share your PHI as required by law.
Public health activities. We use and share your PHI as required by public health authorities. For example, we may share your PHI with the U.S. Food and Drug Administration (FDA) about medicines you are taking.
Victims of abuse, neglect or domestic violence. We may share your PHI with an authorized government authority if we believe you have been the victim of abuse, neglect or domestic violence. We will only do so if required or allowed to do so by law.
Health oversight agencies. We may share your PHI with government agencies for oversight activities authorized by law, including audits, inspections, and investigations. We will only do so if the agencies have a legal right to oversee our business.
Lawsuits and disputes. We may share your PHI to respond to a subpoena or similar legal request. We will only do so in either of two cases:
- You have been told about the request.
- There is a court order or similar process to protect your PHI.
Law enforcement. We may share your PHI with law enforcement in response to a court order, subpoena, summons, or similar process. We may also disclose limited PHI about you to a law enforcement official for the purpose of providing information to help locate a suspect, fugitive, witness or missing person or to report a crime.
Coroners, medical examiners and funeral directors. We may share your PHI with coroners, medical examiners and funeral directors for purposes of identifying a deceased person, determining the cause of death, and for such persons to carry out their duties as authorized by law.
Avoid a serious threat to health or safety. We may share your PHI to prevent or lessen a serious and imminent threat to:
- Your health and safety
- The health and safety of someone else
Specialized government functions. We may use and share your PHI for specialized government functions. For example, we may use and share your PHI with authorized federal officials for intelligence and national security activities.
Workers’ compensation or similar programs. We may share your PHI as authorized by and to the extent necessary to comply with laws relating to workers’ compensation or similar programs.
Research. Under certain circumstances, we may use or share your information for health research. All research projects are subject to a special approval process or otherwise must meet certain requirements.
Respond to organ and tissue donation requests. We may share health information about you with organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of cadaveric organs, eyes, or tissue for the purpose of facilitating organ, eye or tissue donation and transplantation.
When we need your permission
We need your written permission to share your PHI for any reason not covered in this notice. We will not require you to give your written permission as a condition of receiving medications from us.
We will never share your PHI for marketing purposes unless permitted by law or you give us written permission.
We must also ask you for written permission, in most cases, to share psychotherapy notes, but it is unlikely that our medical records would have psychotherapy notes.
We may be paid to share your PHI with a third party, like a drug manufacturer. In this case, we need your written permission. Often, the third party will have gotten the written permission from you.
When you give us your written permission, you may revoke your permission at any time by returning a “Revocation of Authorization” form. If you revoke your permission, we will no longer use or disclose your PHI for the reasons covered by your permission. We are unable to take back any uses or disclosures we have already made with your permission. We will provide you with instructions on filling out a Revocation of Authorization form whenever you provide us with your written permission.
We are required by law to maintain the privacy and security of PHI. We must follow the duties and privacy practices described in this notice and give you a copy of it.
Breach notification. We will let you know promptly if a breach occurs involving unsecured health information about you. Changes to the terms of this notice. We may change our privacy practices at any time. The changes may apply to your PHI we already have. We will revise this notice to explain any big changes. You can find the most current notice posted under the Privacy link at www.rxapex.com
Additional copies of this notice may be made available by using the contact information printed at the end of this notice.
Complaints. If you think we have not met our duties explained in this notice or that your rights have been violated, you may complain to us or to the U.S. Department of Health and Human Services. No action will be taken against you for complaining. You may also contact us if you have questions about our privacy practices.
Toll Free: 855.257.2584
|Apex Specialty Pharmacy
Attn: Compliance Officer
616 NW Platte Valley Drive
Riverside, Missouri 64150
If you wish to release your medical information to a third party, please complete and submit the Authorization to Release Health Information form.
Questions or concerns? Contact us
We know that filling a Specialty Medication can be a long, confusing and expensive process. We’re here to help.
At Apex, we strive to make filling a Specialty Medication as simple and seamless as possible for both the patient and provider. If there’s anything we can do to assist you, please let us know.Send us a Message