Locally owned. Locally operated. Locally loved.
Home IconFind Your Store
HIPAA Notice of Privacy Practice
Protecting Your Privacy Roller Pharmacy is committed to ensuring the privacy and confidentiality of our customer?s Protected Health Information (PHI) and fully supports the provisions of the Privacy Rule Of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). 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. This Notice of Privacy Practices describes how Roller Pharmacy may collect, use and disclose your protected health information, and your rights concerning your protected health information. Protected health information is information about you or your dependents, including demographic information, that can reasonably be used to identify you and that relates to your past, present or future physical or mental health or condition, the provision of health care service to you or our payment for that care. We are required to safeguard your protected health information and to provide you with this notice about our legal duties and privacy practices. We must follow the privacy practices described in this notice while it is in effect. This notice takes effect April 14, 2003 and will remain in effect until we replace or modify it. WHAT IS PROTECTED HEALTH INFORMATION (PHI)? Whether based on our long-standing confidentiality policy or pertinent law, Roller Pharmacy, safeguards the privacy of your protected health information (?PHI?). PHI is information that alone, or in conjunction with other data that we collect from or about you, would allow you to be identified. For example, medical information used to help customers get needed care, or information about payments for services you have received, as well as descriptive information about those services, is PHI. HOW WE MAY USE AND DISCLOSE YOUR PHI In order to provide coverage for treatment and pay for those services, we need to use and disclose your PHI in a number of different ways. Roller Pharmacy staff is trained in the appropriate handling of your PH and execute their specific responsibilities using only that information required for their role. Roller Pharmacy maintains and enforces policies governing the use of PHI by workforce members to ensure their proper handling. Procedures to afford these internal protections against mishandling of PHI throughout the workforce include provisions pertinent to physical and technical safeguards taken in order to protect verbal, written and electronic PHI from being mishandled by workforce members as they execute their responsibilities. The following are examples of the types of uses and disclosures of your PHI that we are permitted to make without your authorization: FOR PAYMENT Roller Pharmacy will use and disclose your PHI to administer your health benefits policy or contract, which may involve the determination of eligibility; claims payment; utilization review activities; medical necessity review; coordination of benefits and responding to complaints, appeals, and external review requests. Examples include: * Using PHI in order to pay claims that have been submitted to us by physicians and hospitals for payment * Transmitting PHI to a third party to facilitate administration of a Flexible Spending Account, a Healthy Savings Account, a Health reimbursement account, or a dental benefits plan, in you have one * Additional PHI of dependents may be shared with subscriber when administering a family membership contract ( the current status of co-payments and deducible amounts for dependents) FOR HEALTH CARE OPERATIONS Roller Pharmacy may use and disclose your PHI for operational purposes. For example, your PGI may be disclosed to staff members within Roller Pharmacy, such as medical-management, risk- management or quality-improvement personnel, and others to: * Assess the quality of care and outcomes in your cases and similar cases * Learn how to improve our services and facilities through the use of internal and external surveys * Determine how to continuously improve the quality and effectiveness of health care services our members receive * Evaluate the performance of our staff, for example, to review our member service representatives? call documentation In addition, your PHI may be used for the following purposes, each of which is also considered health care operations: * Sharing of data used for enrollment, disenrollment, and premium billing, as well as summary renewal data with your Plan Sponsor (your employer and/or their representatives, if you are enrolled through an employer) * Other information beyond what is listed may be shared only after Roller Pharmacy receives appropriate certification that the PHI will not be used by your employer for employment decisions or other non-intended purposes) * If you have a primary care physician who manages your care, we may furnish his or her name to your Plan Sponsor in order to permit your Sponsor to evaluate the effects of changes to the network available to you * Quality assessment and improvement activities, such as peer review and credentialing of our affiliated providers. * Accreditation by independent organizations such as the National Committee for Quality Assurance. * Performance measurement and outcomes assessment, health claims analysis and health services research * Preventive health, early detection, disease management, case management and coordination of care programs, including sending preventive health service reminders * Underwriting, rate making and determining cost sharing amounts, as well as administration of reassurance policies. * Risk management, auditing and detection of unlawful conduct * Transfer of policies or contracts from and to other insurers, health plans or third party administrators. * Facilitation of any potential sale, transfer, merger, or consolidation of all or part of a ?covered entity? like HPHC, with another covered entity, and due diligence related to that activity * Other general administrative activities, including data and information systems management, customer service and collecting premiums. FOR TREATMENT Roller Pharmacy may disclose your PHI to health care providers (doctors, dentists, pharmacies, hospitals and other caregivers) who request it in connection with your treatment. For example, for your safety, we may provide a list of medications you?ve received through Roller Pharmacy to emergency room clinicians treating you in an effort to minimize the potential for adverse drug interactions. This information will only be furnished to emergency room clinicians with your consent, unless you are unable to provide consent. We may also disclose your PHI to health care providers in connection with preventative health initiatives, early detection programs, and disease management programs. For example, Roller Pharmacy may disclose information to a physician involved in your care that includes a list of medications you?ve filled at Roller Pharmacy( this will alert those physicians treating you to those medications prescribed for you by others and will help minimize potential adverse drug interaction). Roller Pharmacy may also disclose information to your primary care physician to suggest a disease management or wellness programs that could improve your health. At times, Roller Pharmacy may contract with other organizations to provide services on our behalf. As these services are performed, PHI is accessed or disclosed. In these cases, Roller Pharmacy will enter into an agreement explicitly outlining the requirements associated with the protection, use and disclosure of your PHI. Examples of such ?business associates? include behavioral health management companies and pharmacy benefit managers. Other permitted or required uses and disclosures of PHI that do not require your authorization include the following: * Parents as personal representatives of minors: In most cases, your minor child?s PHI may be disclosed to you. However, we may be required by law to deny a parent?s access to a minor?s PHI for certain diagnoses or treatment such as sexually transmitted diseases, family planning services, etc. * Worker?s compensation: Your PHI may be used and disclosed in order to comply with laws and regulations related to Workers? Compensation. * Public Health Activities: Your PHI may be used or disclose for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury or disability, tracking of prescription drug or medical device programs, or for other health oversight activities. This can include expanded public health activities data collection by state government-mandated or sponsored consortiums or public health authorities. * Research: Roller Pharmacy may use your PHI for research purposes when our Human Subjects Committee has reviewed the research proposal and approved the research based on established protocols to ensure the privacy of your PHI. * Legal proceedings: You PHI may be disclosed in the course of any legal proceeding, in response to an order of a court or an administrative tribunal and, in certain cases, in response to a subpoena, discovery request, or any other legal process. * If you are enrolled in a group health plan: If you are enrolled in Roller Pharmacy through your work or through a family member?s policy, you are enrolled in a ?Group health plan.? If your employer has established procedures to safeguard your PHI as required by federal law, and the Group Health Plan elects to receive PHI from Roller Pharmacy, we may disclose this information to your sponsoring employer and/or their representative, including, if requested by your Group Health Plan, data describing specific treatments and medications. Talk to your subscriber?s sponsoring employer to get more details. * Health oversight: Your PHI may be disclosed to a government agency authorized to oversee the health care system or government programs or its contractors, (the US Department of Health and Human Services (HHS), a state insurance department or the US department of Labor), for activities authorized by law, such as audits, examinations, investigations, inspections and licensure activities. Although we do not anticipate the following situations will occur frequently, we are required by law to notify you of these additional potential uses and disclosures which can occur without your written authorization * As required by law: Roller Pharmacy may use and disclose information about you as required by law. For example, Roller Pharmacy may disclose information for the following reasons: to report information related to victims of abuse, neglect or domestic violence; to assist law enforcement officials in performing their duties. * Government functions: Your PHI may be disclosed to prevent serious threat to your health or safety or that of any person pursuant to applicable law. We may also disclose your protected health information to authorized federal officials for nation security purposes. In addition, under applicable conditions, we may disclose your PHI if you are, or were a member of the Armed Forces, for those activities deemed necessary by appropriate military authorities. * Inmates: If you are an inmate, your PHI may be disclosed to a correctional institution or a law enforcement official having lawful custody, if the provision of such information is necessary to provide you with health care, protect your health and safety, and that of others, or maintain the safety and security of the correctional institution. * Decedents: PHI may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties. * Organ/tissue donation: Your PHI may be used or disclosed to organ procurement organizations to facilitate cadaveric organ, eye or/tissue donation/ transplantation purposes only subsequent to your prior authorization. USES AND DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION Uses and disclosures of PHI other than those listed in the previous section will be made only with your written authorization, unless otherwise permitted or required by law. You may revoke such an authorization, at any time in writing, except to the extent that we have already taken action based on a previously executed authorization. If a written authorization is obtained from you, your PHI may be disclosed to your personal representative, a person (an adult or emancipated minor) that Roller Pharmacy recognizes as having the authority to act on behalf of another individual in making decisions related to health care. A form to designate your personal representative is at the end of this document. Many members ask us to disclose their PHI to third parties for reasons not described in this notice. For example, elderly members often ask to make their records available to family members or caregivers. To authorize us to disclose any of your PHI to a person or organization for reasons other than those describe in our notice, you may request in writing and we will be glad to assist you. You may revoke the authorization at any time by sending a letter to our Member Services Department. It is important for you to note that once you give us authorization to release your health information, the PHI that we release is out of our control. Roller Pharmacy is unable to safeguard such PHI from redisclosure by the person(s) that you have authorized us to release it to. Finally, Roller Pharmacy will not use your PHI to offer you services or products unrelated to your health care coverage or your health status without your authorization. YOUR RIGHTS REGARDING YOUR PHI The following are your rights with respect to your PHI RIGHT TO ACCESS AND RECEIVE COPIES OF YOUR PHI You have the right to receive a copy of your PHI. We may ask you to request access to copies of your records in writing and to provide us with specific information we need to fulfill your request. We reserve the right to charge a reasonable fee for the cost of producing and mailing the copies of such information. There are certain cases in which we are not permitted to fulfill your request to access or receive your PHI. You may not inspect or copy: * Information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding: * Psychotherapy notes that may be submitted to Roller Pharmacy incidental to a member complaint or appeal. (Roller Pharmacy never requests these confidential notes) * PHI that is subject to the Clinical Laboratory Improvements Amendments of 1988; * Information created or obtained by Roller Pharmacy in the course of research that includes treatment. Access to these records may be temporarily suspended for as long as the research is in progress; * PHI that was obtained from someone other than a health care provider under a promise of confidentiality and the access requested would be reasonably likely to reveal the source of the information. RIGHT TO AMEND YOUR PHI If you believe that your protected health information is incorrect or incomplete, you have the right to ask us to amend it. All requests for amendment must be in writing. In certain cases, we may deny your request. For example, we may deny a request if we did not create the information, as is often the case for medical information that is generated by a provider and stored in our records, or if we believe the current information is correct. All denials will be made in writing. You may respond by filing a written statement of disagreement with Roller Pharmacy and we would have the right to rebut that statement. If you believe someone has received an un-amended PHI from us, you should inform us at the time of the request if you want him or her informed of any amendment we may subsequently agree to execute. RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS Roller Pharmacy recognizes that members have the right to receive communications regarding their PHI in a manner or at a location that the individual feels is safe from an authorized use or disclosure. To support this comment, Roller Pharmacy will permit individuals to request that they receive PHI by alternative means or at alternative locations. We will attempt to accommodate reasonable requests. All requests must be made in writing. RIGHT TO AN ACCOUNTING OF DISCLOSURES OF PHI You have the right to request an accounting of those instances in which we have disclosed your PHI for any purpose other than the following: * For treatment, payment or health care operations * To others involved in your care * Disclosures that you or your designated personal representative have authorized * Certain other disclosures, such as disclosures for national security purposes * Information disclosed to correctional institutions, law enforcement agencies, and health oversight agencies. * Information that was disclosed or used as part of a limited data set for research, public health or health care operations purposes, and * Disclosures made prior to April 14, 2003. All requests must be made in writing. Roller Pharmacy will required you to provide us with the specific information we need to fulfill your request. If you request this accounting more than once in a twelve month period, we may charge you a reasonable fee. RIGHT TO REQUEST LIMITS ON USES AND DISCLOSURES OF YOUR PHI You have the right to ask us to place restrictions on the way we use or disclose your PHI for treatment, payment or health care operations or as described in the section of this notice titled ?Other Permitted or Required Uses and Disclosures of PHI.? We are not, however, required by law to agree to these restrictions. If we do agree to a restriction, we may not use or disclose your PHI in violation of that restriction, unless it is related to an emergency. We may ask that you request these limits in writing. RIGHT TO RECEIVE Roller Pharmacy NOTICE OF PRIVACY PRACTICES You have the right to receive a paper copy of the Notice of Privacy Practices upon request at any time and you may also view a pdf version of the Notice. RIGHTS UNDER STATE LAW You may be entitled to additional rights under state law, e.g. Tennessee provides for enhanced protection of genetic testing and HIV testing. While Roller Pharmacy pays careful attention to protecting this information for all of our members, there are state laws that are more stringent than Provisions of HIPAA?s Privacy Rule. HOW TO OBTAIN INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT PRIVACY PRACTICES To request a copy of this Notice of Privacy Practices at any time, or obtain additional information about this notice, you may contact: Roller Pharmacy 109 N Main Ave. Erwin, TN 37650 423-743-7105 If you believe your privacy rights have been violated, you may file a written complaint with: President Roller Pharmacy: Roller Pharmacy, 109 N Main Ave., Erwin, TN 37650 or by contacting this office at 423- 743-7105. CHANGES TO THIS NOTICE We may make a change to this notice and our privacy practices at any time, as long as the change is consistent with our current privacy policies or state or federal law. If we make an important change to our policies, we will promptly provide you with the new notice by mail and post it on our website. EFFECTIVE DATE OF THIS NOTICE The original effective date is April 14, 2003 and the first revision became effective on September 1, 2004.

About Us

Welcome to Roller Pharmacy. As your local Good Neighbor Pharmacy, we offer quality products at affordable prices, while providing the personalized attention and customer service you expect from a local business. As your neighbors, we live, work and play in the same community as you and your family. We’re the local business owners you see in the neighborhood, at the school play, and volunteering at the local charity. We believe it is our responsibility to take care of our community and our neighbors, and it’s one we take very seriously. We thrive on the opportunity to serve you and your family to the best of our abilities because your business and your health are very important to us. Get to know your neighbor – we’re here to help.

    HIPAA Notice of Privacy Practice
    Protecting Your Privacy Roller Pharmacy is committed to ensuring the privacy and confidentiality of our customer?s Protected Health Information (PHI) and fully supports the provisions of the Privacy Rule Of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). 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. This Notice of Privacy Practices describes how Roller Pharmacy may collect, use and disclose your protected health information, and your rights concerning your protected health information. Protected health information is information about you or your dependents, including demographic information, that can reasonably be used to identify you and that relates to your past, present or future physical or mental health or condition, the provision of health care service to you or our payment for that care. We are required to safeguard your protected health information and to provide you with this notice about our legal duties and privacy practices. We must follow the privacy practices described in this notice while it is in effect. This notice takes effect April 14, 2003 and will remain in effect until we replace or modify it. WHAT IS PROTECTED HEALTH INFORMATION (PHI)? Whether based on our long-standing confidentiality policy or pertinent law, Roller Pharmacy, safeguards the privacy of your protected health information (?PHI?). PHI is information that alone, or in conjunction with other data that we collect from or about you, would allow you to be identified. For example, medical information used to help customers get needed care, or information about payments for services you have received, as well as descriptive information about those services, is PHI. HOW WE MAY USE AND DISCLOSE YOUR PHI In order to provide coverage for treatment and pay for those services, we need to use and disclose your PHI in a number of different ways. Roller Pharmacy staff is trained in the appropriate handling of your PH and execute their specific responsibilities using only that information required for their role. Roller Pharmacy maintains and enforces policies governing the use of PHI by workforce members to ensure their proper handling. Procedures to afford these internal protections against mishandling of PHI throughout the workforce include provisions pertinent to physical and technical safeguards taken in order to protect verbal, written and electronic PHI from being mishandled by workforce members as they execute their responsibilities. The following are examples of the types of uses and disclosures of your PHI that we are permitted to make without your authorization: FOR PAYMENT Roller Pharmacy will use and disclose your PHI to administer your health benefits policy or contract, which may involve the determination of eligibility; claims payment; utilization review activities; medical necessity review; coordination of benefits and responding to complaints, appeals, and external review requests. Examples include: * Using PHI in order to pay claims that have been submitted to us by physicians and hospitals for payment * Transmitting PHI to a third party to facilitate administration of a Flexible Spending Account, a Healthy Savings Account, a Health reimbursement account, or a dental benefits plan, in you have one * Additional PHI of dependents may be shared with subscriber when administering a family membership contract ( the current status of co-payments and deducible amounts for dependents) FOR HEALTH CARE OPERATIONS Roller Pharmacy may use and disclose your PHI for operational purposes. For example, your PGI may be disclosed to staff members within Roller Pharmacy, such as medical-management, risk- management or quality-improvement personnel, and others to: * Assess the quality of care and outcomes in your cases and similar cases * Learn how to improve our services and facilities through the use of internal and external surveys * Determine how to continuously improve the quality and effectiveness of health care services our members receive * Evaluate the performance of our staff, for example, to review our member service representatives? call documentation In addition, your PHI may be used for the following purposes, each of which is also considered health care operations: * Sharing of data used for enrollment, disenrollment, and premium billing, as well as summary renewal data with your Plan Sponsor (your employer and/or their representatives, if you are enrolled through an employer) * Other information beyond what is listed may be shared only after Roller Pharmacy receives appropriate certification that the PHI will not be used by your employer for employment decisions or other non-intended purposes) * If you have a primary care physician who manages your care, we may furnish his or her name to your Plan Sponsor in order to permit your Sponsor to evaluate the effects of changes to the network available to you * Quality assessment and improvement activities, such as peer review and credentialing of our affiliated providers. * Accreditation by independent organizations such as the National Committee for Quality Assurance. * Performance measurement and outcomes assessment, health claims analysis and health services research * Preventive health, early detection, disease management, case management and coordination of care programs, including sending preventive health service reminders * Underwriting, rate making and determining cost sharing amounts, as well as administration of reassurance policies. * Risk management, auditing and detection of unlawful conduct * Transfer of policies or contracts from and to other insurers, health plans or third party administrators. * Facilitation of any potential sale, transfer, merger, or consolidation of all or part of a ?covered entity? like HPHC, with another covered entity, and due diligence related to that activity * Other general administrative activities, including data and information systems management, customer service and collecting premiums. FOR TREATMENT Roller Pharmacy may disclose your PHI to health care providers (doctors, dentists, pharmacies, hospitals and other caregivers) who request it in connection with your treatment. For example, for your safety, we may provide a list of medications you?ve received through Roller Pharmacy to emergency room clinicians treating you in an effort to minimize the potential for adverse drug interactions. This information will only be furnished to emergency room clinicians with your consent, unless you are unable to provide consent. We may also disclose your PHI to health care providers in connection with preventative health initiatives, early detection programs, and disease management programs. For example, Roller Pharmacy may disclose information to a physician involved in your care that includes a list of medications you?ve filled at Roller Pharmacy( this will alert those physicians treating you to those medications prescribed for you by others and will help minimize potential adverse drug interaction). Roller Pharmacy may also disclose information to your primary care physician to suggest a disease management or wellness programs that could improve your health. At times, Roller Pharmacy may contract with other organizations to provide services on our behalf. As these services are performed, PHI is accessed or disclosed. In these cases, Roller Pharmacy will enter into an agreement explicitly outlining the requirements associated with the protection, use and disclosure of your PHI. Examples of such ?business associates? include behavioral health management companies and pharmacy benefit managers. Other permitted or required uses and disclosures of PHI that do not require your authorization include the following: * Parents as personal representatives of minors: In most cases, your minor child?s PHI may be disclosed to you. However, we may be required by law to deny a parent?s access to a minor?s PHI for certain diagnoses or treatment such as sexually transmitted diseases, family planning services, etc. * Worker?s compensation: Your PHI may be used and disclosed in order to comply with laws and regulations related to Workers? Compensation. * Public Health Activities: Your PHI may be used or disclose for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury or disability, tracking of prescription drug or medical device programs, or for other health oversight activities. This can include expanded public health activities data collection by state government-mandated or sponsored consortiums or public health authorities. * Research: Roller Pharmacy may use your PHI for research purposes when our Human Subjects Committee has reviewed the research proposal and approved the research based on established protocols to ensure the privacy of your PHI. * Legal proceedings: You PHI may be disclosed in the course of any legal proceeding, in response to an order of a court or an administrative tribunal and, in certain cases, in response to a subpoena, discovery request, or any other legal process. * If you are enrolled in a group health plan: If you are enrolled in Roller Pharmacy through your work or through a family member?s policy, you are enrolled in a ?Group health plan.? If your employer has established procedures to safeguard your PHI as required by federal law, and the Group Health Plan elects to receive PHI from Roller Pharmacy, we may disclose this information to your sponsoring employer and/or their representative, including, if requested by your Group Health Plan, data describing specific treatments and medications. Talk to your subscriber?s sponsoring employer to get more details. * Health oversight: Your PHI may be disclosed to a government agency authorized to oversee the health care system or government programs or its contractors, (the US Department of Health and Human Services (HHS), a state insurance department or the US department of Labor), for activities authorized by law, such as audits, examinations, investigations, inspections and licensure activities. Although we do not anticipate the following situations will occur frequently, we are required by law to notify you of these additional potential uses and disclosures which can occur without your written authorization * As required by law: Roller Pharmacy may use and disclose information about you as required by law. For example, Roller Pharmacy may disclose information for the following reasons: to report information related to victims of abuse, neglect or domestic violence; to assist law enforcement officials in performing their duties. * Government functions: Your PHI may be disclosed to prevent serious threat to your health or safety or that of any person pursuant to applicable law. We may also disclose your protected health information to authorized federal officials for nation security purposes. In addition, under applicable conditions, we may disclose your PHI if you are, or were a member of the Armed Forces, for those activities deemed necessary by appropriate military authorities. * Inmates: If you are an inmate, your PHI may be disclosed to a correctional institution or a law enforcement official having lawful custody, if the provision of such information is necessary to provide you with health care, protect your health and safety, and that of others, or maintain the safety and security of the correctional institution. * Decedents: PHI may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties. * Organ/tissue donation: Your PHI may be used or disclosed to organ procurement organizations to facilitate cadaveric organ, eye or/tissue donation/ transplantation purposes only subsequent to your prior authorization. USES AND DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION Uses and disclosures of PHI other than those listed in the previous section will be made only with your written authorization, unless otherwise permitted or required by law. You may revoke such an authorization, at any time in writing, except to the extent that we have already taken action based on a previously executed authorization. If a written authorization is obtained from you, your PHI may be disclosed to your personal representative, a person (an adult or emancipated minor) that Roller Pharmacy recognizes as having the authority to act on behalf of another individual in making decisions related to health care. A form to designate your personal representative is at the end of this document. Many members ask us to disclose their PHI to third parties for reasons not described in this notice. For example, elderly members often ask to make their records available to family members or caregivers. To authorize us to disclose any of your PHI to a person or organization for reasons other than those describe in our notice, you may request in writing and we will be glad to assist you. You may revoke the authorization at any time by sending a letter to our Member Services Department. It is important for you to note that once you give us authorization to release your health information, the PHI that we release is out of our control. Roller Pharmacy is unable to safeguard such PHI from redisclosure by the person(s) that you have authorized us to release it to. Finally, Roller Pharmacy will not use your PHI to offer you services or products unrelated to your health care coverage or your health status without your authorization. YOUR RIGHTS REGARDING YOUR PHI The following are your rights with respect to your PHI RIGHT TO ACCESS AND RECEIVE COPIES OF YOUR PHI You have the right to receive a copy of your PHI. We may ask you to request access to copies of your records in writing and to provide us with specific information we need to fulfill your request. We reserve the right to charge a reasonable fee for the cost of producing and mailing the copies of such information. There are certain cases in which we are not permitted to fulfill your request to access or receive your PHI. You may not inspect or copy: * Information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding: * Psychotherapy notes that may be submitted to Roller Pharmacy incidental to a member complaint or appeal. (Roller Pharmacy never requests these confidential notes) * PHI that is subject to the Clinical Laboratory Improvements Amendments of 1988; * Information created or obtained by Roller Pharmacy in the course of research that includes treatment. Access to these records may be temporarily suspended for as long as the research is in progress; * PHI that was obtained from someone other than a health care provider under a promise of confidentiality and the access requested would be reasonably likely to reveal the source of the information. RIGHT TO AMEND YOUR PHI If you believe that your protected health information is incorrect or incomplete, you have the right to ask us to amend it. All requests for amendment must be in writing. In certain cases, we may deny your request. For example, we may deny a request if we did not create the information, as is often the case for medical information that is generated by a provider and stored in our records, or if we believe the current information is correct. All denials will be made in writing. You may respond by filing a written statement of disagreement with Roller Pharmacy and we would have the right to rebut that statement. If you believe someone has received an un-amended PHI from us, you should inform us at the time of the request if you want him or her informed of any amendment we may subsequently agree to execute. RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS Roller Pharmacy recognizes that members have the right to receive communications regarding their PHI in a manner or at a location that the individual feels is safe from an authorized use or disclosure. To support this comment, Roller Pharmacy will permit individuals to request that they receive PHI by alternative means or at alternative locations. We will attempt to accommodate reasonable requests. All requests must be made in writing. RIGHT TO AN ACCOUNTING OF DISCLOSURES OF PHI You have the right to request an accounting of those instances in which we have disclosed your PHI for any purpose other than the following: * For treatment, payment or health care operations * To others involved in your care * Disclosures that you or your designated personal representative have authorized * Certain other disclosures, such as disclosures for national security purposes * Information disclosed to correctional institutions, law enforcement agencies, and health oversight agencies. * Information that was disclosed or used as part of a limited data set for research, public health or health care operations purposes, and * Disclosures made prior to April 14, 2003. All requests must be made in writing. Roller Pharmacy will required you to provide us with the specific information we need to fulfill your request. If you request this accounting more than once in a twelve month period, we may charge you a reasonable fee. RIGHT TO REQUEST LIMITS ON USES AND DISCLOSURES OF YOUR PHI You have the right to ask us to place restrictions on the way we use or disclose your PHI for treatment, payment or health care operations or as described in the section of this notice titled ?Other Permitted or Required Uses and Disclosures of PHI.? We are not, however, required by law to agree to these restrictions. If we do agree to a restriction, we may not use or disclose your PHI in violation of that restriction, unless it is related to an emergency. We may ask that you request these limits in writing. RIGHT TO RECEIVE Roller Pharmacy NOTICE OF PRIVACY PRACTICES You have the right to receive a paper copy of the Notice of Privacy Practices upon request at any time and you may also view a pdf version of the Notice. RIGHTS UNDER STATE LAW You may be entitled to additional rights under state law, e.g. Tennessee provides for enhanced protection of genetic testing and HIV testing. While Roller Pharmacy pays careful attention to protecting this information for all of our members, there are state laws that are more stringent than Provisions of HIPAA?s Privacy Rule. HOW TO OBTAIN INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT PRIVACY PRACTICES To request a copy of this Notice of Privacy Practices at any time, or obtain additional information about this notice, you may contact: Roller Pharmacy 109 N Main Ave. Erwin, TN 37650 423-743-7105 If you believe your privacy rights have been violated, you may file a written complaint with: President Roller Pharmacy: Roller Pharmacy, 109 N Main Ave., Erwin, TN 37650 or by contacting this office at 423- 743-7105. CHANGES TO THIS NOTICE We may make a change to this notice and our privacy practices at any time, as long as the change is consistent with our current privacy policies or state or federal law. If we make an important change to our policies, we will promptly provide you with the new notice by mail and post it on our website. EFFECTIVE DATE OF THIS NOTICE The original effective date is April 14, 2003 and the first revision became effective on September 1, 2004.
       
    • Diabetes Shoppe

      Good Neighbor Pharmacy can help you understand and manage your diabetes with monitoring, medications and recommendations that can help you independently maintain a healthy living.

      Learn More
    • Prescription Savings Club

      Enjoy great cost-savings on your medications, along with the personalized care and service that only your locally owned Good Neighbor Pharmacy can deliver.

      Learn More
    •  
       

    HIPAA Notice of Privacy Practice

    JOSEPH PHARMACY 216 WEST 72ND STREET NEW YORK, NY 10023 TEL (212) 875-1718 FAX (212) 875-0921 E-Mail: JOSEPHPHARMACY@YAHOO.COM OR WWW.JOSEPHPHARMACY.COM 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. JOSEPH PHARMACY is required by law to maintain the privacy of Protected Health Information ('PHI') and to provide individuals with notice of our legal duties and privacy practices with respect to PHI. PHI is information that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. This Notice of Privacy Practices ('Notice') describes how we may use and disclose PHI to carry out treatment, payment or health care operations and for other specified purposes that are permitted or required by law. The Notice also describes your rights and with respect to PHI about you. JOSEPH PHARMACY is required to follow the terms of this Notice. We will not use or disclose PHI about you without your written authorization, expect as described in this Notice. We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain. Upon request, we will provide any revised Notice to you. Your Health Information Rights 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 the Privacy Officer at (212) 875-1718 or e-mail request to JOSEPHPHARMACY@YAHOO.COM. *Request a restriction on certain uses and disclosures of PHI. You have the right to request additional restrictions on our use and disclosure of PHI about you by sending a written request to the Privacy Officer or e-mailing the request to JOSEPHPHARMACY@YAHOO.COM. We are not required to agree to those restrictions. *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 JOSEPH PHARMACY maintains the PHI. The 'designated record set' usually will include prescription and billing records. To inspect or copy PHI about you, you must send a written request to the Privacy Officer or e-mail it to JOSEPHPHARMACY@YAHOO.COM. We may charge you a fee for the cost 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. To request an amendment, you must send a written request to the Privacy Officer or e-mail it to: JOSEPHPHARMACY@YAHOO.COM. In addition, you must include a reason that supports your request. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with the decision, and we give you a rebuttal to your statement. *Receive an accounting of disclosure of PHI. You have the right to receive an accounting of the disclosures we have made of PHI about you after April 14, 2003 for most purposes other than treatment, payment, or health care operations. The accounting will exclude disclosures we have made directly to you, 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. To request an accounting, you must submit a request in to the Privacy Officer or e-mail it to JOSEPHPHARMACY@YAHOO.COM. 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 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 may request we contact you about medical matters only in writing or at a different residence or post office box. To request confidential communication of PHI about you, you must submit a request in writing to the Privacy Officer or e-mail it to JOSEPHPHARMACY@YAHOO.COM. Your request must state how or where you would like to be contacted. We will accommodate all reasonable requests. *Revoke your consent to use or disclose PHI. You may revoke consent 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 that we have already taken action in reliance on the consent. We may refuse to continue to treat a customer that revokes his or her consent. Example of How We May Use and Disclose PHI The following categories describe and provide examples of different ways we use and disclose PHI about you. We will use PHI for treatment. Example: Information obtained by the pharmacist will be used to dispense prescription medications to you. We will document in your record information related to the medications dispensed to you and services 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 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 health care operations. Example: JOSEPH PHARMACY may use information in your health record to monitor the performance of the pharmacists providing treatment to you. This information will be used in an effort to continually improve the quality and effectiveness of the health 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. Examples include the analysis of prescription costs and their trends for groups and sub- groups of patient populations. When these services are contracted for, we may disclose PHI about you to our business associates 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 care 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 can identify, PHI relevant to that person's involvement in your care or payment related to your care. Personal communications: 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 recalls, repairs, or replacements. 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 law or in response to a valid subpoena or other legal process. Health Oversight activities: We must 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 health care system, government programs, and compliance with civil rights laws. Judicial and administrative proceedings: If you are involved in a lawsuit or 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 only 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 and disclose PHI about you for the following purposes: Research: We may disclose PHI about you to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your information has approved their research. 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 health and safety of others. To avert a serious threat to health and safety: We may use and disclose PHI about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Military or veterans: If you are a member of the armed forces, we may release PHI about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law. 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 violent: We may disclose PHI about you to a government authority, such as a social service, or protective service agency. If we reasonably 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 of 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. Other Uses and Disclosures of PHI JOSEPH PHARMACY will obtain your written authorization before using or disclosing the PHI about you for purposes other than those provided 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. For More Information or to Report a Problem If you have questions or would like additional information about Joseph Pharmacy's privacy practices, you may contact our privacy officer. If you believe your privacy right have been violated, you can file a complaint with our HIPAA privacy officer or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint. Effective Date

    Store Location & Directions

    109 North Main Avenue
    Erwin, TN, 37650
    (423) 743-7105

    Get Directions

    Pharmacy Hours

    Mon - Fri: 8:30am - 5:00pm;Sat: 8:30am - 1:00pm;Sun: Closed;

    Store Hours

    Mon - Fri: 8:30am - 5:00pm;Sat: 8:30am - 1:00pm;Sun: Closed;
     
     
     
    • HIPAA
      Notice of Privacy
    • About HIPAA’s Notice of Privacy and how it protects you.

      Learn More
     
     
     
    • Care and Convenience,
      Wherever You Go.

      • Product information, a medication guide    and up-to-the minute health news
      • Store locator
      • Prescription refills
      Learn More

     
    • Vitamin BottleGet FREE
      Vitamins
      for the
      children in
      your family.
    • The Healthy Kids Free Vitamin Program offers each child in your family a FREE 30-day supply of Children’s Multi-Vitamins each month.
      Learn More

     
     
         
    Close
    MEDILANE DRUG CORP 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. LEGAL DUTY We are required by federal and state law to maintain the privacy of your health information. We are also required to give you this notice about our privacy practices, our legal duties and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This notice takes effect April 14, 2003 and will remain in effect until we replace it. You may request a copy of our Privacy Practice Notice at any time. For more information or additional copies of this Notice, please contact us at the telephone number listed in the Company Information section at the top of this Notice. If and when permitted by applicable law, we have the right to change our privacy practices; if we do so, we will notify you in writing of these changes. USE AND DISCLOSURES OF HEALTH INFORMATION We are permitted by law, to use and disclose health information about you for reasons concerning treatment, payment, and healthcare operations. Examples: Treatment: We may disclose your health information to a physician or healthcare provider that is providing treatment or other healthcare services to you. Payment: We may use and disclose your health information to obtain payment for services that we provide to you. Operations: We may use and disclose your health information in connection with our healthcare operations, which include administration and planning and other tasks that help us improve that quality. Family and Friends: We may disclose your health information to a family member, relative or a friend that has been identified by you while you are present. If you are not present, professional judgment will be utilized to determine whether a disclosure is required or in your best interest. We will only disclose information that is believed to be relevant to the person's involvement with your healthcare of payment related to your health care. We may also disclose your health information in order to notify such persons of your location, general condition or death. As required by law: We must disclose your health information when required to do so by law. Victims of Abuse or Neglect: We may disclose your health information to authorities if reasonable belief is that you are a possible victim of abuse, neglect or domestic violence. We may disclose information to the extent necessary to avert additional serious threat to your health or safety or the health or safety of others. Public Health Activities: We may disclose your health information to public health authorities for the purpose of preventing or controlling disease or preventing injury; to report information to a health oversight agency that is responsible for ensuring compliance with governmental rules and regulations, such as Medicare and Medicaid. National Security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counter intelligence, and other national security activities. Appointment Reminders: We may contact you to provide you with appointment reminders, such as voice messages; including essential information such as time, location, and the name of the company/provider. Workers' Compensation: We may use or disclose your health information to the extent necessary to comply with state laws relating to workers' compensation. Disclosures Requiring your Authorization: For any reasons other than those listed in this notice, we may only use or disclose your health information with your written authorization. You authorization must also be obtained prior to using your health information for any marketing activity. YOUR RIGHTS TO YOUR PERSONAL HEALTH INFORMATION Access to Record: You may have access to your health information, with limited exceptions. Request must be made in writing, utilizing our Records Access Request Form. We may charge a reasonable fee to compensate for time and materials. Revocation of your Authorization: You make revoke your authorization to disclose your health information at any time. Request must be made in writing, using our Authorization Revocation form. Restriction of Information: You may request that we place restrictions on our use or disclosure of your health information. You must make you request in writing by sending us a letter that specifies the type of information to be restricted and to whom the information is to be restricted from. Requests should be sent directly to the address listed in the heading of this Notice. We will consider all requests: however are not required to agree to the request. We will respond to all such requests in writing. Disclosure Accounting: You may request a list of instances in which we (or our business associates) disclosed your health information for purposes, other than treatment, payment, healthcare operations and certain other activities, for the last 6 years, but not before April 14, 2003. You must make your request in writing by sending us a letter that specifies the type of information and the time period involved. Requests should be sent directly to the address listed in the heading of this Notice. If you request this information more than once in a 12-month period, we may charge you a reasonable fee to compensate for our time and materials. Alternative Communication: You may request that we communicate with you about your health information by alternative means or to an alternative location. You must make your request in writing by sending a letter that specifies the alternative means of location and provide satisfactory explanation how payments will be handled under the alternative means or location you have requested. Requests should be sent directly to the address listed in the header of this Notice. Amendment: You have the right to request that we amend your health information. You must make your request in writing by sending a letter that explains why the information should be amended. Requests should be sent directly to the address listed in the header of this Notice. We will comply to your request unless we believe that the information to be amended is accurate and complete. Right to Receive Paper Copy of this Notice: Upon request, you may obtain a paper copy of this notice. QUESTIONS OR COMPLAINTS If you are concerned that we may have violated your privacy rights, or if you disagree with a decision we have made about a request for access to your health information, a request you have made to amend or restrict the use or disclosure of your health information or a request you have made for us to communication with your by alternative means or locations, you may complain to us using the contact information listed in the header of this Notice. You may also submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to the U.S. Department of Health and Human Services upon request. If you have any questions, concerns, or complaints about this Notice, please contact us.