SUNRx – HIPAA Privacy Policy
Please Review This Policy Carefully
SUNRx, Inc. is committed to shielding your Protected Health Information (“PHI”). SUNRx, Inc.'s use and disclosure of your personal health information are also very important to providing you with quality Prescription benefits in accordance with certain laws.
This notice applies to SUNRx, Inc.'s use and disclosure of individually identifiable PHI received or created by SUNRx, Inc. as a Prescription Benefit Administrator under the Standards for Privacy of Protected Health Information disseminated under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), subject to applicable state laws.
Under HIPAA, we are legally required to protect your PHI pursuant to HIPAA regulations and are committed to:
A. Maintaining the privacy of your PHI;
B. Providing you with this Notice; and
C. Complying with this Notice at All Times.
SUNRx, Inc. reserves the right to change its privacy practices and to make any such change applicable to your PHI obtained before the change. In the event of a future change to our Privacy Policy and This Notice, we will revise this Notice to reflect the change, if material. You may obtain a copy of any revised Notice by contacting SUNRx, Inc.'s Customer Service Department at 6 Executive Campus, Cherry Hill , NJ 08002 or on-line at www.SUNRx.com.
The law permits us to use and disclose your PHI for purposes of providing treatment, obtaining payment and for certain operations related to healthcare. Below please find some examples of each of these permitted uses and disclosures.
Permitted Uses and Disclosures for purposes of treatment, payment and healthcare operations .
We may use and disclose your PHI to provide treatment to you or for the treatment activities of another healthcare provider. Some examples include:
We may disclose your PHI to physicians, pharmacists, nurses, and other healthcare providers and suppliers who are involved in your care for purposes of your treatment.
We may also use and disclose your PHI to tell you and your physician or other healthcare provider about or recommend treatment options or alternatives, or to tell you and your physician or other healthcare provider about health-related benefits, products or services under your benefit plan. In addition, depending on your condition, we may use and disclose your PHI for purposes of contacting you regarding your prescription refills, compliance with dosage requirements, proper drug administration, drug precautions and side effects, and product storage.
For those participating in our disease management programs, your PHI may be used and disclosed by SUNRx, Inc.'s pharmacists, nurses and case managers to provide you with health education, reminders about upcoming appointments, to monitor your compliance with therapies and to assist in the coordination of your care with physicians and other healthcare providers and suppliers.
We may use and disclose your PHI for our various therapeutic intervention programs. We may review your PHI to help us identify potential issues related to your treatment, such as proper dosage or potential drug interactions. We may use and disclose your PHI for purposes of contacting your retail pharmacist and your physician or other healthcare provider prior to dispensing a prescribed drug in the event we have identified a potentially inappropriate therapy, such as potential drug to drug interactions, or if we have identified issues related to frequency or dosage, as well as other recommendations regarding your drug regimen.
We may also use and disclose your PHI to contact your physician for purposes of recommending alternative medications when appropriate, alerting your physician regarding potential drug interactions, potential dosing issues, potential side effects and issues related to your compliance with therapy.
We may also use and disclose your PHI to advise you or your physician or other healthcare provider that an alternative generic medication is available or that a specific medication is not preferred or approved by your health plan or third party payer.
We may also use or disclose your PHI in order to get paid for treatment provided to you by SUNRx, Inc. or for the payment activities of another entity. For example:
We may use your PHI to create the bills that we submit to the insurance company or health plan sponsor to receive payment for the services we provide to you.
We may use your PHI to determine if you are eligible for insurance coverage or benefits under a health plan or other program.
We may disclose certain portions of your PHI to your insurance or health plan sponsor for payment audit purposes or to our business associates who perform billing, adjudication, claims processing or other related services for us.
We may use your PHI during payment-related data processing.
We may also use or disclose your PHI for our operations related to healthcare. For example:
We may use your PHI to evaluate the quality of care you received from us, or to evaluate the performance of those involved with your care.
We may use and disclose your PHI to provide utilization reports and other data analyses to your plan sponsor for purposes of prescription benefits management.
We may also use and disclose your PHI to perform periodic quality assurance reviews and audits, to develop protocols, and for purposes of case management and care coordination.
PHI may be provided to our internal auditors, attorneys, accountants, and other consultants to make sure we are complying with the laws that affect us.
We may use and disclose your PHI in conducting data analysis for purposes of providing information and data to your plan sponsor, new program development and providing services to improve outcomes and effectively manage prescription drug costs.
In addition, we may also disclose your PHI to another healthcare provider, health insurance plan, or healthcare clearinghouse for purposes of their operations related to healthcare. However, we will only do so if they have or have had a relationship with you and if the PHI they request pertains to that relationship. In addition, we will disclose your PHI to these third parties for limited purposes only, such as conducting quality improvement activities, reviewing the performance of a healthcare provider, or training purposes.
Uses and Disclosures That Require Us to Give You the Opportunity to Object . Unless you object, we may provide relevant portions of your PHI to a family member, friend, or other person you indicate is involved in your healthcare or in helping you get payment for your healthcare. In an emergency or when you are not capable of agreeing or objecting to these disclosures, we will disclose PHI as we determine is in your best interest, but will advise you of such use and disclosure after the emergency, and give you the opportunity to object to future disclosures to family and friends. Unless you object, we may also disclose your PHI to persons performing disaster relief notification activities.
Certain Other Uses and Disclosures Which Do Not Require Your Authorization . The law allows us to use and disclose PHI without your authorization in the following circumstances:
Other uses and disclosures of your PHI that are not covered by this Notice or permitted by the laws that apply to us will be made only with your written authorization. If you give us written authorization for a use or disclosure of your PHI, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your PHI for the purposes specified in the written authorization, except that we are unable to take back any disclosures we have already made with your permission. In addition, we can use or disclose your PHI after you have revoked your authorization for actions we have already taken in reliance upon your authorization. We are also required to retain certain records of the uses and disclosures made when the authorization was in effect.
Your Rights Related to Your Protected Health Information. You have the following rights:
If we deny the requested amendment, we will tell you in writing how to submit a statement of disagreement or complaint, or to request inclusion of your original amendment request in your PHI.
The Right to Receive a List of the Disclosures We Have Made . You have the right to receive a list of instances in which we have disclosed your PHI. The list will not include disclosures we have made for treatment, payment, and healthcare operations purposes described in Section III, those made directly to you or your family or friends, for disaster notification purposes, or those that were made per an authorization from you. Neither will the list include disclosures we have made for national security purposes or to law enforcement personnel, or disclosures made before April 14, 2003 .
Your request for a list of disclosures must be made in writing and be addressed to our Customer Service Department at 6 Executive Campus, Suite 400 Cherry Hill, NJ 08002. We will respond to your request within 60 days (or 90 days if the extra time is needed). The list we provide will include disclosures made within the last three years unless you specify a shorter period. The first list you request within a 12-month period will be free. You will be charged our costs for providing any additional lists within the 12-month period.
T he Right to Receive a Paper Copy of This Notice. Even if you have agreed to receive the Notice by email, you have the right to request a paper copy as well. You may obtain a paper copy of this Notice by contacting our Customer Service Department at 6 Executive Campus, Suite 400 Cherry Hill, NJ 08002.
Complaints . If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Federal Department of Health and Human Services. To file a complaint with us, put your complaint in writing and address it to our Chief Executive Officer at SUNRx, Inc., 6 Executive Campus, Suite 400, Cherry Hill, NJ 08002. We will not retaliate against you for filing a complaint. You may also contact our Chief Executive Officer if you have questions or comments about our privacy practices.
As applicable, please refer to the notice of privacy practices of your benefit plan or other healthcare provider with respect to the uses and disclosures of PHI received or created by SUNRx, Inc. in the course of performing services for or on behalf of such health plan or other healthcare provider.
Effective Date: 4/14/03