Privacy Policy

The Diabetes Store, Incorporated
1760 Moriah Woods Blvd. Ste. 2
Memphis, TN 38117
Phone: 800-501-1556  Fax: 800-208-0863

The Diabetes Store, Inc.

HIPAA NOTICE OF PRIVACY PRACTICES
EFFECTIVE JANUARY 20, 2017

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.

As part of the federal Health Insurance Portability and Accountability Act of 1996, known as HIPAA, The Diabetes Store has created this Notice of Privacy Practices (Notice). This Notice describes The Diabetes Store’s privacy practices and the rights you, the individual, have as they relate to the privacy of your Protected Health Information (PHI). Your PHI is information about you, or that could be used to identify you, as it relates to your past and present physical and mental health care services. The HIPAA regulations require that The Diabetes Store protect the privacy of your PHI that The Diabetes Store has received or created, provide you with notice of The Diabetes Store’s legal duties and privacy practices with respect to PHI, and notify you if you are affected by a breach of unsecured PHI.

The Diabetes Store is required to abide by the terms of the Notice currently in effect. For any uses or disclosures that are not listed below, The Diabetes Store will obtain a written authorization from you for that use or disclosure, which you will have the right to revoke at any time, as explained in more detail below. The Diabetes Store reserves the right to change The Diabetes Store’s privacy practices and this Notice. Revisions to the Notice will be posted at The Diabetes Store and upon your request, provided to you in a paper format.

HOW THE DIABETES STORE MAY USE AND DISCLOSE YOUR PHI

The following is an accounting of the ways that The Diabetes Store is permitted, by law, to use and disclose your PHI.

Uses and disclosures of PHI for Treatment: We will use the PHI that we receive from you to provide health care services ordered by your physician and coordinate or manage your health care.

Uses and disclosures of PHI for Payment: The Diabetes Store will disclose your PHI to obtain payment or reimbursement from insurers for your health care services.

Uses and disclosures of PHI for Health Care Operations: The Diabetes Store will use your PHI to conduct quality assessments, improvement activities, and evaluate The Diabetes Store workforce.

The following is an accounting of additional ways in which The Diabetes Store is permitted or required to use or disclose PHI about you without your written authorization.

Uses and disclosures as required by law: The Diabetes Store is required to use or disclose PHI about you as required and as limited by law.

Uses and disclosure for Public Health Activities: The Diabetes Store may use or disclose PHI about you to a public health authority that is authorized by law to collect for the purpose of preventing or controlling disease, injury, or disability.

Uses and disclosure about victims of abuse, neglect or domestic violence: The Diabetes Store may use or disclose PHI about you to a government authority if it is reasonably believed you are a victim of abuse, neglect or domestic violence.

Uses and disclosures for health oversight activities: The Diabetes Store may use or disclose PHI about you to a health oversight agency for oversight activities that it is authorized by law to conduct.

Disclosures for judicial and administrative proceedings: The Diabetes Store may disclose PHI about you in the course of any judicial or administrative proceedings, provided that proper documentation is presented to The Diabetes Store.

Disclosures for law enforcement purposes: The Diabetes Store may disclose PHI about you to law enforcement officials for authorized purposes.

Uses and disclosures about the deceased: The Diabetes Store may disclose PHI about the deceased, or prior to, and in reasonable anticipation of an individual’s death, to coroners, medical examiners, and funeral directors.

Uses and disclosures for cadaveric organ, eye or tissue donation purposes: The Diabetes Store may use and disclose PHI for the purpose of procurement, banking, or transplantation of cadaveric organs, eyes, or tissues for donation purposes.

Uses and disclosures for research purposes: The Diabetes Store may use and disclose PHI about you for research purposes with a valid waiver of authorization from the research board. Otherwise, The Diabetes Store will request a signed authorization by the individual for all other research purposes.

Uses and disclosures for special governmental functions: The Diabetes Store may use and disclose PHI for special governmental functions, such as military, national security, and presidential protective services.

Uses and disclosures to avert a serious threat to health or safety: The Diabetes Store may use or disclose PHI about you, if it believed in good faith, and is consistent with any applicable law and standards of ethical conduct, to avert a serious threat to health or safety.

Disclosure for workers’ compensation: The Diabetes Store may disclose PHI about you as authorized by and to the extent necessary to comply with workers’ compensation laws or programs established by law.

Disclosures for disaster relief purposes: The Diabetes Store may disclose PHI about you as authorized by law to a public or private entity to assist in disaster relief efforts.

Disclosures to business associates: The Diabetes Store may disclose PHI about you to The Diabetes Store’s business associates for services that they may provide to or for The Diabetes Store.

Disclosures to individuals involved in your care: Unless you object, The Diabetes Store may disclose to your relative or close personal friend the PHI directly relevant to such person’s involvement with your care or payment for your care. The Diabetes Store may use professional judgment in allowing a person to act on your behalf to pick up filled prescriptions, medical equipment or supplies, or other similar forms of PHI.

OTHER USES AND DISCLOSURES

The Diabetes Store may contact you for the following purposes:

Refill reminders: The Diabetes Store may contact you to remind you of items or supplies on such time they are ready to be refilled.

 

Information about treatment alternatives: The Diabetes Store may contact you to notify you of alternative treatments and/or products.

FOR ALL OTHER USES AND DISCLOSURES

The Diabetes Store will obtain a written authorization from you for any use or disclosure of PHI for marketing purposes, any sale of PHI, and any other use or disclosure not described in this Notice, and The Diabetes Store will only use or disclose PHI for those purposes pursuant to such an authorization. You may revoke such an authorization in writing at any time. To revoke an authorization, please contact The Diabetes Store at the address at the end of this Notice.

YOUR HEALTH INFORMATION RIGHTS

The following are a list of your rights in respect to your PHI.

Request restrictions on certain uses and disclosures of your PHI: You have the right to request additional restrictions of The Diabetes Store’s uses and disclosures of your PHI. The Diabetes Store is required to agree to a request to restrict disclosure of PHI to a health plan if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law, and if the PHI pertains solely to a health care item or service for which you have paid The Diabetes Store in full. Otherwise, The Diabetes Store is not required to accommodate a request. If you wish to request additional restrictions, please obtain the form, Request for Restriction of Uses & Disclosures, from The Diabetes Store and return the completed form to The Diabetes Store.

The right to have your PHI communicated to you by alternate means or locations: You have the right to request that The Diabetes Store communicate confidentially with you using an address or phone number other than your residence. However, state and federal laws require The Diabetes Store to have an accurate address and home phone number in case of emergencies. The Diabetes Store will consider all reasonable requests. If you wish to request a change in your communicating address and/or phone number, please obtain a form, Request for Alternative Arrangements for Confidential Communication, from The Diabetes Store and return the completed form to The Diabetes Store.

The right to inspect and/or obtain a copy your PHI: You have the right to request access and/or obtain a copy of your PHI that is contained in The Diabetes Store for the duration The Diabetes Store maintains PHI about you. If you wish to inspect or obtain a copy of your PHI, please obtain a form, Request for Access to Records, from The Diabetes Store and return the completed form to The Diabetes Store. There may be a reasonable cost-based charge for furnishing documents. You will be notified in advance of incurring such charges, if any.

The right to amend your PHI: You have the right to request an amendment of the PHI The Diabetes Store maintains about you, if you feel that the PHI The Diabetes Store has maintained about you is incorrect or otherwise incomplete. Under certain circumstances we may deny your request for amendment. If we do deny the request, you will have the right to have the denial reviewed by someone we designate who was not involved in the initial review. You may also ask the Secretary, United States Department of Health and Human Services, or their appropriate designee, to review such a denial. If you wish to amend your PHI files, please obtain a form, Request for Amendment to PHI, from The Diabetes Store and return the completed form to The Diabetes Store.

The right to receive an accounting of disclosures of your PHI: You have the right to receive an accounting of certain disclosures of your PHI made by The Diabetes Store. If you wish to receive an accounting of disclosures of your PHI, please obtain a form, Request for Accounting of Disclosures, from The Diabetes Store and return the completed form to The Diabetes Store. You should be aware, however, that such an accounting excludes uses and disclosures made for treatment, payment, or health care operations purposes.

Health related benefits or services: The Diabetes Store may use your PHI to notify you of benefits and services The Diabetes Store provides.

The right to receive additional copies of The Diabetes Store’s Notice of Privacy Practices: You have the right to receive additional paper copies of this Notice, upon request, even if you initially agreed to receive the Notice electronically. If you wish to receive a paper copy of this request, please ask an employee of The Diabetes Store and they will provide you with a copy.

REVISIONS TO THE NOTICE OF PRIVACY PRACTICES

The Diabetes Store reserves the right to change and/or revise this Notice and make the new revised version applicable to all PHI received prior to its effective date. The revised Notice will be available, upon request, to all individuals. The Diabetes Store will also post the revised version of the Notice at The Diabetes Store.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with The Diabetes Store and/or to the Secretary of HHS, or their designee. If you wish to file a complaint with The Diabetes Store, please contact _______________ at the address at the end of this Notice. If you wish to file a complaint with the Secretary, please write to:

U.S. Department of Health and Human Services
Office for Civil Rights
Centralized Case Management Operations
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F HHH Bldg.
Washington, D.C. 20201
Phone (800) 368-1019
TDD (800) 537-7697

The Diabetes Store will not take any adverse action against you as a result of your filing of a complaint.

CONTACT INFORMATION

If you have any questions on The Diabetes Store’s privacy practices or for clarification on anything contained within the Notice, please contact:

The Diabetes Store, Inc.

Attn: ____________________
1760 Moriah Woods Blvd., Suite 2
Memphis, TN 38117
(901) 312-3150