Patient Packet | Epiq Scripts

Epiq Scripts Pharmacy Information

Patient Packet Privacy practices, patient rights, and state-specific information.

Epiq Scripts thanks you for choosing our pharmacy to facilitate your prescription. We take great pride in serving you and make it our goal to offer the best customer service in the industry.

Introduction

Thank you for choosing Epiq Scripts.

Epiq Scripts reserves the right to modify this Pharmacy Information Packet at any time. Epiq Scripts thanks you for choosing our pharmacy to facilitate your prescription. We take great pride in serving you and make it our goal to offer the best customer service in the industry. We encourage you to provide feedback relating to your pharmacy experience so that we may continue improving our processes.

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Notice of Privacy Practices

This notice describes how medical information about you may be used, disclosed, and how you may attain access to this information. PLEASE READ CAREFULLY.

Our Responsibilities

We maintain the privacy and security of your Protected Health Information.

Federal and state laws require that we maintain the privacy and security of your Protected Health Information (PHI) and provide you with notice of our legal duties and privacy practices concerning PHI, including but not limited to breaches. References to “pharmacy”, “we”, “us”, and “our” include the pharmacy in addition to the members of its affiliated covered entity. An affiliated covered entity is a group of organizations under common ownership or control that designate themselves as a single affiliated covered entity for purposes of compliance with the Health Insurance Portability & Accountability Act (HIPAA). The pharmacy, its employees, workforce members, and members of pharmacy-affiliated covered entities who are involved in providing and coordinating health care are all bound to follow the terms of this Notice of Privacy Practices (“Notice”).

The members of the affiliated covered entity may share PHI for treatment, payment, and health care operations of the affiliated covered entity and as permitted by HIPAA & this Notice. For complete listings of the members of Pharmacy’s affiliated covered entity, please contact the Privacy Office. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this notice and give you a copy of it. We will not use or share your information other than as described above unless you provide authorization in writing. If you provide us authorization, you may change your mind at any time by stating so in writing. Additional information can be found at www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

Our Uses & Disclosures

How PHI may be used, shared, and accessed.

PHI is information that identifies you and relates to your past, present, or future physical/mental health and/or condition, along with the provision of your healthcare products, services, and payment for such services.

This Notice describes your rights concerning your PHI.

This Notice describes how we may use and disclose PHI about you, as well as how you obtain access to such PHI. This Notice also describes your rights concerning your PHI.

We are required by HIPAA to provide this notice to you. Epiq Scripts is required to follow the terms of this Notice or any change to it that is in effect. We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain. If we do so, the updated Notice will be posted on our website and will be available at our facility and locations where you receive healthcare products and services from us. Upon request, we will provide any revised Notice to you.

Ways we may use or share your health information

Treating you

We may use your health information and/or share it with other professionals who are treating you. Example: We consult your physician, nurse, or specialist regarding your medications, treatment, and/or condition.

Running our organization

We may use and/or share your health information to run our pharmacy, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services.

Billing for your services

We may use and/or share your health information to bill and obtain payment from health plans or other entities. Example: We give information about you to your health insurance plan for payment of services.

Additional Ways We Use Or Share Your Health Information

We are allowed or required by law to share information in additional ways.

We are allowed/required by law to share your information in additional ways. Use or disclosure (additional to listed as permitted here, or required by law), requires your written authorization in advance. You retain the right to restrict disclosures of protected health information (PHI) to a health plan where out of pocket in full for the health care item or service. However, we are required to meet numerous conditions outlined by law before sharing your information for these purposes. Additional information can be found at www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

Help with public health, safety issues, and research: We may use or share your information for health research and/or for certain situations such as preventing disease, reporting adverse reactions to medications, preventing or reducing a serious threat to anyone’s health or safety, and helping with product recalls. Reporting suspected abuse, neglect, or domestic violence: We will comply with the law and will share information about you if state and/or federal laws require it; including the Department of Health & Human Services if they elect to verify that we’re compliant with federal privacy laws. We may share health information about you in response to a court or administrative order, and/or in response to a subpoena and for certain situations such as:

  • Worker’s compensation claims
  • Law enforcement/law enforcement officials
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Important Information Regarding Your Rights

When it comes to your health information, you have certain rights.

This section explains your rights and some of our responsibilities to help you.

Request an electronic or paper copy of your medical record: You may ask to see and/or receive an electronic and/or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary of your health information (typically within 30 days of your request). We may charge a reasonable, cost-based fee to deliver this to you.
Ask us to correct your medical record: You may ask us to correct health information about you that you think is incorrect or incomplete. We may deny your request, but we’ll provide you with an explanation in writing (typically within 60 days of your request).
Request confidential communications: You may ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will honor all reasonable requests.
Ask us what we use or share: You can ask us not to use or share certain health information for treatment, payment, and/or our operations. We are not required to agree to your request and we may say “no” if it would negatively affect your care.
If you pay for a service or health care item out-of-pocket in full: You can ask us to not share that information for payment and/or our operations with your health insurer. We will say “yes” unless we are required by law to share that information.
Get a list of those with whom we’ve shared information: You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask (who we shared it with and why). We will include all the disclosures except for those about treatment, payment, and healthcare operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for additional information within 12 months.
Choose someone to act for you: You have the right to designate another person as a medical power of attorney and/or your legal guardian. That person can exercise your rights and make choices about your health information, including allowing this individual to accept prescriptions on your behalf. We will ensure the person has this authority and can act for you before we take any action.

State Information

State-specific pharmacy information.

If you are a patient in one of the following states, please read for state-specific information.

Georgia

Georgia Board of Pharmacy

2 Peachtree Street, NW

6th Floor

Atlanta, GA 30303

Phone: (404) 651-8000

Fax: (470) 386-6137

Illinois

Illinois law requires the pharmacist to talk to you about any new or changed prescriptions. Education ensures safe and effective use of your medications, reducing the chances of a serious infection. If you receive prescriptions by mail, you may contact the pharmacist at the number provided on your order. If the pharmacist fails to discuss any new or changed prescriptions with you, please contact the state regulatory authority.

Department of Financial and Professional Regulation

Division of Professional Regulation

Complaint Intake Unit

100 West Randolph Street, Suite 9-300

Chicago, IL 60601

Phone (312) 813-6910

www.idfpr.com

Maine

Complaints against our pharmacy may be filed with the complaint coordinator.

Office of licensing and Regulation

35 State House Station Augusta, ME 04333

Phone (207) 642-8696

Oregon

A prescription reader is available upon request for anyone with visual impairment. For more information, please contact (855) 748-2663.

Texas

Complaints concerning the practice of pharmacy may be filed by mail with the Texas State Board of Pharmacy (TSBP):

1801 Congress Avenue, Suite 13.100

Austin, Texas 78701

Toll-free: (800) 821-3205 (select option 1)

www.pharmacy.texas.gov/complaint

Written information about this prescription has been provided for you. Please read this information before you take the medication. If you have questions concerning this prescription, a pharmacist is available during normal business hours to answer these questions at (833) 654-3553.

AVISO A CONSUMIDORES

Las quejas relacionadas a la practica de la farmacia pueden presentarse ante el Texas State Board of Pharmacy (TSBP):

1801 Congress Avenue, Suite 13.100

Austin, Texas 78701

Gratuito: (800) 821-3205 (Seleccione opcion 1)

www.pharmacy.texas.gov/complaint

Se le ha proporcionado informacion escrita sobre esta receta. Lea esta informacion antes de tomar el medicamento. Si tiene preguntas sobre esta receta, un farmaceutico esta disponible durante el horario commercial normal pararesponder estas preguntas al (833) 654-3553.

Wisconsin

Wisconsin law requires a pharmacist to consult with you about any new or changed prescriptions. You may contact the pharmacy about any prescription. Contact the pharmacy about any delivery concerns including the timeliness of delivery. Condition of the prescription drug upon delivery. Failure to receive the proper prescription drug product or device. Any prescription that is damaged or lost due to delivery must be replaced by the pharmacy at no additional cost to the patient. If the timeliness of the replacement leads to an interruption in therapy, the dispensing pharmacy must take steps to reduce patient harm. If a pharmacist fails to consult or resolve your delivery concern, you may contact:

Wisconsin Dept. of Safety and Professional Services

Division of Legal Services and Compliance

P.O. Box 7190, Madison, WI 530707-71900

Phone (608) 266-2112

[email protected] or https://dsps.wi.gov (click on File A Complaint)