HIPAA Privacy Policy
Kay Pharmacy takes your privacy seriously. Below is our HIPAA Privacy Policy.

Payment examples: For reimbursement purposes, your PHI may be disclosed to one or several intermediaries employed by your plan sponsor including (but not limited to) insurer, pharmacy benefit mangers, claims administrators and computer switching companies. For example, we use your PHI in order to process your claims.

Health Care Operations examples: We may disclose your PHI as a part of certain operations, such as quality improvement. For example, we may use your PHI to evaluate the quality of pharmacy services that were performed.

We may disclose to you, to one of your family members, to a relative, to a close personal friend, or to a person not included in the aforementioned group, but identified by you, PHI that is directly relevant to your care or PHI that is directly relevant to payment for your care. For example, this PHI may be released on prescriptions, dispensing history reports, year end tax statements, or answers to questions regarding your treatment or payment for your treatment.

We may send you a postcard thanking you for becoming our customer.

We may use or disclose your PHI without your authorization for several other reasons. Subject to certain requirements, we may give out PHI without your authorization for public health purposes, auditing purposes, research studies, and emergencies. We provide PHI when otherwise required by law, such as for law enforcement in specific circumstances, workers compensation laws, or for judicial or administrative proceedings. In any other situation, we will ask for your written authorization before using or disclosing your PHI. If you choose to sign an authorization to allow disclosure of your PHI, you can later revoke that authorization to stop any future uses and disclosures (other than for treatment, payment and health care operations).

We may change the terms of this Notice at any time and make a new Notice effective for all PHI we maintain. Revised Notices will be posted in the pharmacy, on our website (www.kaypharmcy.com) and upon request.

Individual Rights In most cases, you have the right to view or get a copy of your PHI. You also have the right to receive a list of instances where we have disclosed your PHI without your written authorization for reasons other than treatment, payment or health care operations. If you believe that information in your record is incorrect or if important information is missing, you have the right to request that we correct the existing information or add the missing information.

You may request in writing that we not use or disclose your PHI for treatment, payment and health care operations except when specifically authorized by you, when required by law, or in emergency circumstances. We will consider your request but are not legally required to accept it. You also have the right to receive confidential communications of PHI by alternative means or at alternative locations, if you clearly state that disclosure of all or part of your PHI could endanger you.

Complaints If you are concerned that we have violated your privacy rights, or you disagree with a decision we have made about access to your records, you may contact the address listed below. You may also send a written complaint to the U.S. Department of Health and Human Services. Our pharmacy staff can provide you with the appropriate address upon request.

Our Legal Duty We are required by law to protect the privacy of your information, provide this notice about our information practices, and follow the information practices that are described in this notice.

If you wish to inspect your records, receive a listing of disclosures, or correct or add to the information in your record, or if you have any questions, complaints or concerns, please contact:

Mike Koelzer
Privacy Officer
Kay Pharmacy & Home Medical Equipment
2178 Plainfield NE
Grand Rapids MI 49505