SIMPLEFILL TAKES PRIVACY SERIOUSLY
Simplefill is dedicated to protecting your medical information. We are required by law to maintain the privacy of protected health information and to provide you with this notice of our legal duties and privacy practices with respect to protected health information. Simplefill is required by law to abide by the terms of this Notice.
HOW YOUR MEDICAL INFORMATION WILL BE USED AND DISCLOSED
Simplefill will use your medical information as part of rendering our prescription assistance services and functioning as a health care advocate. For example, your medical information may be used by the health care professional assisting you, by the business office to process your payment for the services rendered and by administrative personnel reviewing the quality and appropriateness of the service you received.
Simplefill may also use and/or disclose your information in accordance with federal and state laws for the following purposes:
- Simplefill advocates may contact you to provide appointment reminders or information about service alternatives or other health-related benefits and services that may be of interest to you.
- Simplefill may use your personal and/or medical information to make referrals for other related services you may have requested or may have been recommended to you.
- Simplefill may disclose medical information when required by the United States Department of Health and Human Services as part of an investigation or determination of the Company’s compliance with relevant laws.
- Unless you object, Simplefill may disclose your medical information to a Family member, Guardian, Power of Attorney or Health Care Surrogate as related to the services being rendered if deemed necessary to complete process for which services have been requested.
- Simplefill may disclose your medical information in the course of certain judicial or administrative proceedings as required by law.
- Simplefill will not use or disclose your medical information for any other purpose without your written authorization. Once given, you may revoke your authorization in writing at any time.
RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
You have the following rights with respect to your protected health information:
- The right to request restrictions on certain uses and disclosures of your medical information.
- The right to receive communications from Simplefill in a confidential manner.
- The right to inspect and copy your medical information.
- The right to request an amendment of your medical information.
- The right to receive an accounting of the disclosures of your medical information made by Simplefill.
- The right to request a paper copy of this Notice of Privacy Practices for Protected Health Information.
- The right to complain to Simplefill and/or to the United State Department of Health and Human Services if you believe that the Company has violated your privacy rights.
YOUR CHOICE TO OPT-OUT
Even though we take your privacy seriously, we understand that you may still prefer to opt-out from being included in Simplefill services. To opt-out, email us at firstname.lastname@example.org. In the subject bar please put Opt-Out. We always appreciate feedback and any details with reasons on why you are choosing to opt-out is appreciated but not required. This request will go into effect within 48 hours. You will be removed from Simplefill’s program and will not receive further correspondence from us. It’s simple!
Please contact Simplefill’s Privacy Officer at (646) 783-3744
This Privacy Notice was developed and is used by Simplefill as part of its HIPAA compliance efforts.