As required by the Privacy Regulations Promulgated Pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

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.

This notice of Privacy Practices describes how Mesa Verde Pharmacy may use and disclose your protected health information (PHI) to carry out treatment, payment(s), or health care operations (TPO), and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that, relates to your past, present, or future physical or mental health or condition and related health care services.

Uses and Disclosures of Protected Health Information: Your protected health information may be used and disclosed by Mesa Verde Pharmacy, Mesa Verde Pharmacy office staff and others outside of Mesa Verde Pharmacy who are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the organization, and any other use required by law.

Treatment: Mesa Verde Pharmacy will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, Mesa Verde Pharmacy would disclose your protected health information, as necessary, to a home health agency that provides care to you. Or, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.

Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. For example, obtaining approval for equipment or supplies coverage may require that your relevant protected health information be disclosed to the health plan in order to obtain approval for coverage.

Healthcare Operations: Mesa Verde Pharmacy may use or disclose, as needed, your protected health information in order to support the business activities of the Mesa Verde Pharmacy organization. These activities include, but are not limited to, quality assessment activities, employee review activities, accreditation activities, and conducting or arranging for other business activities. For example, we may disclose your protected health information to accrediting agencies as part of an accreditation survey. We may also call you by name while you are at our facility. We may use or disclose your protected health information, as necessary, to contact you to check status of your equipment.

Mesa Verde Pharmacy may use or disclose your protected health information in the following situations without your authorization: as Required by Law, Public Health issues as required by law, Communicable Diseases, Health Oversight, Abuse or Neglect, Food and Drug Administration requirements, Legal Proceedings, Law Enforcement, Criminal Activity, Inmates, Military Activity, National Security, and Workers’ Compensation. Required Uses and Disclosures: Under the law, Mesa Verde Pharmacy must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine Mesa Verde Pharmacy's compliance with the requirements of Section 164.500.

Other Permitted and Required Uses and Disclosures Will Be Made Only with Your Consent, Authorization or Opportunity to Object, unless required by law. You may revoke this authorization, at any time, in writing, except to extend that your physician or Mesa Verde Pharmacy has taken an action in reliance on the use or disclosure indicated in the authorization.

You have the right to inspect and copy your protected health information. Under federal law, however, you may not inspect or copy the following records; psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information.

You have the right to request a restriction of your protected health information. This means you may ask Mesa Verde Pharmacy not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care, or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. Mesa Verde Pharmacy is not required to agree to a restriction that you may request. If Mesa Verde Pharmacy believes it is in your best to permit use and disclosure of your protected health information, your protected health information will not be restricted. Then you have the right to use another Healthcare Professional.

You have the right to request to receive confidential communications from Mesa Verde Pharmacy by alternative means or at an alternate location. You have the right to obtain a paper copy of this notice from Mesa Verde Pharmacy, upon request, even if you have agreed to accept this notice alternatively, electronically.

You have the right to have Mesa Verde Pharmacy amend your protected health information. If Mesa Verde Pharmacy denies your request for amendment, you have the right to file a statement of disagreement with Mesa Verde Pharmacy and Mesa Verde Pharmacy may prepare a rebuttal to your statement, and will provide you with a copy of any such rebuttal.

Complaints: You may complain to us at 714-884-3574. You may also contact the Department of Health Care Services, CA (DHCS) at 916-552-9500/ specialtyprovider@dhcs.ca.gov or the Secretary of Health and Human Services if you believe your privacy rights have been violated by us Mesa Verde Pharmacy. You may file a complaint by notifying Mesa Verde Pharmacy's privacy contact of your complaint. Mesa Verde Pharmacy will not retaliate against you for filing a complaint.

Customer privacy is always a priority for Mesa Verde Pharmacy. Mesa Verde Pharmacy wants to assure you that your privacy is important and that we Mesa Verde Pharmacy is committed to treating customer information responsibly. If you would like to receive additional information or a copy of our privacy policy, simple send your written request to:

Mesa Verde Pharmacy Headquarters

16782 Von Karman Ave.

Suite #12

Irvine, CA 92606