This notice describes how personal and medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully
When you request services, request information, subscribe to materials, or register for meetings, Select Care Benefits Network, hereinafter referred to as Prescription Lifeline, may ask you to provide personal information to complete these transactions and deliver the services or materials. The types of personal information you provide to us may include contact information such as your name, address, telephone number, Social Security Number, and/or e-mail address, or other unique information such as user IDs and passwords. We may also collect contact preference information and educational and/or employment background data.
In addition to the information you provide, Prescription Lifeline may collect non-personal information during your visit to our website, hereinafter referred to as the Site. Such anonymous information includes, but is not limited to, certain standard data that your browser sends to the Site such as your browser type and language, access times, and the address of the Website from which you arrived at the Prescription Lifeline Site. We may also collect information about your Internet Protocol (IP) address or click stream behavior (i.e., the pages you view, the links you click, and other actions you take in connection with the Site).
Personal demographic and profile data may be used to tailor your experience at the Site, for example, to show you content you might be interested in.
Prescription Lifeline might store some information on your computer hard drive in the form of a "cookie" to assist you with purchasing services from Prescription Lifeline, to speed the log-in process, or to store information, such as personal preferences.
When you pay for services, credit card or banking information may be collected by Prescription Lifeline through its Site, or you may be securely transferred from the Site to an Prescription Lifeline third-party vendor, which may collect credit card information and other personal information for the purpose of processing your payment on behalf of Prescription Lifeline. Credit card information, which is obtained by Prescription Lifeline through its Site, is handled securely, in accordance with applicable laws and regulations, as well as payment card industry standards for such information.
Use of Personal Information
Prescription Lifeline uses your personal information to deliver the service(s) you have requested and may use it for advocacy operations, including quality assurance purposes, to contact you on behalf of the prescription advocacy programs in the event of an emergency, to deliver to you information about Prescription Lifeline, such as promotional material, or to contact you about your account.
You may contact Prescription Lifeline to arrange to inspect or obtain a copy of your personal information, or to request a restriction on the uses and disclosures of your personal information, as well as amend your personal information. Prescription Lifeline will also provide you upon request an accounting of disclosures of your personal information.
When personal information is no longer needed, Prescription Lifeline disposes of the personal data it has collected in such a manner as to protect the security and confidentiality of the material, such as shredding, erasing, or rendering personal information to be unreadable.
Prescription Lifeline does not sell to third parties any personal or financial information gathered on this Site. Prescription Lifeline may share your personal information with licensing agencies including, but not limited to, boards of pharmacy, pharmacy technician organizations if you are a certified pharmacy technician, or regulatory or law enforcement agencies as required by law. Prescription Lifeline may provide its vendors with personal information for purposes of delivering the services you requested. For example, Prescription Lifeline may provide your name and address, to mail information to you. Such third parties agree to protect your personal information in conformance with Prescription Lifeline requirements and applicable state and federal laws.
This Site may contain links to third-party Websites that are not controlled by Prescription Lifeline. These third-party links are made available to you as a convenience and you agree to use these links at your own risk. Please be aware that Prescription Lifeline is not responsible for the content or operations of third-party Websites linked to Prescription Lifeline, nor are we responsible for the privacy policies or practices of third-party Websites linked to the Site or Prescription Lifeline. Our Policy only applies to personal information that we collect from you while you are using the Site.
Prescription Lifeline utilizes industry-standard measures to protect from misuse and alteration the personal information under our control. For example, Prescription Lifeline uses encryption technology to protect personal information collected through the Site. While Prescription Lifeline cannot guarantee that these measures will fully protect the personal information you submit through the Site, we will take all reasonable steps to protect the safety of your personal information.
Our Site and the servers that make this Site available world-wide are located in the United States. The laws of the US govern all matters relating to and all transactions involving this Site. Any information you provide in registering or purchasing goods or services from Prescription Lifeline will be transferred to the US. By visiting the Site and providing information to Prescription Lifeline through your use of the Site, you authorize this transfer, processing, and use of information.
Prescription Lifeline is required by law to maintain the privacy of the health information it maintains about its customers (also known as "Protected Health Information" or "PHI") and to provide its customers with notice of our legal duties and privacy practices with respect to PHI. PHI is 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. This Notice of Privacy Practices ("Notice") describes how we may use and disclose PHI to carry out treatment, obtain payment or perform our health care operations and for other specified purposes that are permitted or required by law. This Notice also describes your rights with respect to PHI about you.
Prescription Lifeline will follow the practices described in this Notice. Except as described in this Notice, we will not use or disclose PHI about you without your written authorization. We reserve the right to change our practices and this Notice. In the event that we revise this Notice, the new Notice provisions will be effective for all PHI we maintain. We will provide you with a revised Notice upon request.
EXAMPLES OF HOW WE MAY USE AND DISCLOSE YOUR PHI
The following categories describe different ways that we may use and disclose your PHI. Examples of such uses or disclosures are provided for each category. These are provided for illustrative purposes only and not every use or disclosure within each category is listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories below.
- We may use and disclose your PHI for treatment. Information obtained from your pharmacy or physician may be used to determine coverage criteria for medications.
- We may use and disclose your PHI for payment. We may contact your insurer or health plan to determine whether it will pay for your prescription and the amount of your co-payment. We will adjudicate the claim with your pharmacy and provide payment on your behalf to your pharmacy. Alternatively, we may disclose your PHI to a third party administrator or other designated recipient retained by your insurer for those similar purposes.
- We may use and disclose your PHI for health care operations. We may use your PHI to review and assess the quality of the services we provide to you. We also may disclose your PHI to our attorneys and auditors for assistance with legal compliance and financial reporting requirements. We also may use or disclose your PHI for limited operations purposes of certain other health care providers, clearinghouses or health plans. The persons or entities to which personnel may disclose your PHI must have or have had a relationship with you, and the PHI disclosed must pertain to that relationship. The operations purposes for which we may disclose your PHI include, but are not limited to, various quality assessment and improvement activities, credentialing and training activities, and health care fraud and abuse detection, or compliance activities.
In addition, we may use or disclose your PHI for the following purposes.
- Business associates. Certain of the services we provide may be delegated to contractors, known as business associates. We may provide your PHI to those of our contractors who require the information to perform certain services on our behalf. For example, we may provide PHI to a claims submission service that ensures that our claims are submitted in the appropriate form to the appropriate payers. To protect you, we require the business associate to appropriately safeguard the PHI.
- Communication with individuals involved in your care or payment for your care. We may disclose to a person involved in your care or payment for your care PHI relevant to that person's involvement in your care or payment.
- Food and Drug Administration (FDA). We may disclose to the FDA, or persons under the jurisdiction of the FDA, PHI relative to adverse events with respect to drugs, foods, supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacement.
- Health-related communications. We may contact you to provide formulary coverage information or other health-related benefits and/or services that may be of interest to you.
- Workers' compensation. We may disclose PHI about you as authorized by, and as necessary, to comply with laws relating to workers' compensation or similar programs established by law.
- Public health. We may disclose PHI about you to public health or legal authorities charged with preventing or controlling disease, injury or disability.
- Law enforcement. We may disclose PHI about you for law enforcement purposes as required by law or in response to a valid subpoena or other legal process.
- As required by law. We must disclose PHI about you when required to do so by law.
- Health oversight activities. We may disclose PHI about you to an oversight agency for activities authorized by law such as state boards of pharmacy, CMS, or the U.S. Drug Enforcement Administration (DEA). These oversight activities include audits, investigations, and inspections, as necessary for our licensure and for the government to monitor the health care system, government programs, and compliance with laws.
- Judicial and administrative proceedings. If you are involved in a lawsuit or a dispute, we may disclose PHI about you in response to a court administrative order. We may also disclose PHI about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made by the requesting party to tell you about the request or to obtain an order protecting the requested PHI.
Finally, we may use or disclose PHI about you for the following purposes:
- Notification. We may use or disclose PHI about you to notify or assist in notifying a family member, personal representative or another person responsible for your care, of information regarding your location and your general condition.
- To avert a serious threat to your health or safety. We may use and disclose PHI about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
- Victims of abuse, neglect or domestic violence. We may disclose PHI about you to a government authority, such as a social service or protective services agency, if we reasonably believe you are a victim of abuse, neglect, or domestic violence. We will only disclose this type of information to the extent required by law, if you agree to the disclosure or if the disclosure is allowed by law, and we believe it is necessary to prevent serious harm to you or someone else, or the law enforcement or public official that is to receive the report represents that it is necessary and will not be used against you.
OTHER USES AND DISCLOSURES OF PHI
Prescription Lifeline must obtain your written authorization before using or disclosing PHI about you for purposes other than those provided for above or as otherwise permitted or required by law. For example, in limited circumstances, state or federal law (that provides special privacy protections for certain types of highly sensitive health information) may require Prescription Lifeline to obtain your authorization to use or disclose sensitive health information. You may revoke an authorization in writing at any time. Upon receipt of a written revocation, we will stop using or disclosing PHI about you, except to the extent that we already have taken action in reliance on the authorization.
YOUR HEALTH INFORMATION RIGHTS
You have the following rights with respect to your PHI that we maintain:
- Obtain a paper copy of the Notice upon request. You may request a copy of this notice at any time. To obtain a paper copy of this Notice, please contact us through our website, in person or by mail and directed to "Attention: HIPAA Privacy Official".
- Request a restriction on certain uses and disclosures of PHI. You have the right to request certain restrictions on our use or disclosure of your PHI that we maintain. To request such a restriction, please provide a written request in person or by mail and directed to "Attention: HIPAA Privacy Official". We are not required to agree to accept your requested restrictions unless the disclosure is unrelated to your health plan and health care operations and the information pertains solely to a health care item or service for which you have paid a pharmacy out of pocket in full. In the event that we do grant your request, however, we will abide by the restriction as it related to your PHI on a going-forward basis.
- Inspect and obtain a copy of PHI. You have the right to inspect or obtain a copy of PHI about you that is contained in a "designated record set" for as long as Prescription Lifeline maintains your PHI in the designated record set. The designated record sets we maintain include your contact information, records about drugs and services provided to you, and claims history. To inspect or copy PHI about you, you must send a written request in person or by mail and directed to "Attention: HIPAA Privacy Official". We may charge you a fee for the costs of copying, mailing and supplies that are necessary to fulfill your request. We may deny your request in certain limited circumstances. If you are denied access to your PHI, you may request that the denial be reviewed.
- Request an amendment of PHI. If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it. You may request an amendment for as long as we maintain the PHI in a designated record set. To request an amendment, you must send a written request in person or by mail and directed to "Attention: HIPAA Privacy Official". You must include a reason that supports your request for amendment. In certain cases, we may deny your request for amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with the decision and we may provide a rebuttal to your statement.
- Receive an accounting of disclosures of PHI. You have the right to receive an accounting of certain disclosures we have made of PHI about you for most purposes other than treatment, payment and health care operations. The accounting will exclude certain disclosures, such as those made directly to you, disclosures you authorize, disclosures to friends or family members involved in your care, and disclosures for notification purposes. The right to receive an accounting is subject to certain other exceptions, restrictions and limitations. To request an accounting, you must submit a written request by mail and directed to "Attention: HIPAA Privacy Official". Your request must specify the time period for which the accounting is requested, which may not be longer than six years. The first accounting you request within a twelve month period will be provided free of charge, but you may be charged for the cost of providing additional accountings. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time.
- Request communications of PHI by alternative means or at alternative locations. You may request that we contact you concerning your PHI by alternative means and/or at alternative locations. For example, you may request that we contact you about medical matters only in writing or at a different residence. To request to receive communications of your PHI by alternative means or at alternative locations, you must submit a written request by mail and directed to "Attention: HIPAA Privacy Official". Your request must state how/where you would like to be contacted. We must accommodate all reasonable requests. We will not ask you to provide a reason for your request.
FOR MORE INFORMATION, TO CORRECT INFORMATION, OR TO REPORT A PROBLEM
You may request changes to information previously provided to Prescription Lifeline, or notify Prescription Lifeline of the preferred method by which Prescription Lifeline contacts you, by contact Customer Service via:
- Email: firstname.lastname@example.org
- Phone: 866-722-6479
- Fax: 877-304-5719
- Regular mail: 8701 N. Mopac Expressway, Ste 450, Austin, TX 78759
When notifying Prescription Lifeline of a change in sensitive information (such as Social Security Number and/or credit card information), we request that you call in or write to Prescription Lifeline Customer Service. If you would like a paper copy of this Policy, have any questions about this Policy, the practices of the Site, your interactions with this Site, to place restrictions on the uses and disclosures of your personal information, or file a complaint about our services, you can contact Prescription Lifeline via e-mail at email@example.com or phone at 866-722-6479.
If you believe your privacy rights have been violated, you may submit a complaint to the Department of Health and Human Services OCR.
RIGHT TO CHANGE TERMS OF THIS NOTICE
We may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective for all of your PHI that we maintain, including any information created or received prior to issuing the new notice. If we change this Notice, we will post the new notice on our website. You also may obtain any new notice by contacting us through our website, in person or by mail, and directed to "Attention: HIPAA Privacy Official"
By logging onto this Site, you signify your agreement to the terms of this Policy and any modifications thereof and that you release and hold harmless Prescription Lifeline, its members, directors, officers, employees, contractors, and affiliates from any and all claims arising from information that you provide or transmit to Prescription Lifeline in an unsecured manner.
If you prefer that Prescription Lifeline not contact you with information about Prescription Lifeline or for other Prescription Lifeline purposes, you may opt-out by contacting Prescription Lifeline Customer Service via:
- Email: firstname.lastname@example.org
- Phone: 866-722-6479
- Fax: 877-304-5719
- Regular mail: 8701 N. Mopac Expressway, Ste 450, Austin, TX 78759
Please note that your opt-out choices do not apply to communications from Prescription Lifeline related to registrations or services and materials that you purchased through the Site.
The term "Patient Assistance Programs" as used on this website refer to programs sponsored by pharmaceutical companies to assist people who cannot afford their medications. We are not affiliated in any way with any of these programs but are a third party advocacy program that assists consumers in applying for and managing administrative processes to receive continuous help from these programs. You do not need to use our services in any way to access any Patient Assistance Program. Our fees for our services vary based on your individual needs, the level of assistance you need, the amount of programs or medications you need help with and other factors. Please call an advocate for a personalized pricing quote.